Rhon1991

edited due to uncoolness

Dianah, Thanks for the info on the 6 types. I hadnt heard of them before. Ive heard of the 3 in the DSM IV with them being the primarily hyperactive, primarily inattentive and cant recall the third. I know you gave a brief description of the types however it would be interesting to see the positive aspects of those types as well. Does he go into that in his book? I will have to look at it next time I go to Borders. Thanks again!

Thanks! It looks like great info and would love to go to one of his appearances. I couldnt find the info on the 6 different types though, could you give me some direction there? I found the forum where they are asking about a couple of diff types.

Well, thats why the ADDer's are called the 'shakers and the makers' of the world... lol I am sure you are an asset to your unit and very fun to work with. That is, when we are not grouchy... right? lol My perfectionism used to make me grouchy... but now I am a little more realistic. I think there should be more nurses like you, actually. We are supposed to be advocates for our pts. Sometimes, who else is going to?

Although I have heard that the meds they prescribe have helped many deal with the ADHD symtoms, I have to say, that I have been there, done that and I wished I had never tried them. I took them about 2 years -the first year I was in grad school then trying to get off them the next year. Its a long story but although they helped me initially, it was a downhill spiral for me. So I have been off them 4years now and just keep my coffee coming... But I also know that everyone with ADD is different and have different degrees of it, so you have to make the right choice for you.

It does make it hard not to talk about ADD when you see it in other colleagues... I especially couldnt hold back after I first 'discovered' all about it and felt I could 'educate' others... what I found though was a big controversy, way bigger than I could handle (because there are even those in the psych community that dont believe in it). I got tired of debating it and then having to 're-proove' that I was a good nurse... after you have disclosed, have you ever turned and saw them watching you like you are some kind of new species they need to study? LOL... Due to others ignorance, I choose to keep my mouth shut from here on out... unless I find the irresistable need to disclose one on one and the only reason I would- would be if I thought it would help someone else (and only if they are actually asking/wanting help). Im glad I didnt know about ADD going through nursing school and then trying to succeed at being an ICU nurse... just dont know how that would have skewed my thinking process regarding when I 'messed up'... Just curious, how do they diagnose ADD in a 4yo? I thought it would be difficult at they age since they have short attention spans anyway, ect and really couldnt have a definitive dx until the school years when they are in a structured setting... Have I gotten in trouble at work? hmmm... I dont know... could it be my first year as a nurse (12 yrs ago) when they told me I wasnt 'efficient' because I chose to spend too much time in the am rounds with lady with bp 80's and lethargic when i had 7 other pts to see? YOU BETCHA... no, after that little 'supervisor to new nurse' convo they told me I had an attitude and couldnt take contructive criticism... or could it be when I didnt suck up to the unit clerk (that everyone else did because they were intimidated by her) and she ended up yelling at me then ultimately threatening me? I have been told that I 'obsessed' about some small things. For example, in CVICU, the hourly urine outputs? I like to raise the catheter up and down until all urine out. That drove my preceptor crazy. But she was also known to smack the resident's hand for the same thing... Even tho it bugged her, I really couldnt help myself... found myself looking to see if she was watching... lol. But yea, I get hyperfocused on a pt with a vent/swan who needs blood, ect and sometimes forgot to turn my other pt... I was actually told that I couldnt work in a paticular small hosp icu because 'when I got busy, routine nursing care wasnt done'. I made her specify what and made her write in my eval TURNS. I know they are important but when you are trying to get your system and speed back (after being off 3 years!), some things may fall to the wayside. (I get pulled to this ICU all the time and they like having me there as casual, but not good enough for PT position? go figure) Dont know what your paticular situation was, but my advice to any nurse would be to listen to criticism with an open mind, defenses down but if the criticisms are not what you agree with, then say so. There are just too many out there who would rather knock you down than help you up. So keep your chin up no matter what and keep doing your best. We all make mistakes one time or another...

!Edited- imagine the above meds and blood sugar 'to do list' without the s....

The thing I have to do to know what needs to be done as Im taking report is put a line out from it so it catches my eye and I know I need to checkmark it or put in a result... Hgb___ (when the nurse says, I meant to look it up but didnt have time or whatever) So through out my scribbled report I will see little things with lines out from them telling me I need to do that. The first thing I do after report then is my 'to-do' list on each pt PCP (remember this is icu, dont think i would have time to do this on the floor?) e.g. bloodsugars and meds due: BS____1800____ 2000___ 2100____ 2200____ BS____2400____ 0200____ BS____0600____ So then I write BS result in there (small, just so I recall what it was to chart it) then, a little line thru it to show that I charted it where I was supposed to. A checkmark by the med time. I'm kinda anal this way... I just cant depend on my mind to remember and so that I dont waste time rechecking myself. I found that Im slow until I get a system down. Because otherwise Im constantly rechecking myself. When you have a systematic way of doing things ABC and not ACABCC... then its a timesaver and you can trust that you have done B if you have done A. Does that make sense? It took me about 4 months to get a system then about a year to perfect it and really pick up the speed. Hope that helps some!

