I've been a RN for 9 years (8 of those years are in ICU & pre/post/intra-op). I was diagnosed with ADHD 7 years ago & PTSD 3 years ago (and am prescribed ADHD, anti-anxiety, anti-depressant meds. Currently in therapy).
That last few years have been difficult. Lost multiple jobs. Can see it's stress related - personal reasons and work place reasons. Work-related stress impacts me hard (poor teamwork, high turnover, gossip, bad reports during shift change, being accused of things I didn't do which leaves me feeling like I cannot trust my co-workers). I get distracted and "stuck in my head" when things like that comes up.
When an actual problem (mistake was on me and I own it) OR a perceived "concern" would be brought up to my Nurse Director by co-workers, 90% of time I would just accept the feedback, and we'd talk about ideas that would help improve performance (FMLA or going part time for awhile).
I also came up with my own "toolbox" to help with stress management: regular exercise, creating routines, grounding techniques, timers, lists, good sleep/good diet /staying hydrated, arriving extra early to work, asking for "check ins" to see if I'm doing better or worse or the same, hobbies, spending time with friends, reaching out to EAP, reaching out to HR to inquire about options/resources... (I really wished HR would have responded to me... Reached out to HR for 3 months, told my Director I had been reaching out, but HR was never available nor replied to any of my messages).
Lost last job due to performance issues - I was burnt out and already seeking another jobs before being let go. I don't want to keep losing jobs & I don't want to fail as a nurse.
I know that there are certain stressors that really "trigger" the ADHD and PTSD symptoms (such as being ganged up on/accused of something I did not do, being shouted at by co-workers, feeling like the "outsider"). I realize that I tend to "people please" and over - extend myself, and that can be taken advantage of (probably due to poor boundaries). Personal problems, managing super sick patients, running a code, and even COVID didn't/doesn't stress me out nearly as much as, what often feels like, being bullied.
I DO work hard, am creative, detail-oriented, flexible, love to learn, great with computers/anything "techy", am team-player focused, and receptive to feedback. I don't complain, gossip, and I show up with a cool/calm/collected attitude, no matter what is going on in or outside of work.
Now am currently job searching, and while I do that, want know more about when/if/how to ask for a reasonable accommodation, and what that would look like. Never explored the idea before... I usually just push myself to exhaustion and then blame myself and my confidence is certainly taking a hit.
One idea was something like requesting regular check-ins AHEAD of time, or having a nurse mentor, or something like that.
Also just open to general advice. Any ideas and thoughts are welcome.
Weird that they would try bupropion and not one of the multiple non-stimulant medications that are specifically used to treat ADHD (Strattera, Catapres, there are a few others as well).
Funny enough, I've already been on clonidine since before I was even put on an ADHD med. I take it for anxiety, I guess it has two uses! I will ask about Strattera though. Thank you!
Passive-aggressiveness, bullying needs to stop. I wonder why this is not a bigger concern in nursing. Bullies should start being held more liable.
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Personal problems, managing super sick patients, running a code, and even COVID didn't/doesn't stress me out nearly as much as, what often feels like, being bullied.
I DO work hard, am creative, detail-oriented, flexible, love to learn, great with computers/anything "techy", am team-player focused, and receptive to feedback. I don't complain, gossip, and I show up with a cool/calm/collected attitude, no matter what is going on in or outside of work.
I am so sorry to hear that you are struggling because I think you are a really great nurse! I am going to share my two cents from years of struggling with people pleasing, burnout and other codependency issues as well as professional experience working with people with severe, disabling mental health, trauma and substance use issues.
1) Medications can help, but they won't be the only answer. You work in a stressful, high paced, socially fraught environment. You have a history of trauma. The right combination of meds might improve symptoms and mood stability but will only be one "piece" of the pie. The system is broken and we are all working in it...on to the next bullet
2)You are not broken and don't need to be fixed. You are an amazing person who has been through hard things, and for some inexplicable reason other nurses are bullying you (immature).
3)Get honest with yourself about what you like and don't like about jobs you have had. Zoom out and take a macro view. Don't like working with petty, immature nurses on the hospital floor? There are positions in home health care, occupational health where you will essentially be a "lone wolf" and rarely have to interact with other nurses unless desired. You can focus on the patient, trust yourself, communicate with the docs and do your own thing. I am sure other members here have great alternate career suggestions.
4)Get the best treatment you can afford for your top issues. I received mentorship from a yogi nurse in nervous system regulation and burnout that was incredibly helpful. I attend regular family support meetings to help myself as a child of and spouse of an addict. Recently, I went through a round of hypnotherapy with another nurse coach, this time focusing on issues of self-sabotage and self-doubt. Unfortunately none of these treatments were paid for by my insurance but they have been literally invaluable and helped me not only in my personal relationships, but with overall life satisfaction and workplace issues as well.
Wishing you luck and myself as well. It's hard out there why not be kind?
I am so sorry to hear that you are struggling because I think you are a really great nurse! I am going to share my two cents from years of struggling with people pleasing, burnout and other codependency issues as well as professional experience working with people with severe, disabling mental health, trauma and substance use issues.
1) Medications can help, but they won't be the only answer. You work in a stressful, high paced, socially fraught environment. You have a history of trauma. The right combination of meds might improve symptoms and mood stability but will only be one "piece" of the pie. The system is broken and we are all working in it...on to the next bullet
2)You are not broken and don't need to be fixed. You are an amazing person who has been through hard things, and for some inexplicable reason other nurses are bullying you (immature).
