Coping as a RN with ADHD

[suri]

Hello, and I'm grateful I found this forum. It is great to be able to communicate with other frum nurses, as well has to have an outlet to vent and get advice without revealing my identity.
My problems have started before I can even remember. Growing up with ADHD is not easy especially years ago. I always wanted to be a model child and tried very hard to but for some reason I never succeeded. I was unable to sit still for for than a few minutes. I struggled until I couldn't anymore. Because my mind wandered I used to say inappropriate things in class (even in high school!) which sent me to the principle's office. I was physically and mentally abused by my parents, made fun of in school, and always knew I was different. I was frequently asked, "Why did you say that?" I tried to think before talking but had no idea whether it was appropriate or not. This made me very depressed. I was never kissed or hugged as a child which made matters worse. I was extremely lonely. I had constant headaches, stomach issues, debilitating back pain, and more. It was very difficult for me to sleep at all, and when I did sleep I almost always had extreme nightmares which I now think are more like night terrors. I used to wake up shaking violently and sweating profusely. I used to dream every night I was dying a different horrifying death before waking up. I dreamed I was in hell. I was afraid to sleep. My mother told me to do teshuva and to daven more erlich. That was the last time I told anyone about it. I was told by my siblings I'm crazy, and nobody will ever want to marry me. In elementary school my teacher forced me to sit in the back of the class, and therefore, it was impossible for me to focus. I was physically in the classroom but had no idea what the contents of the lessons were. My teachers always gave me a minus in effort because I was tested in the resource room and passed with flying colors. The only subject I was very good at was poetry and creative subjects. I came up with ideas nobody thought of.
By the time I started 11th grade I couldn't take it anymore. I started praying for a car to hit me or I should be stricken with any illness that would take me out of my misery. I used to stand at my 5th floor window contemplating jumping. I knew that if I do I will go straight to hell, although I was not sure what is worse - my current situation or hell.
By the time 11th grade was over I stopped talking. I was afraid I'll embarrass myself again. My parents were so alarmed and started screaming to me to stop being a shadow. I was finally sent to therapy which made me feel even worse. He was unable to help me. For them, medication was not an option.
After I graduated 12th grade I was unable to get past the job interview. Until I was miraculously hired working with developmentally disabled kids. I gave them endless love, and received love in return. These kids were my genuine friends. Not like the girl in my class that was a mitzvah friend... ( I always knew she was not a genuine friend but desperately needed her. It was impossible to survive without her.) I wouldn't have done well working with normal people because I always embarrassed myself. An office was out of the question.
I finally married with the man that gave me tons of love. Endless hugs and love. I was starved. I let him get away with everything as long as the love kept on flowing. But my issues didn't disappear. I suffered alot mostly because my confidence was nonexistent. I cycled from being hyper to extreme depression (after embarrassing myself). I was afraid of getting help. I was afraid to admitting my craziness. In the interim had several children. I was a great mom. It gave me an excuse to release the child in me. I horsed around with them. They loved it. I constantly hugged and kissed them while telling them how much I love them. But they were my only true friends. Most of the time I'm anxious around adults. I'm still always afraid of embarrassing myself in public. I also felt trapped in the house with babies. I started pacing around the house. I always paced outside walking alot without getting tired, but now I couldn't just leave the house to release the jitters.
My husbands siblings kept on telling me I have to take some pills. It made me feel even worse about myself. I stopped picking up the phone.
After 6 years of marriage I decided that either I go for help or I won't survive. The past memories haunted me. It was later diagnosed as PTSD.
I was started on a stimulant. I was able to focus better, but my depression would not budge. I was still hyper. When I was started on Paxil and I got worse, my Dr. said it must be mild bipolar in addition to ADHD.
Fast forward 5 years. I decided to start nursing school. Initially my husband and family discouraged me. The were absolutely certain I would fail. I somehow found the courage to go anyways. To my husband's and family's surprise I did very well. That's when they started giving me support. I struggled throughout nursing school, but managed to graduate with a 3.7
My struggles are not over. At work I manage to arrive on time, and have my paperwork on time too, but I frequently lose important papers at work. At staff meetings my coworkers have a difficult time to understand my questions. My messages are not that clear. My coworkers keep on telling me to be short and to the point and it gets me depressed. I'm always worried I'll lose my job.
I'm very frequently misunderstood. I'm sometimes very nervous at work. My coworkers stopped asking me if I'm OK. Now they are just giving me the looks.
The only reason I'm still there is because the patients love me, I'm a hard worker, I take on extra tasks, and I do a good job.
I spoke to my psychiatrist about it, and he started me on a mood stabilizer a while ago. It helped a bit, and my anxiety is still there. My hands sometimes shake. He wants to increase or add medication. He said, "You are under medicated." Its making me nervous. I don't know what to do. I refuse to take any any anti anxiety meds like xanax because they are addictive.
Now I'm worrying nonstop. I'm afraid I'll lose my job.

