10 Tips for Healthcare Providers with ADHD
In many ways, a career in healthcare is great for people with ADHD. Whether you’re a doctor, nurse, psychologist, advanced prescriber, therapist, technician, patient care coordinator or any of the countless other careers there’s something for you. For those who crave energy and stimulation, there are settings like the emergency room with its constant buzz of activity and high acuity situations. For those who like to daydream, there are research, teaching, information technology (HIT) and work-from-home opportunities galore.
That said, it's not all sunshine and roses. Intense settings like the ER can lead to pressure to rush, interpersonal conflict and rejection which can be especially difficult for those struggling with executive dysfunction. Less stimulating environments can lead to boredom and under-productivity. That’s not to mention potentially serious ramifications that come from disorganization and sloppy mistakes that plague most of us with ADHD.
Here are 10 practical tips for healthcare providers who struggle with executive dysfunction:
1. Know the symptoms of ADHD and how they impact your performance. I am shocked at how many ADHDers insist they are lazy because they procrastinate a lot. While it’s certainly true that not all procrastination is due to executive dysfunction, people with ADHD are especially prone to procrastination. There are also a host of other related symptoms that are not core symptoms, but are often seen with ADHD. This includes:
Higher degrees of emotional reactivity.
Difficulty with transitioning tasks (hyperfocusing).
Under- or over-estimating how long things will take.
2. Get your ADHD treated properly. Hopefully this goes without saying but we have an ethical obligation to be on top of our game for the safety of our patients. It can be scary to seek help, but it’s the right thing to do. If you strongly suspect your ADHD symptoms are impacting your work talk to your prescriber. Don’t be afraid to get a second opinion if you don’t feel you’re being listened to. You owe it to your patients.
3. Put safeguards in place to prevent losing valuable equipment. Stethoscopes are expensive. Do NOT rely on your memory alone when it comes to valuable and essential equipment.
Tag essential items like your ID badge, and personal tools with trackers such as Tile app or Apple. (Pro tip - Not all trackers are the same. I highly recommend splurging for higher quality ones that are more reliable).
Buy writing utensils in bulk so you are never in a situation where you need to write something down but you don’t have a pen.
Better yet, keep important items physically attached to you. Bungees, carabiner clips and retractable key rings go a long way. When I was a resident rounding I kept my rounding notes on a notebook attached to a retractible cord attached to my belt. It was a clumsy awkward system but the consequence of losing those notes would’ve been disastrous.
Write your name and phone number on your equipment. (Hint: Hospital patient ID bands are perfect for this and they are usually brightly colored).
(Don’t leave your stethoscope on a random fence outside.)
4. Learn how to use reminder apps and tools. One of the challenges of working in healthcare, especially with patients is managing all the requests, demands, and deadlines that come your way. This is no different than any other field, though the consequences for not following up can be catastrophic. Avoid the temptation to tell yourself you’ll remember later on because you won’t! Here are some ways to make reminders work for you. Though first, be sure to check with your employer and organization regarding any rules about setting reminders pertaining to patient care on your device.
Learn how to give voice commands to your phone
Apple ( Siri): https://support.apple.com/en-us/HT205890
Amazon (Alexa): https://www.pcmag.com/how-to/set-up-reminders-alarms-timers-lists-with-alexa
Google Android (Google Assistant): https://support.google.com/assistant/answer/9387035?hl=en&co=GENIE.Platform%3DAndroid
If your organization uses Microsoft Outlook, there are a host of features for tracking and following up on critical tasks, such as:
Flagging emails for follow-up. Pro tip: You can organize your inbox so flagged items show up first before new messages so you don’t miss them.
Using reminder features built into your electronic health record (EHR).
5. Consider the pros and cons of disclosing your history of ADHD to your employer. Unfortunately there is no one size fits all answer to whether or not you should tell your employer. On one hand you may be able to request accommodations such as working from home, or being scheduled during times when you’re more likely to be focused. On the other hand, even well meaning healthcare providers may stigmatize you for disclosing a mental health condition. Here is a great article from CHADD on the topic: https://www.additudemag.com/should-you-tell-your-boss-about-your-adhd/
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6. Train yourself in the science of quality improvement. Medical errors, delays, and inefficiencies are almost always a systems issue rather than the fault of one individual or department. Quality improvement is a scientific pursuit to provide the right treatment to the right people at the right time. In other words quality improvement can be taught and applied to all aspects of healthcare. By learning the science of quality improvement you can help your team to work safely and more efficiently. Even the basics of quality improvement is outside the scope of this blog post. However here are some resources to get started:
This 2016 article from Future Healthcare Journal: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6465816/
Institute for Healthcare Improvement: https://www.ihi.org/resources/Pages/default.aspx
7. Handle mistakes like a pro. While I firmly believe that most errors are the result of systems problems, mistakes happen. Even if you do your best to treat your ADHD mistakes can happen. Here are some tips to make the best of a bad situation:
Allow yourself to feel bad, and then move on.
Own your mistake. Don’t blame or shirk.
Be proactive. Let your supervisor and team know as soon as possible.
When it comes to apologizing to patients, work with your supervisor and team to determine how/when/if an apology is needed. Generally speaking apologies lead to better outcomes, though it’s also important to have all the facts before apologizing.
Process what happened and led to the mistake.
Show that you learned from your mistake.
8. Don’t forget the basics. Even the best and brightest among us can skim past the essentials of wellbeing in the pursuit of the latest and greatest. Make sure you are eating balanced healthy meals, getting adequate sleep, exercising, avoiding drugs and alcohol, and taking time to recharge. You know, the basics!
9. Chart more efficiently by knowing how your note is used by others. For most of us, charting is about as low stimulating as it gets. And yet your treatment notes are a critical part of modern healthcare. Generally speaking the medical record is a legal document, which underscores the important of keeping accurate records. The best way to make this tedious task less tedious is to understand the purpose of your note. Find out who has access to your note and why, and what are the critical items that must be in your note. If you’re not sure, considering asking the people who read your note what information they look for and what you can do to help them do their job better. If it turns out that much of what you chart isn’t pertinent or needed then see what you can do about changing that.
10. Leverage your strengths. There are many things that ADHDers excel at, which can be applied to medical settings.
Look for positions that offer a lot of variety and reward you for being energetic and distractible. For instance, the emergency room often thrives on high energy situations.
ADHDers are often passionate about things that matter and this can be contagious to the rest of your team.
Demonstrate empathy and compassion for colleagues and patients who struggle with organization skills. It’s the perfect way to fight burnout and cynicism that plagues many of us.
There’s no mistaking that executive functioning is essential for safe and effective healthcare. Disorganization, poor time management, distractibility and impulsivity, the hallmarks of ADHD can lead to serious problems for healthcare providers. However when healthcare providers with ADHD are properly treated and take steps to improve their functioning, we can thrive!
Have an A+ Day!
References:
How to apologize effectively for medical errors. Healio.com. Published May 14, 2019. Accessed September 23, 2022. https://www.healio.com/news/primary-care/20190514/how-to-apologize-effectively-for-medical-errors
