I am a newly diagnosed ADD-er and am currently working third shifts as a Medic. Work keeps me interested (for the most part; a forgiving and patient partner helps LOL) although I notice that when I get busy, I get tired easily and then I get lazy in when I do my documentation, often waiting until I get back to the station to complete patient reports. I have been seeing a psychi for about a month now and he not yet placed me on meds, he has suggested a to -do list which worked great for the first week (I let it slide this week--eek!). I find that this hasn't really helped; I know a lot has to do with my sleep and home life. (I am a mom to a 4 yr old with high functioning autism/ AD/HD and we go to OT,PT and SPT twice a week in another town.)

I go back in the morning for another appointment and am going to ask about going on meds. I am willing to try something at this point... I just don't know what. Does anyone have any suggestions on what might work? Adderall, XR/LA formulas, I've even considered Amantadine....I have a rather consistent yet irregular schedule (week one 5 days work, week 2 2 days work, week 3 repeats week 1 and so on....) Any suggestions are appreciated!!!

Kim (31)

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Many of your experiences mirror mine. Being newly diagnosed (after I sought help with disciplinary actions), now I find I am more distracted by noticing things that distract me. The only job I could get after let go from ER was at an LTAC--worse than med/surg. I don't want to get fired, so I am contemplating notifiying HR. But what reasonable accommodations can they make if the nature of the job is multi-tasking? ( I am a hyper-focuser.)

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Medications for ADHD are great examples of non-cookie cutter health care. No one med fits all. SO expect to work in collaboration with your NP or MD on this issue. Once give a script, try it, research the drug, and find out what and when you should expect changes. When you do not get what you want or expect on a particular drug/dose, revisit the NP or MD and get the dose and or drug tweaked. With that said, I was on Straterra for about 2 years. It worked until it no longer did (habituation). Upping the dose helped for a while and then we switched to Vyvanse on low dose and gradually increased until I got what I needed. The difference between the two besides chemical structure is that Straterra is not a Level 3 such that you can get refills on one script. Vyvanse requires a new prescription each month. I have to say for that inconvenience, I DO prefer Vyvanse to Straterra which gave me continuous cottonmouth. I was drinking water constantly. My husband, on Straterra still, never had that issue. Different strokes for different folks.

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It's like reading my own story over and over..so sad. I've been an RN for 30 yrs and have ADHD. I'm 59 and was diagnosed about 4 yrs ago, but suspected for quite some time. I was just fired from my job for the first time in my career, but that's only because prior to this, I would quit if things were becoming to obvious. I want to tell you that it doesn"t get better. Nursing management are all from the same mold no matter where you go, I've never been able to figure it out. I was upfront with this manager about the ADHD only because I had a family crisis going on and it threw me off completely, which caused me to be late several times. I kept her informed and explained ADHD, but it didn't matter. I worked on a behavioral health unit and it was appauling how negative and degrading the nurses on the unit were about the dx. Accommodations...Can you imagine being given the special treatment of being able to chart in a quiet room?! And we're going to leave the other nurses out on the unit to take care of the interruptions! Oh, yeah, that would go over well in a field where they eat their young! Best of luck to all...but if you're young and new....get out while you can.

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An RN for nearly 30y. Nurse practitioner for 15 of those. Have worked in many areas. Always a struggle, but usually good at it. Seems ADD symptoms have gotten worse in the last 10 yrs, complicated by injury, chronic pain, and depression. I thought I was managing well by taking a LOT of meds. But my last 2 jobs involved managers who over time, became aware that I had ADD (knew what meds I was on because there is no confidentiality in the system w insurance and seeing a psychiatrist- not if you are a nurse). 2 jobs in a row: each management person,both known to be 'evil' as they simply had the habit of taking nurses down, backstabbing, writing up things. My coworkers in the past have been a good team to work with. But in the last 2 jobs nobody could be trusted. I was written up at both jobs for multiple things, including vague complaints that I was basically distracted, and probably on too many meds. I talked to my psychiatrist, was sent to a lawyer, and between them they gave me a week off for medical leave. adjusted meds a little bit, but I really felt no different and don't believe I functioned any differently. I have good days and bad days. I continued working for another year and quit. Now I have been off work for nearly a year. In the past high doses of meds give me side effects, then am given more meds to manage the side effects. I follow a good diet, and have many behavioral skills to cope with ADD symptoms. But working full time results in extreme fatigue, chronic pain, and I am unable to do anything but work (no social energy) . Time off has been a great gift, but I am out of money, and am looking for low stress, part-time work as a nurse practitioner. So far employers all want a full time person, and will probably offer me full time, but I know I can't do a normal work week and maintain emotional and physical health. I am tired of fitting a square peg in a round hole. I am thinking about applying for disability.

