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I should add that sometimes it takes a few visits with them to determine if yes their history and assessment points to ADHD/ADD. We generally only use the longer acting stimulants in adults like Vyvance and Concerta as first line. Wellbutrin or Strattera if they don't want stimulant or can't for other medical reasons.

Hello! I agree - there has been a major increase in patients requesting assessment for ADHD/ADD - I work in Canada and there is a push for primary care providers to take this one and do the assessment and prescribe if appropriate. There is just not enough specialists doing this and the wait times in our public health system are many many months long. From my understanding there are a couple reasons for the increase in clients coming in for this - social media is talking about it more like TikTok, more news articles and discussions and it is talked about more in our conferences/CMEs etc. The reality that there is genetic component and more children are being diagnosed which could be the trigger for the parents to wonder if they have it too especially when they often help fill out the assessment forms. My colleagues and I have talked about how the changes to how school and work are structured during COVID have probably caused adults with ADHD to notice their symptoms more - whereas they were managing and coping in the structured environment - they are not now. Most patients don't abuse stimulants and you can assess for their risk beforehand - I had a 22yr client who was bipolar on lithium and known recent history of crystal meth use prior to being assessed for ADHD. She went to a different specialist for her ADHD assessment than her psychiatrist. They recommended that she was candidate for stimulants if her bipolar was managed and she was off crystal meth - her psychiatrist said that she had to have therapeutic level of lithium prior and clear urine prior to trial of stimulant. Anyways, I have found that my patients will notice a different right away if the stimulant will work for them - if not they stop it. I can be life changing for them. Check if your scope of practice in the state you work allows you to diagnose and prescribe. I can prescribe all except the Adderall. I use the screening forms ASRS, WURS, PHQ-9, GAD - in our clinic we have an amalgamated form that includes questions about bipolar, ODD, OCD, sleep problems, substance use.

I think the second I paid the expedited fee they must have sent it because I received it in Canada 3 days later! I did it because I had been told it would take 6-10 business weeks and I had an employer waiting on this

are you working at pali momi tele now? if you are, good luck to ya!

just wondering what travel company you are going with, I am planning on going to alaska in june, would like to go with a good company, thanks!

Does anyone have any info on Providence in Anchorage? We negotiated a $1600 monthly stipend, $3400 sign on bonus, $1700 travel, and $33/hr. I thought that sounded like a pretty good deal for Alaska. :beercuphe Hello, i was just wondering which travel company you are going with? I am planning on going to alaska in June and would like the best offer, thanks

The pay rate was good about $32-34 and hour, of course that was for staff, i dont know about travelers.

HI, i wasnt a traveler at Pali Momi. Two of my friends were and one hated it and the other didnt find it so bad-she went back a few times. She is from the east coast and said that the patient ratios were just like back home! ha ha. I worked a couple years ago though so things may have changed.

Hello, I nursed in hawaii for a couple years from 2003-2005. I lived in waikiki which was great since you can walk everywhere-that is a great place to live if you will be working at Queens or Straub or Kapiolani women and children's. If you wil be working in Pali Momi(located in Aiea near Pearl Harbour) or St. Francis(Ewa Beach) you could live out there but then i would recommend buying a cheap car to drive while there. I know a lot of travelers who bought a really cheap car to drive that was just fine for the time they were there, then you can really get to explore the island. Hope this helps

HI, i worked at Pali Momi telemetry floor in 2003 for about ten months. I really didnt like it as i found the patient ratio was usually 5-6 to 1 on day shifts and 6-7 to 1 on nights shifts. Their tele patients were really sick with alot of bipaps, and cardiac drips-something i wasnt used to. The unit is 35 beds and all single rooms and the whole unit is so big you wear a pager. and there is only three aids to help; i think the worst part was that the unit wasnt very nurse-friendly-you had to walk from one end of the unit to the other just to get rid of your dirty laundry-there was no laundry baskets in the rooms. The manager was very very nice and supportive though, the nurses were generally nice. lots of travellers. Hope this helps!