workplace accommodations for ADHD

[pinkiepieRN]

I was diagnosed with ADHD in December and put on meds. I have a long acting stimulant (Vyvanse) and a short acting one for when the Vyvanse wears off (Zenzedi). I am easily distracted and have difficulty finishing tasks. I have exceptional documentation skills, I'm great with patients and I love my job. 99% of the time, I have everything done that needs to be done, but there's at least 1% of the time where I'm missing a little bit of charting or still have a med to give when it's time for report. (We give meds between 0600 and 0700 and report starts at 0700. Meds cannot be given any earlier. I work with kids. Giving meds can either take 15 minutes for 5 kids or 30 minutes for just one.) I have a spreadsheet/shift brains that I use but if I get distracted for one minute, I'll likely forget something. I'm not in a clinically/skills based field so if I miss something, it doesn't cause any physical damage. I give my meds (all of them) in a timely manner 99% of the time, but if one kid gives me pushback, I have a hard time staying on track. I'm also in charge and have a full load of patients, which makes it hard to get everything done AND charge at the same time. Not all the kids have meds in the morning but everyone requires a minimal amount of documentation (sleep note, sleep hours, observation level). I try 100% to be accountable for my actions. If someone tells me I missed something, I'm all about staying later and fixing it. I usually catch myself if I've forgotten something and I'll add it while giving report. I realize this can likely be tedious for my co-workers, who must think I'm a spaz that just doesn't remember anything.

My NM has discussed these issues with me and she's brought up a suggestion - take less patients as charge. So, I would have 4 patients and my co-worker would likely have 6. I think this is a great accommodation because it's a good idea for everyone running as charge to take at least one less patient or maybe even a lighter mix of patients. She's asked me to consider any other accommodations that might be helpful and I'm kind of at a loss. I'd honestly like to be treated just like anyone else. What I'd like is to be held accountable for my actions and not be punished. Unfortunately, it leaves people to feel like they're cleaning up my mess by pointing out that I've missed something, even when I acknowledge I missed something and resolve to fix it.

I'll admit I'm probably not optimized on meds. I see my psychiatrist within the next few weeks and will see if we can adjust my medications upward but I don't want to rely on just meds. Aside from organizational methods and people double checking my work, any work place accommodations that anyone else has been able to have that have worked?

[Wuzzie]

Personally I think you should be taken out of the charge rotation so you can focus on one role at a time until your treatment is optimized and you can handle both responsibilities. Your co-workers should not be required to take both a larger patient load AND have to monitor your work for mistakes. That is not reasonable accommodation by any definition and will likely make you unpopular at work. Even if they change it for everyone in charge I think there is a good chance you would struggle with the larger patient load when you are not the one in charge.

[pinkiepieRN]

Understood. While that is possible, it won't always be possible. A lot of the nurses on nights are newer and I'm in charge maybe 50% of the time. This is something my NM has been thinking of for everyone, not just me but I triggered her to think about it more closely. It comes down to balancing the patient load, which I guess we're all not so good at. It was just a thought but I see now how it seems unfair.

[Wuzzie]

Understood. While that is possible, it won't always be possible. A lot of the nurses on nights are newer and I'm in charge maybe 50% of the time. This is something my NM has been thinking of for everyone, not just me but I triggered her to think about it more closely. It comes down to balancing the patient load, which I guess we're all not so good at. It was just a thought but I see now how it seems unfair.

I think, for the time being, it would be better for all involved if you focus on stabilizing your ADHD. It doesn't mean you would never be in charge again just not until you are able to handle both roles without making multiple mistakes, even small ones. That would be a reasonable accommodation and I think your co-workers would understand. Good luck to you.

[Shelia Gravlee]

I'm searching for successful accommodations and came across this thread. I've made med errors and it's just not working out for me. Requesting assistance would result in demotion and/or discrimination, as demonstrated above. Why are there no accommodations in healthcare of all places? Our systems have not shown to be successful but we continue anyway. It's time for change and I shouldn't be afraid of retaliation.

[learningeveryday]

Yes I agree Shelia. Workplace accommodations would be wonderful, the thing though is how much are they going to work with you.

For instance I told work I have ADHD and now my start date is prolonged because they have to "figure out" if they can employ me. It's one of those things where I might feel grateful for them helping me, but also frustrating because I can't start at all

[Shelia Gravlee]

I think the way it works is the employee requests specific accommodations. The employer usually doesn't do that. I'm searching for accommodations that I could ask for but it seems no one does.

[learningeveryday]

Any recommendations is sure appreciated, thank you for helping

[beachynurse, ASN, BSN]

I found a few websites that may help you. I have ADHD as well and I find it very difficult to stay on task as my meds wear off. I hope one of these helps.

 

https://adhdatwork.add.org/adhd-accommodation-guide/

https://www.psychologytoday.com/us/blog/the-best-strategies-for-managing-adult-adhd/202204/accommodations-for-adhd-in-the-workplace

https://www.healthcentral.com/article/workplace-accommodations-for-adults-with-adhd?scrlybrkr=04443a0b

[BeatsPerMinute, BSN, RN]

Following. 

9 years a nurse, 8 years in critical care, and wanted to do something new and get a break from ICU

I applied for a staff RN job at a wholistic health focused clinic. The employer asked me if I would be interested in a Lead position vs just a staff RN position. At first, things were going well... and then things started not going so well. I have zero leadership experience. The expectations of me learning the ropes of this environment on top of being a leader in that position was too much: I had to learn everything in 5 days. I couldn't do it. I NEED to take notes, or I will forget, or miss something, and likely upset someone. But me needing to take notes took away time, and we ran out of training time, so I didn't succeed in this. 

The employer wants to keep me and are re-evaluating the situation. Since I was upfront about having ADHD and that I learn differently, they are requesting a MD note that would outline specific (& reasonable) accommodations. I have never pursued this and usually just found a way but the whole "just grind it through and find a way" mentality is starting to catch up with me and is holding me back. 

[qwacky411, BSN, RN]

I was diagnosed with ADHD 11 years ago, just after my first year of college. My school helped enormously with accommodations, I.e. allowing more time for taking tests, testing in separate room, using lecture recorders. However I never learned how to actually LIVE with ADHD... I was extremely lucky to have a wonderful environment and nurse educator in my first job. They worked with me to get the best out of me and it went very well. Every job since then has promised to work with me but in actuality has no intention of altering "what's worked for everyone else", and expects my brain to just fall in line. It's extremely frustrating. I've also found disclosing I have ADHD and learn/think differently than others isn't always met with understanding.

The only advice I have is to not work with leadership that doesn't already have alternatives/accommodations in place. Trust your gut, be upfront, and ask specific questions. Being a nurse with ADHD is difficult, but it's much easier when the people around you work with you.