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I, like many of you have had many nursing jobs where my ADHD was not compatible, and it also seemed like managers could never understand my distractibility, impulsivity, and increased anxiety. I was diagnosed in the 60's, and I am 51 years of age. At that time a person with hyperactivity was placed on Phenobarbitol, a terrible drug for anyone trying to absorb the environment around them, because I was a zombie. I find it very difficult when a situation becomes overwhelming, such as, trying to pass medications to 50 people and then get treatments done as well. I eventually do get the hang of it but I become very stressed out. I love being independent and using the knowledge that I have to care for my patients; however, it never fails that some Manager picks me apart for something. In my last job I worked as a hospice case manager, I loved my job and my patient's and their families loved me; however, I refused to admit a patient who did not qualify for hospice and was terminated, because I was only at that job for 9 months there is no law firm that will take on this case. I was also written up for things such as one patient's wife complaining because I did not get out to her home immediately. I did get out to that home and did care for her spouse; however, our triage system was not working that day and I had many other patients to visit. I work really hard at what I do, am currently finishing my BSN with a high grade point average; however, I am tired of dealing with failure after failure. My marriage of 28 years failed, now I am a divorced mom of 4 children, on many medications and want others to see the nurse not the disease, help.

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Okay, so I am told that I care too much, work too hard and question about everything. Will isnt this the kind of nurse you would want to help you or your loved one? So , I believe that makes the others that sit around and play on the computer , text friends and just dont care that much..... look bad. That is what I have experienced. And as a perfectionist, no one works harder than us. And that is the kind of nurse that is quality. Being througho, caring, kind , energetic and excellent communication skills is not appreciated??????

I am just so confused, why cant we be open and honest to our employer, and when i am, i am told I am not appropriate for the job.

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I am a fairly new nurse living in Australia. About 1 year since graduation. I am having most of the problems that others with ADHD have described with nursing. I really have so much trouble with the practical aspects of nursing although I'm really intelligent and my knowledge is very good. When I described my problems to a doctor including my suspicion I had something like dyspraxia he failed to see my concerns as genuine because 'I wouldn't have got through university'. He did some stupidly simple test to test for brain injury (only one of the causes of dyspraxia) told me he would send me to a physician to look at my brain so I'd be happy, but he said I could just tell my superiors I was having trouble and they would give me all the extra help that I needed. In fact they had been putting pressure on me to improve already and I resigned because my supervisors threatened to start some kind of inquisition if I didn't show incredible improvement within about a week, despite telling them I was being investigated for a learning disability that could be affecting my performance. My GP sent a large report to a psychiatrist, who then told me it was hard to believe I was messy and subsequently told my GP I probably had OCD or another personality disorder which would explain why I didn't get tasks done on time. I saw a psychologist who eventually said my anxiety was probably the reason for my extremely poor score on her working memory test. It didn't seem very scientific. I also scored high on another test for ADHD and I didn't know much aout it so I said tentatively ' I don't think I have ADHD' and instead of explaining anything about ADHD she told me that if I decided to change careers it wouldn't matter anyway and said she would be happy with a diagnosis of anxiety. Perhaps she thought a diagnosis of ADHD would be too distateful? And isn't it almost natural to develop anxiety when everyone is watching you like a hawk? Since seing her I haven't actually made any drastic career change. I had forgotten about it until I googled something about being absentminded in my daily life and ADHD came up. Anyhow I tried home based nursing for a while but I don't think it's really my thing either. I went into a position where my job expectations were very broad I had to schedule the carers for shifts and had to fill in any that I couldn't find anyone for. I was getting stressed out, still not working at the expected pace, and getting very little practical nursing experience so I decided to resign to have time to update my skills and figure out what to do. I still haven't figured it out. I'm in my late 20s with 2 degrees (first was health science) and no savings. Of all my university placements I felt most competent and supported in ED and ICU. However I still had some difficulty with remembering what to do next and I'm pretty sure they would want me to have done a full year of nursing in a hospital before they hired me there, epecially considering my past employment. I dont' even know if I want to stay in nursing. The only thing I can think of is working in a GP clinic, but as I understand it I think it requires considerable organisation and I don't know if I can 'go another round' just to find out. A lot of the positions I'm interested in are generally for people with considerable experience on the floor- diabetes educator, advanced care planning etc. Anyone know differently? Does a diagnosis help? I'm going to see a different psychiatrist, hopefully soon. Thinking about going back to uni.....again :(. Thinking about exercise physiology. I want something where I can be more of a therapist. Suggestions, comments, questions?

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As if my previous post wasn't long enough I'll post about some of the more major difficulties on the floor. Some of these are my own difficulties. Others I think go to show actually how inefficient and limiting the floor actually is for someone like me. I know I'm not officially diagnosed so can anyone relate?

I had trouble listening to bedside handover AND checking charts oxygen AND suction at the same time as my ward required. Could only concentrate on one of the tasks at a time. Half of the time I still couldn't hear what the nurses said because they spoke too quickly, and it just didn't sink into my brain. It was like a big blur and couldn't write down what I needed about the patient. I started to wonder whether any of this was physically possible or if it was an incredible standard set because it sounded good on paper and could be there as a backup for the hospital if a mistake was made . Anyhow, invariably I would forget to write something down and someone would pick me up on it.

