Nursing students on medication

Covaryx · Feb 23, 2014

Adderall and ritalin are actually controlled stimulants similar to amphetamine (Adderall is actually a type of amphetamine) and don't necessarily provide simply "focus". In those with true ADHD, psychostimulants such as adderall and ritalin have an effect that is sort of paradoxical compared to the effects on someone without ADHD; the drugs appear to have more of a calming than stimulant effect. When abused by those without ADHD, adderall and ritalin are used in the same way that amphetamines or other stimulants are abused. And while I would argue that Physicians have unfairly stolen the title of "Doctor", a DPT isn't actually a Doctor as the term is generally understood.[/quote'] chillax chillax. Besides, keep in mind that a Doctorate still gives that person the right to have Dr in their name. Even a Doctorate of Art History. Even if you don't care for them to have "MD" for Medical Dr after their name, they're still a Dr was always my understanding. (Could be wrong, I certainly don't have a Doctorate lol)
It's not meant to be a stimulating kind of focus for a mind that is too slow/sleepy. It's meant to be a focus for a mind that is too awake/jumpy. The way my psychiatrist and Mental Health instructor had described it was that my brain can't take everything in and it's overexcited and jumps from thing to thing to thing as an attempt to take everything in. I can't sit there and notice the sign on the door like normal people could, but I'll certainly notice the crack in the wall. Adderall helps me focus by literally calming my brain and dimming my energy levels enough that I am actually able to focus on one thing at a time. Where it would take me LITERALLY 30mins to read one page of text I am now able to read almost at normal speed, like 5-10 mins. But even with this help I'll notice when sharing a screen/book/chart that I'm always still the slower reader.
It was bc of this huge amount of time wasting in order to finish one task that I returned to my dr to get back on my meds. I hated them my entire life bc I didn't like needing them bc I was different. and I didn't like that they stopped me from acting energetic and fun.
Now that I think of it, maybe the reason that poor SN couldn't still sit was bc of ADHD, maybe him and his dr are in between medication regimens or had decreased his dose or something. That could certainly account for his "not being able to sit still"
And I still stand by that if he had posed a risk to patient safety that he would have been excused from the floor. But that didn't happen, so I don't think he was a risk.

NurseGirl525, ASN, RN · Feb 23, 2014

um, first I completely understand what a DPT is and yes she gets to use the word doctor in her name, she earned it. She went to school for 8 long years for it and has earned it. No, she doesn't prescribe meds, but she is still a doctor. I am not a moron. It's a matter of respect. My microbiology teacher has her doctorate in micro and I addressed her as doctor because she earned that title. You are the one who is mistaken here.

Also I am fully aware of what adderrall and ritalin are and their affects on the body. The reason why they focus is because they are a stimulant. If someone who does not have ADHD is given these meds they act as a stimulant but in people with this condition it calms them down and helps them focus. I do have a full understanding of this.

It's not chemical cheating if someone who does not have a script takes it. It is illegal but Adderall and Ritalin to not help people "magically" retain info. That's a lot of where my problem is. They are idiots, yes, but not cheating. Those drugs are not magic pills that if you don't study and pop one you'll pass the test. Yes, they help you stay awake to study longer but hey, I can go to the doc and get a script for Adipex because I am overweight and get the same affect.

There were a lot of accusations that were unfounded by the OP. She needs to mind her own business and not worry what types of meds people are on. If this person had a script (which by her own admission, she did not know), then she needs to focus on her and her work and keep her biases about meds to herself. It's great she makes it without them but people who take them for varying reasons are not beneath her or "high" all the time which is what she was inferring.

MunoRN, RN · Feb 23, 2014

In my state and many others, a DPT, DNP, D-pharm can only refer to themselves as "Doctor" in any sort of healthcare setting so long as it's clarified in the same statement that they are not a medical doctor. I would agree that's a bit unfair, but it's the way it is. So she's free to say "I'm Doctor so-and-so, not a medical doctor".

nurseprnRN, BSN, RN · Feb 23, 2014

In my state and many others, a DPT, DNP, D-pharm can only refer to themselves as "Doctor" in any sort of healthcare setting so long as it's clarified in the same statement that they are not a medical doctor. I would agree that's a bit unfair, but it's the way it is. So she's free to say "I'm Doctor so-and-so, not a medical doctor".

Better, "I'm Dr. Smith, your physical therapist." "I'm Dr. Jones, your nurse practitioner." "I'm Dr. Doe, your pharmacist."

"As generally understood" can be changed by education. :)

ixchel · Feb 23, 2014

A person with ADHD has imbalanced levels of dopamine (a behavior inhibitor) and norepinephrine in the prefrontal cortex, which causes increased motor activity, decreased attention and impulsivity. It is based on an imbalance of neurotransmitters, just as depression and bipolar. Methylphenidate is a cerebral stimulant, increasing dopamine and norepinephrine in the prefrontal cortex. For a person with ADHD, methylphenidate (aka Concerta, Ritalin, Daytrana) will make them feel "normal". It likely doesn't increase focus or attention beyond a non-ADHD person. I say "likely" because I wouldn't know personally, and a person with ADHD couldn't fairly say if it makes them more or less focused than an unaffected person, since they don't know how it feels to be unaffected by ADHD.

