I've been at my job for 6 1/2 years. I have a boos who cares and really wants me to succeed but she needs results. I have had issues with time management, prioritization, lack of confidence, indecisiveness... and have been unable to meet productivity expectations for almost the entire time. My boss has tried watching me work, given me many suggestions of things to do different but I can't seem to implement them successfully - it's like there are too many balls to juggle and if I focus on one I drop something else... Or I have all these what if's or reasons why an exception would be good but then it backfires... I find it hard to implement the suggestions consistently - I suppose in part due to anxiety or emotional blocks or something...
My boss says my coworkers are getting frustrated about me not being able to carry my share of the load and my problem is getting more obvious now that my coworkers are more involved in assigning workloads than they were in the past and they can't give me as much - or if they do I just don't get enough done...
She gets pressure from HR about my low productivity and my overtime (they even asked her once "why is she still here?" - I can stay an hour or more longer than the others and still have bad numbers... or if they are even close to good the overtime counteracts them because you are supposed to get it done in 8 hours not 9...
She doesn't know how long she can stand up for me... she doesn't want to fire me - she wants me to succeed... she sometimes asks me "what happened yesterday that you only saw 4 patients?" Or "what happened that you had 1 1/2 hours overtime?" And she wants me to think of what went wrong and what I will change to fix it... reasonable - but it's hard...
I feel like I am just stringing her along and being a drain on the department if I can't make progress - if it were going to change wouldn't it have happened by now? Am I never going to get it - if so why keep trying? - How do I know when this is just a bad fit and I just need to find a different job that suits me better? Surely there is some job that would rely more on my strengths and less on my weaknesses... but I am scared to even look for another job - scared a new boss wouldn't be as patient with me and would fire me or let me go in short order if I couldn't measure up in a few months... and how could my current boss give me a good recommendation with this glaring work performance problem?
She sees a lot of good in me - says I am a good therapist (I am a physical therapist) - it's not really my work they have a problem with - it is that I take too long, don't prioritize well and can't meet productivity expectations... don't get enough done... I also struggle with asking for help - it is embarassing to ask for help when I haven't done "enough" for it to be reasonable to need help - I can't do my share of the workload...
I'm trying to figure out what to do... I don't want to get fired and perhaps at some point my boss will have to give up or HR will make her fire me... I've already been fired once before but I was a fairly new graduate then so it was easier for people to understand the job was not a good fit for me as a new graduate... now I have enough experience/time that that excuse is no longer applicable...
I have a counselor who has been very helpful to me in some areas of my life - I have learned a lot about myself and made some progress I value in some areas of my personal life - but work has not really budged much - I don't feel I have really improved there... I am kind of staying the same... my counselor says baby steps is what works with ADHD - and I so appreciate that - but I don't know if my boss has time for baby steps... I've already had how many years to get this? My boss tells me to try REALLY REALLY HARD... she so needs improvement... but I'm not sure how to do that - when I manage to drum up enough drive for that it doesn't last - it it is hard to maintain constant intense focus and drive ...
My counselor is the one who told me I have ADHD - she could see it very clearly and it was so nice to have a "reason" for my struggles other than "moral failing" or not trying hard enough or something...
I wondered though if I need more than therapy - maybe I also need an ADHD career coach who can really drill in on the work thing and help me figure it out whether it means a different job that would suit me better or how to improve at this one and make improvement that lasts...
I asked my counselor if she thought career coaching would be a good idea for me/whether it would help, whether I am ready for it... she said it wasn't a bad idea but she needed to think about it... I wasn't proposing quoting therapy - I still have things I want to work on there... It would be expensive to do both counseling and coaching - but losing my job would also be expensive especially if I couldn't get or keep a new one. Maybe I need to invest more in myself now while I still have income - I need to be able to keep a job... and ideally to get to where I can just go do my job and come home knowing my work was adequate and acceptable so I don't have to stress about it or about when my boss is going to talk to me next - or about losing my job... I don't want to have to mooch on family - I need to be able to keep supporting myself...
I'm a little scared whether coaching would be too much pressure - just another list of stuff I have to do without getting rid of the mental blocks or emotional blocks or whatever is holding me back - my boss gave me a list of ideas and it didn't work for me - would a coach be different?