Any suggestions? I'm so desperate.
Now I worry that it was a stupid decision to post all that. What if anyone finds out my identity?
But I'm lost.

Thanks for letting me vent and I hope this vent won't come back to haunt me.

Suri

[medic09]

First off, welcome to the neighborhood.

Since it is Erev Shabbat, I feel like someone should bring you a hallah and salt, and a bottle of wine (being new to the neighborhood). Alas, you'll have to forgive us.

You sound like one tough gal. To get through all that, keep going, and to keep doing good with and for others requires amazing abilities and support from Hashem. I tip my kippa to you!

Remember to be good to yourself, too. That may the hardest thing at times. Maybe that is what the psychiatrist is helping you to do. We aren't always able without someone to help remove the obstacles.

Undoubtedly you've learned alot along this tortured path. I hope you'll share those insights when they fit. We're all looking for insights that will help us treat our patients and selves better.

Sorry I have no words of wisdom for you, beyond 'welcome'. May Hashem bless you and your beautiful family with a sweet, holy Shabbat.

Shabbat Shalom!

[achot]

Dear Suri,
WELCOME!!! and dont worry, you are totally anonymous here, only post what you want.
We all have a history and I am really proud of you for keeping it together, building your bayit neeman beyisrael etc,
Dont worry about complaints from coworkers too much, that is an integral part of our nursing practice, we all correct each other etc. just go with the flow and try to figure out how they want you to do it, If the patients like you, then you are apparently doing an amazing job as they are tough critics...and apparently you are reading their needs and meeting them. Just be careful not to take on too much and over extend your self..
Regarding your husbands family telling you to take pills,..are they your doctor? I dont think that is a fair thing to tell anyone and I would ignor them when they say silly things like that. You have a professional doctor and it is none of their business.
Continue being the loving mother and wife you are, try your best at work and regarding the organization thing, buy yourself folders and keep your papers organized. Keep a calender and write in it all the time so you are organized.
Regarding your past, it is clearly time to shed it, your teachers and parents did the best they could with the skills and tools that they had at the time, they were clearly mistaken but perhaps they didn't know any better. I cant answer for them, I just know that it is time to leave that behind you and focus on all the blessings Hashem has sent you, a good job, wonderful kids, loving husband etc.
SO you make mistakes, welcome to the world. Be quick to apologize if need be, we are all flawed and make mistakes.
Shavua Tov
achot

[achot]

I read what I wrote and I wasn't intending on being harsh, I just want you to focus on the good in your life. I know people who had fairy tale childhoods, and mazal didn't follow them, they never married and didn't (yet) have children...so sad. A recent article from Dr. Meir Wikler ( well- know therapist and author) pointed out that sometimes schools and parents get it wrong and punish kids for no reason. He quoted a story from his own childhood. My point was - dont punish the rest of your life because of what happened. Try to rise above it and see how crazy Hashem is for you and all the amazing brachot you have blessed with!!

