RN-Attention Deficit Disorder-Nonhyperactive

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I'm a new nurse with AD/HD. I began working as an RN and judged harshly on my inablility to get the paperwork done quickly. If you have AD/HD what ways have you used to get your assessments charted, notes charted-before the end of your shift, still providing competent care to your patients?:innerconf

Thank you

Specializes in RN CRRN.

I dont ADDvertise it to pp.....still a stigma i think.....pp judge you....or think you are stupid....and yet we find ways to get everything done....as quick as others....we adapt....and just try to get through the day without making a mistake or screwing up-not in nursing but anything....some days it can be so exhausting to get through a day appearing normal

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:redbeathe I am a heart attack survivor plus I have ADD, and have the joy of going through menopause ! Also am a Certified Dietary Manager (cheap RD), have been in LTC for 8 years. I take Adderall, which does not affect my heart rate, (in fact it lowers it.)

I also work on a very fast paced rehab/ltc unit. I have only been a LPN for almost 1 year. I have found that keeping the lists are very helpful. I cannot do my med pass the same way every day, because someone or most everyone will have times where they did not get pain meds at 5:30am, so I walk in to 10 call bells on for pain meds. If I have IV's due, I have to fit those in, plus therapy hangs at the med cart wanting to know if "their person has had their meds yet" and will park them at my cart, :banghead: plus many with scheduled insulin to administer or Reglan, Precose, or other meds which they must have prior to breakfast. I organize my cheat sheet so that before I start, I have these people in some sort of priority, which depends on how my day starts. I leave enough room on my cheat sheet for each resident to write a brief note. It generally takes most of the shift, for meds and care, however, I then find a quiet room to take all of my paperwork to, at a time (usually close to end of shift) where I will not get interrupted. Then I transcribe my briefnote along with any pertinent info, such as abnormal blood sugars, blood pressures, how they are w/ adl's, transfers, if they are continent of B & B. If they are on psych meds, if there was any abnormal behavior, side effects/adverse reactions. Note: If I have a pt that I have to monitor frequently, I carry a nursing note and attach it to my sheet, and start my note at the time I begin my med pass and assessment. That way, by the time you are done with med pass, hopefully, you will have a nice note chronological care of a difficult patient (or it could be difficult family members with unrealistic expectations.) This has saved me several times, because I had to spend a lot of time going in the pt's room (both pt and family were very demanding, and would accuse staff of being inattentive,loved to ring the call bell unnecessarily, and thought I was their "private duty nurse") :bugeyes: so I had very thorough notes with times of each time I was called in the room, what happened, etc. and signed each entry. These notes sometimes took up a page for the full day, but at the end of the day, I did not have to worry about remembering a lot of details to put into the computer. because they were already there. :yeah: My DON was fine with it, because I was charting as I went along, as it happened. That will allow you to chart the things that arent as time consuming on the computer.

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I'm a new RN with ADHD (no hyperactivity) on a cardiac stepdown/tele floor with no nursing assistants so at time I feel like I am drowning! I made up my own little "brain" report sheet which I've been told is the most organized one most the RN's on the floor have seen around their area, but it STILL takes me forever to get things done, even though I am pretty organized. I can get the tasks done but then finding time to get the info off the paper and onto the computerized charting system is what I struggle with. How do you all do it? I thought about not writing it all down on my brain and instead charting on the pt in the pt's room but I would be LOST giving report to the next nurse with nothing on my paper. Does this make any sense? I wish I had someone that I could delegate vital signs, getting pt's cleaned up, and cups of coffee to but as I said, no NA's or PCT's.

Any suggestions would be welcomed!!! I haven't mentioned my ADD to my boss yet and don't want to have to use special accomodations if I can help it... I try to keep my ADD to myself for the most part. What do you guys do?

It can still be considered a stigma of sorts, however, if you take the time to look around, there are a whole lot more out there with the same difficulties, that show up in different ways. Work on doing what is easiest for you to help maintain your sanity in the midst of a chaotic profession !:yeah:

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Specializes in Tele, MedSurg.