My counselor did say she thinks I probably need to get something about the ADHD in my HR file at work so I have some protection (against getting fired) - and she thinks I need accommodations - though I'm scared to talk about that with my boss and what would my coworkers think if I am held to a lower standard than they are especially if I don't tell them about the ADHD? My boss does know about the ADHD and she is supportive thankfully.
My counselor wanted me to get the official diagnosis from a doctor, psychiatrist or psychologist so I sought testing at a family practice doctor who specializes in ADHD - he at first thought I had it but then I didn't do bad enough on the computerized TOVA test he gave me so he decided I didn't have it and recommended I go to a psychologist for further testing to see what is behind my anxiety and lack of confidence... My counselor's assessment of me was unchanged by this report - she still strongly believes I have ADHD and when I read stuff about ADHD I resonate with so much... I can identify with it... - I have scheduled an appointment with a psychologist for testing - but my appointment is not till June 9 and then it is 4 weeks till you get results...and meanwhile I'm getting stressed about work - as my boss talked to me again about my performance difficulty and my overtime recently...
Bless you if you read all that... I write too much... if any of you have ideas or thoughts they are welcome...
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Chickadee1
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That sounds like a hard situation but maybe an adhd coach could help? Here’s online directory adhdcoaches.org. Any coach you work with should specialize in adhd - if they don’t understand it they’ll just perpetuate the problem by telling you to “just try harder”
And if your boss already knows about your adhd it certainly sounds like she’d be open to accommodations at work; that sounds like an important route to pursue.
Thanks for your kind words and the link to the coach directory. I did talk to my counselor a little more about coaching today and she felt like some of the things a coach would do are things she is working with me on and while it wouldn't be a bad idea to do coaching it is extra expense that she thought maybe I didn't need to spend right now. She said this isn't an overnight fix much as my boss would like a "miracle" quick fix where I finally "get it" and do great... and if I get a coach that just pushes me to just "try harder" that won't work so well... however she said a good coach will be mindful of the other mental health things going on like anxiety/depression etc so should take my "blocks" into consideration...
I’m so sorry you’re going through all that. I can relate to this so much. Before my diagnosis I was a secretary/PA for a rheumatologist. pretty much the worst career choice for an adhd girl, as it’s main requirement was organisation skills and planning ahead and following through on number of tasks… my boss was also very understanding and it was relaxed atmosphere but it was so stressful to have to go into work every day knowing I had no idea what I was doing or if I would get it done properly or on time. Exhausting always feeling like you’re not good enough. Eventually due to a car accident I had to quit that job and a few years later I got my official diagnosis which meant meds! Over the years I’ve been in ritalin concerta and now Vyvanse. I now work from home as a translator. but honestly without the meds I’m not even able to keep up on house work or basic daily tasks. Basically you can try all the life hacks and coaching and strategies to help you at your job and or life but when you have adhd you have adhd and those tools really only go so far. Now Those tools combined with meds are a great combo! Cuz then your brain is actually able follow along and get stuff done. Even if it’s going to take several weeks for you to see a psychiatrist for diagnosis don’t let that stop you. Once you have an official diagnosis you can be medicated and life will change so much for the better. And I’m sure you’ll manage ok at your job until then. Just keep doing your best and concentrate on your strong points and really make those shine so as to blind your coworkers to your shortcomings. If you can find one little thing that’ you’re really good at keep working on that and your weaker points won’t look as bad. And honestly often we think we are doing worse than we actually are sometimes and people aren’t always as annoyed at us as we think they are. But I understand the feeling of not being able to meat certain requirements and feeling guilty that others have to pick up the slack. But you are who you are, embrace it and let your strong points shine and hopefully that will carry you through till you can get an official diagnosis. I really hope you find a solution soon.
Thank you so much for your kind reply - for sharing your story and your suggestions. I can really relate to you point about struggling with housework - I do to - it is hard for me to make myself do stuff at home - especially as I live alone so don't have anyone else to be upset with me if I don't do chores... I wrote about work because it is the most pressing - but the home stuff is a struggle for me too...
I liked you points about making my strong points shine and that maybe people aren't always as annoyed at you as you fear...
What areas of your work do you struggle with? What types of accommodations do you think would help you?
I think you've talked about this before, and that you said the paperwork takes too long to do. Some of the doctors and nurse practitioners at the hospital I work at use dictation software, or a dictation service. If it would be easier to speak to enter notes, then that might be an appropriate work accommodation for you.