[suri]

medic and achot, thanks for your reply.
In regards to achot's reply, I'm not punishing my life for what happened in the past. My problem is that all the negativity that was thrown in my direction is haunting me. Its extremely difficult if not impossible to get rid of it. Also, its not the past that is most troubling to me at the moment. I have lost a job in the past for several med errors, one that could have ended up real bad. My supervisor complained to me that I am not professional to my patients. (I'm not their friends.) I have done crazy spur of the moment things like backing up on a major highway... driving 125mph. (I wasn't caught). I know what you would tell me. Very easy. Just don't do that. But it doesn't work that way. At the moment it seemed perfectly fine.
Sometimes I can't focus at work. And I can deal with the regular work stuff. But everyone at work knows that my comments or questions are sometimes not clear. So much so, that before I make a phone call or talk to a doctor they tell me word for word what to say or even take the phone from me. I stopped missing appointments and PTA's after I started using my blackberry. It keeps on vibrating before my appointments and I don't shut it off until I'm on the way.
I'm using many tricks to help me cope.

You are right. I am lucky. Much people have it much worse. Believe me, I see it daily at work. Both my parents were holocaust survivors. 2 of my siblings and me have a sick child. There is endless suffering. But this doesn't take away my problem. It is still there. Try to tell a mother with 18 kids that can't cope and is depressed that she is lucky others can't conceive at all.

[achot]

You have `18 children? Wow, how do you manage to go to work at all, I would be tzeflaigen trying to manage all that!! 18 kids is a career and a half of its own. I hope you have help.

What I meant was trying to focus on the positive, you arent the first or last to have lost a job because of med errors. We all make them, a nurse who hasn't made an error is a nurse who hasn;t worked or is lying to herself/himself. learn the lesson in order to ensure you wont make that mistake again, and forgive yourself. Many amazing nurses have made mistakes and own up to it and learn from it.
SO, you were once told you were not professional. Perhaps you can try and pick up tips on how to be more professional. That is something that can be learned. If you were cruel, mean, hot tempered or worse, those would be harder traits to change. Try not to be so hard on yourself. In hebrew we say "Kol Ode SheHaNer Dolek, Efshar Ode LeTaKen" (as long as the candle burns we can still work on fixing things. I am constantly trying to improve myself, but know that I cant if I am too hard on myself, Hashem forgives, so let us be forgiving as well- to ourselves!!

SO you have trouble organizing your thoughts to coherent and efficient messages, If you can, there are life coaches who might be able to help you in that area. BUT you are a good person who uses her talents and energies to help people and raise a family and do good. We all have our demons to slay. At work we all know that we each bring our unique talents and energies and help each other in order to make an efficient team. I am sure that each nurse has some trait that she needs help with. So yours is organizing yourself and focusing. Those are important aspects that need working on and you acknowledge it. That is good, and with time I am sure you will also master those traits. Keep yourself focused and try to organize information according to the head to toe list or most important to least important both methods I am sure you learned in nursing school.
You say that you are haunted by things that happened in the past, and I understand that you have spoken to professionals about them. Do bad things still happen to you? I know that you dont like how your coworkers treat you, try to lower your profile, be quieter at work, do your job to the best of your ability. Perhaps dont jump to volunteer to do extra jobs or hours instead try to focus on the basics, Make lists for yourself to help stay organized. The blackberry is a great idea- good for you and its great to see that it helps.

I wish you werent depressed, that is the work of the Yetzer Hora, to put bad thoughts in our brain. For your childrens sake you must take control of them, be good to yourself ( do you take regular vacations?) and focus on the positive. There are loads of books on the topic, Rebetzen Heller, Dr A. Twerski and others have written inspiring books that might be helpful. R'Avigdor Miller zatzal was such an advocate of learning to appreciate all of the good Hashem has given us, have you read any of his books? You can google him and read from the internet.

I apologize if anything I wrote was taken to be negative, believe me I am only trying to help.
May Hashem give you the Koach, wisdom and patience you need to succeed in all your endeavors!!

[suri]

No way! I don't have 18 kids. This was just a metaphor.
Anyways, thanks for your reply.
I will reply another time for I have to run to work now.

[achot]

Sorry but I would still tell a mother of 18 that she is lucky, the lack of coping and depression can be addressed, I would also try and help her find volunteers ( including myself and my daughters) etc. But, YES she is lucky!!!

As we would all agree, every child is a bracha!!