Well, Its nice to know there are alot of people like me. First i wsnt tjo say that I graduated nursing school and passed the nclex the first time and am an official RN. :nurse: I went on to work in an acute care facility as a nurse graduate in an orientation program with a preceptor and went Through two preceptors in 11 weeks. I was told that i had problems prioritizing, making decisions, and time management. Also that i hyperfocus on the small details which takes time from patient care. I feel like my short term memory causes problems. I have been like this all my life. I struggled through school and have always felt there was something wrong. I was diagnosed about 3 yrs ago with ADD and generalized anxiety disorder from the ADD. I recieved longer test taking time which helped alot and a few other accomodations in school that i didnt use. I started taking meds which i felt like was helping only some of the time. I seek to learn as much as i can and use the small details along with the big picture but just not fast enough. I got the boot from the hospital i worked at as a nurse tech (2yr 9 mo)and nurse grad/RN 11 weeks) for a total of 3 yrs. I was told that i was not progressing like i should be and that i should resign or get fired. So i resigned in hopes of being able to go back some day. MY passsion is to one Day work in OR. I was told to get experience in long term care or doctors office. I considered Dr. office and have applied. I do not like long term care and would only consider that as my last resort. I have been told by other nurses, patients/families and instructors and even a clinical preceptor while doing my practicum that i would be a great nurse. i have even been given gifts and care cards from patients and families letting the instutution i worked for know. This is very upsetting and frustrating for me. I feel like they told me what i had problems with but didnt want to help me with them or give me ideas on ways to improve. I worked hard to get here and in my heart i do the best job i can to help patients but it isnt good enough. I know im new and it takes time getting used to everything like paperwork and protocols and such. I feel like once i fell comfortable with all that then i will get my nitch for my own way of doing things that work for me. I really need to find ways to improve these areas. I just hope i can find a Dr's office that will accept a new nurse that doesnt have previous experience and are willing to provide needed training. :wink2: I am in need of some input.

Thanks AP

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Specializes in Tele, MedSurg.

This is great that your are finding ways for this to work for you. I am new to this site and think its really great.

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Well, Its nice to know there are alot of people like me. First i wsnt tjo say that I graduated nursing school and passed the nclex the first time and am an official RN. :nurse: I went on to work in an acute care facility as a nurse graduate in an orientation program with a preceptor and went Through two preceptors in 11 weeks. I was told that i had problems prioritizing, making decisions, and time management. Also that i hyperfocus on the small details which takes time from patient care. I feel like my short term memory causes problems. I have been like this all my life. I struggled through school and have always felt there was something wrong. I was diagnosed about 3 yrs ago with ADD and generalized anxiety disorder from the ADD. I recieved longer test taking time which helped alot and a few other accomodations in school that i didnt use. I started taking meds which i felt like was helping only some of the time. I seek to learn as much as i can and use the small details along with the big picture but just not fast enough. I got the boot from the hospital i worked at as a nurse tech (2yr 9 mo)and nurse grad/RN 11 weeks) for a total of 3 yrs. I was told that i was not progressing like i should be and that i should resign or get fired. So i resigned in hopes of being able to go back some day. MY passsion is to one Day work in OR. I was told to get experience in long term care or doctors office. I considered Dr. office and have applied. I do not like long term care and would only consider that as my last resort. I have been told by other nurses, patients/families and instructors and even a clinical preceptor while doing my practicum that i would be a great nurse. i have even been given gifts and care cards from patients and families letting the instutution i worked for know. This is very upsetting and frustrating for me. I feel like they told me what i had problems with but didnt want to help me with them or give me ideas on ways to improve. I worked hard to get here and in my heart i do the best job i can to help patients but it isnt good enough. I know im new and it takes time getting used to everything like paperwork and protocols and such. I feel like once i fell comfortable with all that then i will get my nitch for my own way of doing things that work for me. I really need to find ways to improve these areas. I just hope i can find a Dr's office that will accept a new nurse that doesnt have previous experience and are willing to provide needed training. :wink2: I am in need of some input.

Thanks AP

I am new to nursing, and I am terrified that I will be in the same boat soon. I'm doing everything I can to prepare and organize, but I'm afraid that it will not be enough. Ug. To get this far, and still find it this hard. :) Tough, huh?

