RN-Attention Deficit Disorder-Nonhyperactive

Hekate · Mar 10, 2009

Be cautious !

If you trust your manager to offer new tools to help you get through your day more efficiently, disclosing your condition should gain you some understanding and more support to improve your practice.

BUT, In the case of a manager that perceives ADD/AD-HD as an unacceptable flaw that could not coexist with good nursing practice, it is a risky move...

Learn to know whom you work with carefully before making the decision to disclose your ADD. Or you could just decide to get it over with right from the start, and if your manager has a negative opinion of the condition,you will know from the get go and you won't waste any time and energy training in a unit that will never accept you for who you are and what you have to offer!

WalkieTalkie, RN · Mar 10, 2009

I don't mind talking about my AD/HD... someone once made a commend that I was hyper and I said "oops, I forgot to take my Adderall at lunch!" Pretty much everyone knows that I have it, and I don't get any grief over it. I actually think it helps me with my job sometimes because I have a lot of energy, and it's needed to work with my super sick patients in the ICU. It can be both a gift and a pain at the same time.

Atheos · Mar 10, 2009

:sstrs: Be cautious whom you disclose your ADD to.
I just disclosed it to my manager in an effort to be very honest about my short-comings...her answer was that a nurse, and especially an ICU nurse, could not possibly be a good one if she doesn't have impeccable organizational skills....

I would agree with your manager. ADD peopel DO have organizational problems. Of course, many of them learn how to compensate for it. If you have developed a system then I suggest you share that system with her.

Though, I would also check the Americans With Disabilities Act. She can't MAKE you leave based on that alone.

RN1982 · Mar 16, 2009

Perhaps there were other issues that your manager found unacceptable other than your ADD. As Stan said, you cannot be let go because of disability so seriously I doubt that was the issue.

Hekate · Mar 16, 2009

Let's play hide and seak...

RN1982 · Mar 16, 2009

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

Do you have a routine? I found that my routine keeps me on track. Like Viking said, make it a point to chart your assessments after you do them. It saves a lot of time and headache when you forget what your patients lungs sound like. For me, when I come in, I get report, do my assessments, chart, review MARs, pass meds, clean the rooms etc. Maybe a routine would help. I used a brain sheet too when I worked my first nursing job, was great because I had to care for four patients then.

Mahage, LPN · Mar 16, 2009

Do you have a routine? I found that my routine keeps me on track. Like Viking said, make it a point to chart your assessments after you do them. It saves a lot of time and headache when you forget what your patients lungs sound like. For me, when I come in, I get report, do my assessments, chart, review MARs, pass meds, clean the rooms etc. Maybe a routine would help. I used a brain sheet too when I worked my first nursing job, was great because I had to care for four patients then.

How can you possibly get meds done on time if you take time to chart assessments before med rounds? :bow:I have assessed before meds, but couldn't possibly take the time to chart it before meds. We have a long computer version of assessment. I have started trying to remember to leave my SBARR at the wallaroo where we keep the chart, so I am loosing them less frequently. I also carry one of those reusable grocery bags that you buy at the store for a dollar on my COW. I keep supplies in it like flushes, fill needles, even some lab equipment, alcohol pads and I can put my SBARRS in there if I need to. That has helped a lot. Leaves my pockets available for carrying narcs and pens, scissors and keys. Now I just have to make sure I keep up with my bag, LOL! This morning an oncoming nurse grabbed my COW while I was giving report, I had to track my bag down before I went home, so I could put it in my locker. Took me 5 or 10 minutes to track her and my bag down. She thought she should get to keep it, seemed surprised that I wanted it. One of my coworkers uses a craft bag which she sets on her COW but I like to hang mine on the back so it is out of the way.

My routine is to get report as quickly as possible, pull up my patients on the MAK, check to see what I need to get out of the PYXIS like colace or pain meds if I know them and know they will be wanting them, then I go to the sickest pt first (if I know) and assess then give meds. I make notes of any particulars on my SBARR, like Rhonchi, bloody urine, IV wouldn't flush, residual levels, etc. I go to the next patient and repeat the process and so on. On a night where noone has a BM and I am not interupted by a crisis I can generally finish my round by 9 pm, then I chart the assessments. That is on IMCU where we have 3 pretty sick patients. On a night where everyone is pooping, in crisis or begging for pain meds, or if I get a new admission it may be after midnight rounds when I get to chart. If I have a lot of line draws, then it will be another 30-45 minutes which puts me up to around 2 am charting. If I have had to call docs I almost always make a computer note at the time I call the doc, then write out the TORB and use that time noted on order to finish charting about the event if I am not at a computer when I get the call back from doc.