ADHD coaching sounds like it might help. I haven't done any coaching yet, but think I would benefit from it, too. I know that my ADHD struggles also include time management and organization.
Thanks for your response to my post. Yes I have written about work before - but included some repeat detail for the current post so people who may not have read what I wrote before will have the background - I tend to write too much detail - long posts...
Yes the paperwork is definitely an issue - When I was doing one of my clinical practice things for school I was someplace where they did dictation - and it was hard for me...I actually thin I do better expressing myself with writing - I can get too detailed but then I have time to think without being "on the spot" - if I were dictating I might get stuck and have too many pauses or need for re-dos... with writing I can just fix it easier... I can think better when I write... so for me I think dictation would be harder but it is a very good suggestion. Some of the doctors still do dictation at my hospital but we PT's don't.
Other things I really struggle with at work include decision making - especially if there is any uncertainty in my mind about what option to choose -
I am also rather shy and can get intimidated if I have a "scary" patient - or a super confident patient that things he/she knows what to do and doesn't think they need instruction - or if I feel like the patient doesn't like my opinion - I can back-peddle and modify what I'm saying trying to "soften it" due to fear of conflict or fear they will think I'm judging them or something - I really struggle with lack of confidence issues...
I also get intimidated at times if I need to call/contact a doctor for a question - it has gotten a little easier because some of them you can now send a message to on secure chat inside the EPIC record system - and to me writing is less scary than talking...
I also struggle with time management and prioritizing... we don't just have a "schedule" to follow for our day... we have a list of patients to see and have to work out when to see them - you may go to try to see one and they are gone from their room to a procedure - or they are eating or they refuse... so you have to go see another one - and you want to see as many as you can but may not have time for all of them so you need to prioritize - seeing the highest priorities (like evaluations, certain diagnoses, ones the case manager needs updated PT notes on etc) early so if you have to skip any patients at least the priorities will be done - well I struggle with prioritizing the wrong things sometimes - or thinking I will have time for the priority patient later and that could backfire because they could give me more priorities - new evaluations or whatever...
I also struggle with getting too much overtime (they want us to minimize overtime and really if we get it it should be "justifiable" - like you have enough productivity units to justify being overtime - well I get overtime and too often I don't really have enough units even for 8 hours let alone more....
I struggle to communicate when I need help - would rather do it myself - am embarrassed to ask for help because I don't feel it is reasonable to need help (say to ask someone else to see one of my patients because I don't have time and they are priority) - if I have seen so few patients or have low "units" so I "should" have had time or a reasonable person would think I should have had time...I don't like asking for help if it highlights my failures and weaknesses...
So my issues are time management, productivity, prioritizing, decision making, also communicating... I guess a lot of that is executive function stuff which ADHD affects badly for me...there may be more but those stand out at the moment and my response is already long....
I forgot to address you question about what kind of accommodations I think would help - I am not entirely sure - my counsellor thinks they need to reduce the productivity requirement for me - to something that is a challenge (not too easy) but more reachable for me... The other doctor I went to suggested making templates for my notes - phrases I use a lot and putting them on a flash drive - with HIPPA that could be an issue at work but my counsellor said that was a potential accommodation - you get a work provide flash drive that is encrypted or something... I'm not sure how helpful that would be - there is some built in feature in the charting program that could probably be used for that so a flash drive wouldn't be needed - you can save your own "smart phrases" that you can pull up by typing a few characters and then it can insert your pre-written sentence or whatever...
I'm not sure what accommodations would really help - I wish I could just see patients and delegate out my documentation but that is definitely not an option...
I'm scared to ask for lower productivity requirements - seems like giving up as that is what my boss has been pushing me on... and just saying - hey I just can't do it - sounds bad... Really she has already tried lowering them a little - told me in the past she would be "happy" if I just got X productivity - even though it was a little lower than the expected number... Right now a lot of us are struggling with productivity to some degree not meeting what they want - but the problem is my averages are worse and I get overtime too much... or some others who get low numbers are newer hires so should be more understandable - maybe she is talking to them too - but my problem has been going on since long before we got the new system... anyway I better get off and go to bed. Thank you for you responses and suggestions.