I would check oxygen and suction later as I had been told off by the manager for not noticing it was not working and she told me it must be done every shift. Then I figured out I was about the ONLY one who knew when the oxygen and suction wasn't operational. After handover on a nightshift I checked O2 and suction while my partner went on a suspiciously unscheduled break. ( I suspect she only was on exclusive nights because she could get away with smoking on premises). When she came back she asked what I had been doing and I told her that I had found 2 suction sets and an oxygen set that were partially missing or unoperational and needed fixing, one which was obscured behind a rather large heavy chair. She actually told me off for not doing it during handover even though we had the same patients and she hadn't done it either!

I am one of the only nurses who actually follows best practice on the little things, as it is drummed into us in college. Checking the respiratory rate, taking a pulse with my fingers instead of just taking a rate from the pressure cuff. Doing a BP before giving blood pressure lowering medication (even though the time we're 'scheduled' to do observations is long after). Is that OCD??? I don't think so. It's what's called best practice, especially when dealing with people who have known heart problems. Paying attention to those things in a ward is important, that's what we are paid to do, not just wipe bums and shower people and stab them with pointy things. How is it fair that many older nurses get by partially because they don't give a damn about these fundamentals. Is it perhaps any wonder my schedule gets all mucked up while they breeze along nonchalantly and don't tell anyone that there is any need for change? Integrity is a word foreign to many RNs.

I take longer partially because I'll forget what I was going to do next and stand in the doorway with a puzzled expresion on my face when another well seeming nurse comes up and asks if I need help with something or other. I think this is very characteristically ADHD. I can't tell them because my brain was going through a complex organisation process of what I had to do and now it's ALL gone and I have to start again. My manager made me write a chart with all the things I had to do on it and cross them off so everyone could see what I had done. I started making careless errors on the chart so I made sure i didn't muck it up. It would take ages to write in the morning, then I would ge hauled over the coals for forgetting to cross them off, and if I didn't get something done in the morning, like a shave or shower, then I wouldn't find time to do it anyway. Even if I did my chart was useless becasue I would have to go through the some kind or reorganisation of my day in my head anyway, so honestly the chart didn't help. However I couldn't tell this to my manager because I'd end up in tears because they are such poor listeners and it is so frustrating (poor emotional regulation characteristic of ADHD?). I found that I was working better with an everchanging list of stuff to do that just was comprehensible to me, but maybe not to others. I even think I tried to explain that this had been useful but I think my manager was just obsessed with me documenting everything I had done for others to see because she wanted to 'keep an eye on me' because she mistook the poor time management for my absolute incompetence.

If I went to get something for doing a task like taking out an IV, doing a dressing change, I'd often forget one of the things I needed to complete the task and I'd have to go back.

I find it difficult to locate things in general.

The bell is my worst enemy. I will answer patients requests to use the bathroom, try to maintain their fluid balance chart by finding a blinking pan to put in the toilet (again as many other nurses fail to do...but as a new nurse all eyes are on me). And then I forget what I was doing before the interruption. So many other distractions too...chasing up medicines that aren't in stock, relaying messages to doctors actually finding where the heck the chart/BP machine/temperature probe has gone. None of these are predictable. None of them work in a perfect little schedule no matter how carefully I set it up.

So basically I was a square peg in a round hole to begin with, but I still maintain that their insistence that I must be incomptetent, their insistence that I scehedule for all to see, and picking on every little thing I did also set me up for failure. Some nurses wouldn't even let me plan my own day they'd just butt in and tell me what to do next which defeated the purpose of all the planning and shit I had to do in the morning. The managers didn't trust my judgement about what was working for me and they set me up with a system that was UNWORKABLE. It didn't help that it was a workplace filled with hypocrisy through and through. Nothing I could do was the right thing. Because of my experience there I am almost convinced that the only reason for 'best practice standards' is to get rid of people they don't want working there. Doing my best and paying closer attention to best practice standards than most other people, I was the one that got hauled over the coals on the odd occasion I didn't follow one. In a similar way a group of people reported on a rather sympathetic nurse they didn't like for her sometimes abrupt manner in an emergency (understandable) and she was disciplined by an anger management course, which I think was a move to force her out. I am sorry for my rather harsh indictment of RNs in this story, I know there are lots of determinedly good ones out there who somehow survived.

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I am in my second semester of nursing school. Although, I have always had a passion for helping the sick and disabled, I'm afraid that I'm just not cutting it in nursing school. No matter how hard I try it never seems to be enough studying. Often, I find myself just studying everything. I'm just not sure what I should focus on when studying. After getting a 67%, 72%, 73% & a 53% on my last exams, myself esteem is at an all time low. It is now mid-semester and when I study a little voice in my head screams "What's the point? Your gonna fail anyway!" At my school a grade of 72% or 73% isn't even passing. My quality of life is at zero. When I'm not studying I feel guilty and when I am studying I feel overwhelmed.

I need a study strategy that works for someone with ADHD and I need to find a way to de-clutter my mind and study materials. I have an undergraduate degree, I know there's a brain in there somewhere, but I'm starting to be on the side of the little voice in my head, "what's the point, you're going to fail anyway."

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