If I work on the other end where we have 6 patients, it is just plain hell the first night because inevitably they are all yelling for pain meds before I can get to them on rounds and I am not going to carry pain meds for 6 different patients in my pockets. I try to see that my "patients in pain" are all nicely medicated:saint: before giving report so that they don't blow up the call light during shift change which can be 30-45 minutes on a good day. I don't know why the shift I follow can't pick up on this and do it too! This floor is notorious for having report interupted which makes it even worse. :banghead: It is a nightmare just getting through report down there, whether you are oncoming or going off! It is so hard to chart assessments on 6 patients especially if you have new admits or surgeries the next day. I am usually charting till 8 or 9 am especially after the 1st night on the floor and if I get a load of new patients in.

Mahage

"The fairly new nurse with 57 years of life experience!"

RN1982 · Mar 16, 2009

We use computer charting and its not bad, there are separate forms for pain, treatments (i.e. turns, oral care, baths, I.V. access, physical assessments, restraints, but it doesn't take long to go through each screen and its very thorough. It's easy for me, then again, I usually only have 1-2 patients. I get report at 7 and by 7:30, i'm starting my assessments, I don't wait because you never know what will happen.

cyndiangel13 · May 6, 2009

First I have to say thanks for starting this thread. It is encouraging to me, as a brand-new 'baby' nurse c ADD (i've been off 8 week orientation for 3 weeks now). I can identify c just about every post in this thread to some degree or another.

I, too, am trying to find my routine. I have caught myself staying as much as 2.5 hours over to finish charting. I was dx at 14 (33 now) and have been on a whole slew of meds (currently on vyvanse 50mg q. day). Meds have def. helped. I have also found that writing small/abbreviated notes down in a little pocket-sized notebook during assessment/rounds. I write my shift report on an 8.5x11 sheet set up c rows and columns for each individual pt down in red (or purple, or blue, or green...etc.) and any changes that occur during the shift I write in black which helps memory when charting and reporting to next shift.

I work on a busy trauma/surgery floor c 5-6 pts a night. I pray that I start the night off c 6 pts because that usually means I don't have to deal c admits (which throw me off in a most awful way). It has been tough at times since I don't have experience which causes flexibility issues for me. One thing I have learned is that I NEED to take a break when I get a chance just to slow down and regroup. I will look at my pocket notes and reprioritize or figure out what really needs to be done next.

As far as disclosing my learning 'difference' to my manager, I have not...yet. However, I have told the nurses that I work with that I have ADD and I take meds. I feel like it helps them to understand how I get backed up at times...especially since they are who I turn to when I need help. Thankfully, most all of the RNs I work with are very helpful. AnyWHO...I hope my little bit of input helps and furthermore I hope to read more feedback from you guys!!! Wishing the best for everyone out there dealing with ADD and nursing.

P.S. - My psychologist informed me that ADD/ADHD is considered a MEDICAL (not necessarily a psych) condition. That has to count for something in regards to the ADA. Might be something worth looking into if necessary. Just sayin'.

armenia · May 16, 2009

I'm on Adderall, but other than that, I made a sheet for myself with all the information I needed and boxes to check off for charting. That sheet helped me incredibly! Try figuring what you are "missing" most often, then what will help you remember to do it. I can send you my sheet if you think it might help to have an example, but you and I both know that every ADDer is a bit different.

Good luck!!!

tripp3horn · May 16, 2009

Firstly, "Silver", thanks for your posts... they provided encouragement to me during a very frustrating patch :-D
It's interesting how life works - just as I'd turned in my resignation - I spoke with a former co worker of mine. She said there were positions open there - on the same floor where I'd previously worked. She told me to call the nurse manager. When I spoke with the nurse manager, she said, "Girl, sounds like they didn't appreciate what they had in you. Why don't you come on 'back home'?"
So, I took some time off to think about it. I decided to give it another shot - one more try. I let the nurse mgr know of my plans for follow up treatment - concerning my ADD - although she says she didn't think it was as much a problem as it appeared to the people ER - she supported my decision in proceeding with a psychiatrist follow up for meds. So, what a gift. I am back on my former floor with a much greater knowledge base and a little more confidence - and glad to be back there.
I am hoping to be able to eventually "float" to the ER at my hospital while continuing to work on this floor.
Will keep everyone posted on my progress - RE: meds, etc.
Sometime wonder if I should contact ADA RE: the previous hospital and their handling of the situation - just for my own knowledge - for example - how to handle and even document meetings and their contents.
Take care and happy holidays, all.

I know this is a pretty old post, but were you working in another ED at a different hospital? I

trina820 · May 17, 2009

Let me say thank you. Why because I was wondering if my disabilities would be in the way of my nursing degree Im still taking pre-reqs and I was wondering if I was cut for Nursing school but thanks to you guys I know that it can be done. I also am ADHD .