PS - while I haven't taken the TOVA test, I've seen samples from it, and it looks like the kind of test that my brain would treat like a game. One single test should not be used to rule out ADHD, because the disorder isn't that straightforward. It's multifaceted. That's why there are 18 different diagnostic criteria for ADHD (9 each for the Inattentive presentation and the Hyperactive-Impulsive presentation, and only 5 criteria needed for a diagnosis as an adult, 6 for kids).
Thanks for your thoughts on the TOVA test - it wasn't an "exciting" game - but I do like computer games - try not to do them much because I take it to excess as an escape/avoidant strategy and it isn't healthy for me - but my brain likes computer games... and I feel like the TOVA does not simulate work for me - at work I have to make decisions and create content - like produce documentation - that requires a lot more thinking and deciding than just paying attention to one of 2 options on the screen and pushing the button for one and avoiding pushing the button for the other... so it doesn't accurately demonstrate my ability to manage my work..
Did pretty good today. Spent a day planting beets and never had a zap once. I went without my Concerta today since crashing when you're on a farm field ain't fun. I found that out already. But that's ok; all a had to do was make holes in the ground and then go back and fill them in. Left my phone in the car so I wouldn't keep looking at the time.
And now I'm about to lie down and probably go zombie for the evening/night. Thanks for all your replies so far; I didn't get a chance to do much responding, but I read them all and every reply has at least a couple things I can relate to. Have a good night, all.
I am so sorry to hear about what you are going through. I can also say that I completely understand what you are going through, as I lived that way for huge portions of my life. I was failing to meet my demands, but people liked me so they would accommodate me. Nice to have someone have your back, but not as your lifeline.
Okay, a quick list:
- Do you like your job?
- Do you like your co-workers?
- Do you feel that if your 'challenges' were to get fixed then everything would be good? (You would be happier about yourself and feel happier about yourself in relation to others, i.e. boss/co-workers)
I ask those questions because I feel that you may be opening up yourself to me vs. my employer situation. Hear me out. It is wonderful that your boss is on your side and has been helping you along. However, once it goes to HR it may start to get out of her hands. Myself, I believe in open communication and sharing but that hasn't always worked out to my benefit. I'm okay with that, but that is up to you.
You do need to get officially diagnosed, as soon as possible, so that you might be able to start seeing what prescription(s) will help you to feel happy about being you. If you have something different about how your brain operates, pushing yourself harder is just going to make you feel worse when you fail(speaking from experience). Medication(s) can assist us in many of our challenge areas.
I am not saying that you can just pop some pills and everything will be perfect. However, something close to that can happen. We are all different...that being said. Have a heart to heart with your boss and be open about what you are trying to do to get this under control. She has people that she reports to, as well. Even your co-workers.
On the plus side, you work in the medical field. I, if I was a betting man, would assume they should have more understanding and/or empathy to your struggles. Maybe, it might not be a bad idea to let everyone in on what you are going through and how you are trying to get it handled, not just for yourself, but for your team.
You probably love helping your clients and your co-workers. Some of them might feel that same way, too. But for now, they just have a big (blank) about why you aren't pulling your weight and people LOVE to play 'fill-in-the-blank.'
If you get everything scheduled and start along this journey (not like you haven't been already, but as far as everyone else knows) while everyone else is along for the ride. You don't have to share everything, but the ADHD symptoms for sure if they relate to your ability to produce at work, then yes.
Okay, I went really long. but there is so much to say. LOL I am rooting for you and if you ever want to chat about this to an almost 53yr, old dad, then hit me up.
Thanks so much for your great response to my post Brian. I'm OK with long - I tend to write long myself - my poor counselor I've probably written her a book worth by now...
I like my boss and my coworkers a lot - we have a good team and nice atmosphere at work - it is just frustrating I can't meet expectations and keep having to be called on it... I'm a people pleaser and hate being in trouble... or feeling like I'm letting the others down, not doing enough or whatever...
I think if my challenges were some how fixed I would be a lot happier at work... and actually the things that frustrate me most at work are probably related to my challenges...
I like working with the patients - most of them anyway - you do get some grumpy ones or intimidating ones sometimes - but there are a lot ones that are nice to work with... and sometimes - wish it was more often - but sometimes I get a patient where I feel I am able to make a real difference - and they are grateful for my help - and that makes me feel really good - fulfilled - and reminds me why I wanted to be a PT in the first place... There are also some times where I get a patient that I feel like my strengths and temperament are especially helpful - and I can do well with the patient that I think would drive some people crazy but I can do well with because of my particular temperament...so that also makes me feel good when that happens...