3)Get honest with yourself about what you like and don't like about jobs you have had. Zoom out and take a macro view. Don't like working with petty, immature nurses on the hospital floor? There are positions in home health care, occupational health where you will essentially be a "lone wolf" and rarely have to interact with other nurses unless desired. You can focus on the patient, trust yourself, communicate with the docs and do your own thing. I am sure other members here have great alternate career suggestions.
4)Get the best treatment you can afford for your top issues. I received mentorship from a yogi nurse in nervous system regulation and burnout that was incredibly helpful. I attend regular family support meetings to help myself as a child of and spouse of an addict. Recently, I went through a round of hypnotherapy with another nurse coach, this time focusing on issues of self-sabotage and self-doubt. Unfortunately none of these treatments were paid for by my insurance but they have been literally invaluable and helped me not only in my personal relationships, but with overall life satisfaction and workplace issues as well.
Wishing you luck and myself as well. It's hard out there why not be kind?
I apologize for the delayed response... Am def working hard on myself and doing the best that I can. Your suggestions are helpful and I cannot thank you enough for this message and your encouragement! It is truly appreciated ❤️
I was once in your place..had horrible family reactions. They just thought I was a blight on the family. Did what was suggested...oh, the medications I have tried. I am now very content...I jettisoned the negative family except when I am having to be with them for wedding or funerals and that is a trial. I found that my hobbies really helped me reshape my feelings, activities and FRIENDS. I grew in an interest in the antiques business.....you can always be busy researching, attending sales, meeting others who have the same interests as you.
As someone told me 40 years ago "jettison your extra cargo" . Find something you love to do......
I recommend reading the book "Woman's inhumanity to women" by Phyllis Chesler. It is a great read about the history of females bullying other females. I am an RN and am currently being bullied by the CNA's at my LTC facility.
I recommend reading the book "Woman's inhumanity to women" by Phyllis Chesler. It is a great read about the history of females bullying other females. I am an RN and am currently being bullied by the CNA's at my LTC facility.
No book is going to help you in that situation. Write up each and every insubordination. Get ready to move on.
Your situation sounds super familiar, and I have experienced something similar. Although I cannot definitively state what human resources was thinking, I'm willing to suspect that HR probably had no clue about what to do with you and what to do for you. I remember reaching out to my HR department for workplace accommodations for my ADHD, and the person working in disability services sounded super annoyed when she asked me, "What do you want?"
So, I was on my own with my supervisor to develop solutions. I did a few interventions with my supervisor's approval, but they weren't always practical, and I couldn't always use them due to time constraints and frequent interruptions. Timers, reminders, alarms, and starting early on the med passes were not a 100% solution. Like you, I owned up to all my mistakes and shortcomings and genuinely tried to learn and grow from those experiences. I know what you mean about feeling like an outsider and people jumping to conclusions about you when they have little to no knowledge about you.
One of my ideas was to ask for a nurse mentor and check-ins, and when I brought up the idea to my supervisor and charge nurse, the charge nurse had a meltdown at the idea and called it "hand-holding." After that, I stopped the suggestions and became anxious to ask for anything from my charge nurse after she jumped to conclusions like that.
Looking back on everything, I now recognize that most of the things that affected my performance were not exclusively due to my ADHD. Multiple layers of failures and poor administrative choices caused them. The biggest culprit I found was poor staffing and poor teamwork. In the future, I plan to push harder for reasonable accommodations when I need them and don't intend to back down so easily.
The nursing profession says they want to embrace neurodivergent nurses but from what I have experienced, you would think that's not true. I know this isn't the case for all people living with ADHD and not all institutions are bad, but I would wager that this is a systemic problem in nursing (among many) that need to be addressed.
Sometimes, it's not necessarily a YOU issue, it's a systemic issue that many hospitals suffer from, and many are too reluctant to admit. You sound bright and mindful of your practice, don't let this get you down. You're not alone.
Side note- I've learned to be careful when disclosing my ADHD to potential employers. I've chosen not to disclose until hired out of fear of being overlooked as a candidate because of my ADHD.
... Well-medicated (whether that means increasing your ER dosage, adding a short-acting med to take later, or a combination thereof) should mean that your ADHD is not even a factor.
This is simply not true. When a person has ADHD it is always a factor, even if well managed with medications. If we give a patient medication for pain, we expect pain management, not pain resolution. This same concept applies to ADHD. Making the symptoms of ADHD manageable does not make it dissappear and, therefore, it cannot be an irrelevant factor. In addition to medications, it requires that a person have a great deal of strategy and coping mechanisms... which can in turn become strained by other stressors and factors that are affecting that person's life.
Specializes in Psych, Addictions, SOL (Student of Life).
It's really hard to get reasonable accommodation for what most people think of as "Invisable" diseases. I my self have three possibly 4 auto-immune disorders and one symptom is chronic unremitting pain. I had an accommodation to reduce the distance I walked to and from the parking lot since December 2022 and it was helping a lot. This past week that accommodation was taken away and now I am thinking I'll have to go back to using a cane for ambulation. Going back to the doctor for documentation.
Lynker, ASN, RN
318 Posts
Funny enough, I've already been on clonidine since before I was even put on an ADHD med. I take it for anxiety, I guess it has two uses! I will ask about Strattera though. Thank you!