What Brandy and Shoelace are describing is how for ADDers all the sensory systems are on hyperalert. Some cant stand strong odors either. Alarms? My husb forgetting to turn his car signal off drives me insane. If I say something it makes him mad so I sit there thinking in silence as one comedian put it 'dumb as hell... dumb as hell' so I can at least tolerate it. Sounds immature but these are the things in our minds that we dont admit to others openly. ICU alarms? Im usually the first to suggest to another nurse that if he/she is not going to treat/respond to her bp alarm >150 then to adjust the alarms. Its really a safety issue and alarms should not be ignored! So yes I have dog ears. I think it makes for a great nurse having hyperalert sensory because I can be in pts room not directly looking at them and know how they are breathing, ect... (I know others are going to say you dont have to be ADD to have that) but my point being, as Dr Hallowell said in his book, this disoder really shouldnt be called attn deficit because its not that we dont pay attn, its because we pay attn to EVERYTHING around us!! I personally thrive in the ICU because I need that stimulation to keep from getting bored. I cant imagine really doing anything outside of nursing unless it was also a high stimulating environment. I think I hyperfocus on critically-ill pts because I dont want to miss anything thats a sign to whats to come... I could go on and on...

edited for uncoolness

edited for uncoolness

I think the top 3 dx that coinside with Adult ADD are: 1) Depression 2) OCD (its actually attepts to compensate for the ADD) 3) Anxiety Cant remember which book I read that out of as I have read many ADD books. My fav authors are Thom Hartman & Ed Hallowell*. Ed is an MD who puts a postive spin on ADHD, relating his own life-Driven to Distraction then there is his Answers to Driven to Distraction. Thom compares ADDers as hunters to the 'normal' people as farmers, he has great things to say as well.. cant recall the title right off. I suspected my ADD in nursing school when I discovered an OTC diet pill did wonders for my attention in the classroom setting. (Didnt take on clinical days) Also required the caffeine and nicotine. Wasnt unusual for me to pull all nighters and be a hoot the next day. I made just as good grades as anyone else. I made an excellent ICU nurse as I was a bit on the OCD side. I think in healthcare, the good ones alway have a tad of OCD ;o) Anyway, thats all for now, just wanted to send some positive vibes your all's way... Feel free to pm me. PS I dont take any meds or smoke anymore, however I do require the coffee and Im struggling with household type stuff, grrr mundane tasks....

I heard VCU has one (4 years now?) and Ive seen some describe it here somewhere.

Thanks Deb!

I have someone asking alot of questions and wanted to refer her there, if there are any. Thanks!

If you want a big wedding... I would plan it for 2 years from now. Whats the rush anyway? I think your first year in school will be the most grueling but then after that, you could really start planning it... and hopefully they have a 'spouses night' in your curriculum so that he may have a bird's eye view into what you will be going through. I hear and know first hand that this curriculum can truly test a marriage or any relationship. Good luck to you!

Just curious... my 3yo was having sleep apnea d/t enlarged tonsils so she had the T&A 12 days ago. Those of you who had children like this, did they have low O2 sats post op? Also, prior to surgery and even still she complains alot of always being cold, no matter how much clothing we have on her! Does your child c/o of being cold all the time? Im just wondering about the long term effects of sleep apnea and how long until that will resolve itself. She still c/o's of her throat hurting and she required the Lortab the full 10 days because anytime I tried to give Tylenol day 3-6 she would be crying an hour later for 2 hours straight and not take anything in! So for the last 2 days Ive been giving the Tylenol just once in the am and once pm and she seems better. But now shes constipated! so now its that we are working on. Just curious about the 'cold' thing and low O2 sats post op... BTW, when they would drop 83-86% she was still having the apnea but although she would pick back up, her RR never compensated for the low O2. She was breathing her regular, comfortable-looking rate! So does that mean she has probably been having low sats at home for a while and her body was used to it?

Just curious... my 3yo was having sleep apnea d/t enlarged tonsils so she had the T&A 12 days ago. Those of you who had children like this, did they have low O2 sats post op? Also, prior to surgery and even still she complains alot of always being cold, no matter how much clothing we have on her! Does your child c/o of being cold all the time? Im just wondering about the long term effects of sleep apnea and how long that will resolve itself. She still c/o's of her throat hurting and she required the Lortab the full 10 days because anytime I tried to give Tylenol day 3-6 she would be crying an hour later for 2 hours straight and not take anything in! So for the last 2 days Ive been giving the Tylenol just once in the am and once pm and she seems better. But now shes constipated! so now its that we are working on. Just curious about the 'cold' thing and low O2 sats post op... BTW, when they would drop 83-86% she was still having the apnea but although she would pick back up, her RR never compensated for the low O2. She was breathing her regular, comfortable-looking rate! So does that mean she has probably been having low sats at home for a while?

Thanks Deepz! Thats just what I was looking for. Tenesma, I still understand what you are saying.

Ok. I thought there were some statistics out there being quoted. Thanks for clearing that up.

To legally consent someone for general anesthesia dont you have to delineate most serious risks of anesthesia such as stroke, MI and death? I thought Ive heard them say there is 'less than 1% or 1 in________' that have life threatening adverse reaction to anesthesia... and then the quote you mentioned in reference to driving in your car or flying in airplane?

Thats who Im asking this question- the anesthesia providers.

When you preop adult pts, what percentage do you quote for death from general anesthesia? Thanks!

Not at children's hosp- I was told to wait in her room... when my 8yo had it done out pt surg, of course I was able to come in once she was more awake. Maybe at children's it was because I had two children and had to be upstairs in his room for when he got back and it was just easier for everyone if I waited there for her as well? I certainly can see where Surgery Centers are becoming more popular. It seems more efficient in every way. I will always go that route, given the choice. Plus I think the teams are used to working with each other thus increases quality of care and efficiency. I just had many minor issues with the whole hosp experience. Now I know what its like being on the parent side. I would always rather be on the nurse side!

yes, they both did. when her o2 sats dropped her RR didnt increase, she was breathing just as she did at home... Yesterday was POD 10 and she was still requiring the Lortab for pain and there was never really a slump time for the pain as it was for my 8yo. (Day 3-6) Isnt 10 days too long to be taking Lortab almost q 4-6 hours? If I gave Tylenol, 2 hours later she would just cry and cry and not take in any fluids... she seems better this morning though, but dont know if husband gave her med during the night yet. I will be calling dr Mon if she is still having alot of pain. Thanks, kae.