I know people who are so desperate to have children that if they thought that biting the tail of an alligator would bring children, they would do it.

I know that depression and burnout can bring us all to say things that we do not mean, and therefore as nurses and advocates of good health practices (including Ve Nishmartem Meod...) we must help such mothers to get minivacations and help..

This is a HUGE problem that we are dealing with here in Yerushalayim as many chareidi mothers are working full time while their husbands (hopefully) are shteiging away, and raising large families without help, proper support and financial stability. Many admit themselves to our Emergency Rooms seeking a rest. We admit them under the diagnosis of dehydration and let them stay 2 to 4 days- this is the closest they will come to a vacation...

I understand your frustration and feelings, truly I do, but we need to support each other so that we keep our perspective and find the strength to continue.

I wish your child and your neice or nephews who are sick, a refua shelaima, if there is a name for tehillim that you want to share, please feel free...

Sorry if I misunderstood your declaration of the 18 kids....As we say here: Mishmeret Kalla ( have an easy shift)!!!
:-)

[chayan]

Hi suri, and welcome! I hope that this forum will be the safe, supportive place you need to vent and figure out these issues.

I'm not a nurse yet, still in school, but a lot of what you describe is familiar to me--the self-doubt, the feeling that despite whatever you've accomplished so far it's not good enough. Keep reminding yourself that you must be an incredibly intelligent, determined person to have accomplished what you have and to have come as far as you did.

another thing I'd recommend is forming some adult friendships. As achot said, the past is the past. You're not a shy high-schooler anymore; you're a professional adult who has a lot to offer. There are many problems with relying on your patients for unconditional love and respect; you are the caregiver, and you don't want the roles to get mixed up. Instead of looking to your patients to give you that positive feedback, you need to get it from adults in your own life. We're here to be your friends! And maybe there are people closer to where you live that you can make friends with.

Good luck!

Chaya

[suri]

HELP!
I had a bad panic attack today at work. It started with shoulder and back pain which then radiated to my chest, and difficulty breathing. I know its not a MI because it improves with rest. I was doubled over with chest pain. At first my coworkers made me sit down and asked me to relax. after a while they sent me home. I really didn't want to but they literally threw me out. They promised to divide my work amongst them. I feel now a little better but its humiliating. Its great to see that they are supportive, but now I'm not so comfortable with my impression on my coworkers.
I'm not so sure that this is the right forum to voice the frustration with my issues, but I'm thankful for all the support I get here. I just thought that nurses have experience with all different types of issues and I might get some advice based on your experience.

[achot]

Refua Shelaima, I hope you went to your doctor, ( did they check your BP?)

I wouldn't worry about your co-workers, this happens sometimes, (not every day of course) and as nurses I am sure that their offer to send you home to rest was sincere, I am sure you would have done the same for them if they werent feeling well. I remember when I was at the end of a pregnancy, how helpful everyone was and I also worried what they must think of me, but it was sincere, and when the opportunity arised I was able to be supportive back to them.

When you come back to work, bring a cake, cookies or chocolates or something you know that they like in order to show your appreciation, and tell them how wonderful it is to work with such a supportive team.

I remember once in the hospital, a nurse was caught by her husband sending a good part of her salary to her family in the Philippines, and he was furious, we sent her home to work that out as well and we covered her work. Nurses do this for each other.

Try not to feel humiliated, you did nothing wrong, you didn't cheat, steal, lie, cover a med error etc., You had a physical symptom and your body was telling you that it needed rest. Thats all. You are not the bad one here!!! and dont worry, if your supervisor calls you in, calmly tell her that you suddenly didnt feel well and went to a doctor. This happens sometimes. There is no need to jump on the defensive and I dont necessarily think you have to tell them at work that it was a panic attack.

The important thing is that you should feel better and take better care of yourself.

[Rivka P]

Welcome to our forum. I mirror the sentiments of all who have commented previously, that I hope this can be a supportive environment for you.

Would it help in your communication with coworkers to use SBAR and possibly write a little script for yourself (or at least an outline or bullet points)?

(SBAR=situation, background, assessment, recommendation)