Hang in there, honey. We may have trouble with a few aspects of nursing because of ADD. But, the way I think, because I have ADD, I truly believe it makes me a better nurse- I See connections between things easier than others, I'm used to paying attention to lots of stuff at once (as long as it's relatively interesting :)) and I know tons about psych meds and what it feels like to be misdiagnosed! The way I think makes me more empathetic and helps me see patterns that I think are harder for non-ADDers. We just have to find crutches to help us get by with the usual problems like organization and speed, or find jobs where the patient load is different. We can do it!

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Specializes in Tele, MedSurg.

I do believe that the last place i worked was just a little hard on me and the fact that they were not a teaching hospital. They obviously didnt want people to succeed. I now have a job in a faced paced ER and love it. The people are great and im happy.

AP

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Specializes in Certified Wound Care Nurse.

Ditto here - you are not alone. You can try brain sheets, etc. but sometimes that isn't enough... You can try meds - sometimes that isn't enough, either. Even with the above, sometimes the "pogo stick" just isn't on the ground - LOL!

But - on the other hand - I also know that ADD'ers tend to be inherently more creative/intuitive than our non-add counterparts.

Hang in there. I've been doing this for a year now and recently went to the ER. What a change! I am in my 7th week there and let me tell you how I goofed up - I sent a pt to XRay - doc had not seen the pt yet. I came back and found the chart at my area. I "assumed" (in my brain) that since the doc had originally signed the ord for XRay, that he'd assumed care of the pt. So, I "sat" on the chart for about an hour... Not so. I got yelled at by a very nice doctor (I'm serious about that) and he evidently had a long talk with my preceptor. Where was my brain? I don't know... Of course, I work nights and was also sleep deprived... LOL - that DEFINITELY has an impact.

Hang in there. It will all work out for you.

Take good care,

Shawna

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Specializes in Certified Wound Care Nurse.

Hi all,

I've been working in an ER environment for 10 weeks (out of a 16 week orientation). I have been told that my charting is not up to standard, that I do not report to doctors in a timely manner and that I am a pt safety risk. I have ADD. Five weeks into orientation, I told my preceptor that I had ADD and that I had not been taking my meds (I've never found a dose or med that worked well), but that I would resume. I did, there was some improvement, but not enough. Last week I was told that I might not be a "good fit" for this ER dept. I thought I might be due to the fast pace and "excitement". However, I admit, I was slow.

Last week I went to a psychologist who referred me to a psychiatrist for better med control. I went back to the psychologist and was tested extensively for ADD - a more thorough test than I'd received years ago. It was discovered that I have a SEVERE case of ADD and that my meds have most likely NEVER worked. So - now I have an appt with a psychiatrist (good for me) at the end of December - YIKES!

Today I went into work - had a conference with my preceptor, educator and the interim manager. They all said I was not a good fit and now - I have two more shifts to decide if I want to find placement in another department or if I want to resign.

I worked so hard - twice as hard it seems - for my nsg degree and license... only to find that I can't keep up. I've been at this for a year now - and every step has been a struggle.

I give. I'm done. I'm throwing in the towel.

I'm glad to have had all your support.

Take care,

RiverNurse

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Specializes in Medical and general practice now LTC.

Sorry to hear you are having a rough time and would be a shame to give up, Can you not consider working in another department?

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Specializes in Certified Wound Care Nurse.

Unfortunately, at this time, I do not think staying in the field is an appropriate option at this time. I was told that my ADD is affecting pt care. My work was systematically picked apart - I was accused of not (currently) taking my meds - which was not true. As soon as I realized my ADD was impacting my work - and I didn't realize it until my preceptor pointed it out - I began taking my meds - ineffective as they were/are.

I was actively in the process of getting a better course of meds and tx on board, unfortunately, the timing was bad. That department will not wait for this to be resolved. On the one hand, it's callous. On the other hand - and intellectually - it is appropriate according to business practices and profit.

So, I do not feel comfortable in any way, shape or form in providing pt care - at this time. Once I have meds and a working treatment on board, I may look around again. Last night I heard the dreaded words that have haunted me since I was young, "Whenever you get whatever problem you have resolved... blah, blah, blah...". I knew then that I needed to take a break and that I am somehow deficient .

Take care all,

River

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Specializes in Medical and general practice now LTC.

Good luck River

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