The stigma of mental health is why a person with ADHD would rather you believe they need a pick me up than that they are dealing with ADHD. Not even the medical profession uniformly takes this diagnosis seriously. (Present company generally excluded.) Society in general thinks we're throwing pills at our hyperactive children just because the parents want their kids to be easier to deal with, as though choosing to put a child on a daily, potentially life-long medication is taking the easy way out somehow.

I have two people in my home with ADHD and they suffer. They genuinely suffer. We don't share our son's diagnosis or treatment with people (not even the school) because of conversations like this one. For every one person who appreciates the validity of ADHD and it's need for adequate treatment, three more people wait in the wings to judge us. This needs to stop. I've had nurses tell me I shouldn't medicate my child with stimulants because they personally oppose giving stimulant medications to children. "It's wrong!" they say. NURSES. People, we should know better, BE better!

For those questioning why this medication might be viewed as cheating, it's because here and there you will find media reporting on students turning to methylphenidate as a "performance enhancing" drug. Yes, it is abused for that reason, and I am not naive to that.

Why this student freely told you they use Ritalin is beyond me. Maybe they ARE abusing it. Maybe they're an idiot for over sharing in clinical. Or, maybe, they have ADHD and they don't want you to know.

Who cares?!

I originally multi quoted a solid page worth of posts, but decided against it since I can climb up on my own soap box with no help (thankyouverymuch), but I did want to reiterate a post that I think got ignored. Methylphenidate is legitimately prescribed for the purposes of staying awake as well. Go grab your drug book and look it up. Also, Methylphenidate is a common medication in many (if not all) drug screens as well. It's a schedule II med and has potential for addiction, and rightfully should be in drug screens. It should be strictly prescribed with physician/NP monitoring.

ixchel · Feb 23, 2014

P.S. It is so lame that this struggle over the title of "doctor" exists. If physicians think people are so stupid they'll misunderstand titles, maybe they're the idiots.

KRVRN, BSN, RN · Feb 23, 2014

The particular student in question was described as so fidgety that he couldn't stand still. That suggests to me that he has ADHD and did not take his med that morning. Perhaps he took a short acting med that wears off at lunch time. The fidgets can come back rather dramatically as it wears off. Was it maybe close to lunch and his med was due? Did he choose not to take the med at all out of concern for patient safety?

ixchel · Feb 23, 2014

The particular student in question was described as so fidgety that he couldn't stand still. That suggests to me that he has ADHD and did not take his med that morning. Perhaps he took a short acting med that wears off at lunch time. The fidgets can come back rather dramatically as it wears off. Was it maybe close to lunch and his med was due? Did he choose not to take the med at all out of concern for patient safety?

Agreed.

I would bet he forgot to take it that day. With how effective extended release is, and with him being an adult (and obviously heavy enough to take extended release), it would be surprising if he was on immediate/regular release.

KRVRN, BSN, RN · Feb 23, 2014

It also occurs to me that his jokey response of taking it "to stay awake" was tongue in cheek. Perhaps it was a quick answer to avoid discussing ADHD or Narcolepsy. Shoot maybe he IS taking it for stinky reasons...but if he has a script for it there's really nothing to do about it.

klone, MSN, RN · Feb 24, 2014

Adderall and ritalin are actually controlled stimulants similar to amphetamine (Adderall is actually a type of amphetamine), and don't necessarily provide simply "focus". In those with true ADHD, psychostimulants such as adderall and ritalin have an effect that is sort of paradoxical compared to the effects on someone without ADHD; the drugs appear to have more of a calming than stimulant effect.
When abused by those without ADHD, adderall and ritalin are used in the same way that amphetamines or other stimulants are abused.
And while I would argue that Physicians have unfairly stolen the title of "Doctor", a DPT isn't actually a Doctor as the term is generally understood.

What an odd, snarky post. You seem to be arguing things that she didn't even say in her post.

Further, anyone with a doctorate is a "doctor," period. But I'm unsure why you felt like throwing that in there, because she didn't say anything about it, other than that she earned her doctorate in PT.

klone, MSN, RN · Feb 24, 2014

In my state and many others, a DPT, DNP, D-pharm can only refer to themselves as "Doctor" in any sort of healthcare setting so long as it's clarified in the same statement that they are not a medical doctor. I would agree that's a bit unfair, but it's the way it is. So she's free to say "I'm Doctor so-and-so, not a medical doctor".

Do you have a link to somewhere that states that is a requirement by the state?

Not_A_Hat_Person, RN · Feb 24, 2014

P.S. It is so lame that this struggle over the title of "doctor" exists. If physicians think people are so stupid they'll misunderstand titles, maybe they're the idiots.

Technically, anyone with a doctorate can use the title Doctor.