Thanks for your thoughts on being a bit more open with my coworkers - part of me wishes I could explain so they would understand... they are great people - I wish my problem didn't have to impact them negatively - like increasing their workload because I can't help out with extra patients sometimes when we are swamped and I am too behind to pitch in and help...
For the HR thing - I think they are already "involved' to a degree... My boss told me they have asked her "why is she (me) still here?" because of my productivity problems - she gets pressure from them (or someone higher up) to have the department be productive - and she has to report on productivity and overtime etc... and she says I am almost always on the list for overtime and she can't really justify it... (because my productivity isn't enough to merit it - and it's not like everyone else is getting overtime all the time - so to have a low performer also staying overtime.... doesn't look great... Anyway - at least a couple times in the past she told me HR might "talk" to me... but so far they haven't... it has been awhile since she told me that... but eventually if I can't get it together or get accommodation they will probably get more involved than they are now...
My counselor thinks I need accommodation - she was wanting the request for accommodation to come from a diagnostic person with a higher degree than she has because she thought it might have more weight - But she is thinking I need to go ahead and get something about it to HR so she is going to write me a letter telling them she has giving me a preliminary diagnosis of ADHD and we are working on getting tested etc... She told me today she would write it so I don't know exactly what it will say.... after I get the official diagnosis she said she can work with the psychologist on coming up with accommodations - since she know me better she know better what to ask for or recommend (we've been working together for 1 1/2 years).
I just finished working for 28 years (26 P/T post children) at a country hospital as a physio and can relate to a lot of what you talk about including forgetting names!I’ve only had a diagnosis for a few years and have not tried medications but have found singing mantras, especially on the way to work helped a little. We didn’t have the option for overtime and I recognised I was less ‘efficient ‘ than others so usually just worked at least an hour late unpaid, often two , getting my notes and hand overs done. I have always loved my work with patients and the problem solving so just saw it as the price I had to pay. I see an OP colleague struggling( were ‘partners in crime staying late) and have thought with 1 in ?8 people having ADHD it is about time workplaces could offer more support and training to help as well as increase awareness.
Thanks for your reply Bella - it is good to here from someone in my field who can understand . I relate to what you said about staying late to finish notes - I used to stay 1-2 hours off the clock almost all the time to try to finish my notes and hopefully help "make up" for my inefficiency... but my boss learned I was doing it and she said it is absolutely NOT allowed... she said it is illegal... She called me on it a couple times and said if I do it again we will have to "do something" about it - I suppose get HR involved - so I can't do it anymore... it seems like if I want to donate might time to try to make up for my inefficiency that would be my choice - but they can't allow it - I guess the hospital could get in big trouble if you are working and they are not paying you for it...I guess even if it is your choice... My boss said working off the clock is a "work around" anyway - and not fixing my problem and she wants me to fix/solve the problem... I guess it was a crutch to me and it's a crutch I'm not allowed to use anymore...I was struggling with productivity even with the crutch - but I will say it is nice getting home earlier in the evening - sometimes I got home so late it was almost time to get ready to go to bed so I could get up and do it again...
This last week I did better avoiding overtime (15 minutes for the week instead of 2-3 hours) - I told my boss Wednesday that I didn't have any overtime so far for the week and she said "I don't care if you have overtime if you have the units to justify it." - But that's the problem - I get overtime and I am often still not at what the want for 8 hours... it is rare that overtime would be "justifiable" based on my productivity units...
I also have a "buddy" that often stays late - she struggles with productivity and efficiency too (though my numbers are usually worse) - I've told her about the ADHD and she says she would be surprised if she doesn't have it though she has not gotten diagnosed...
Thanks for responding to my post and sharing your story and thoughts...
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. I relate to what you said about staying late to finish notes - I used to stay 1-2 hours off the clock almost all the time to try to finish my notes and hopefully help "make up" for my inefficiency... but my boss learned I was doing it and she said it is absolutely NOT allowed... she said it is illegal... She called me on it a couple times and said if I do it again we will have to "do something" about it - I suppose get HR involved - so I can't do it anymore... it seems like if I want to donate might time to try to make up for my inefficiency that would be my choice - but they can't allow it - I guess the hospital could get in big trouble if you are working and they are not paying you for it...I guess even if it is your choice... My boss said working off the clock is a "work around" anyway - and not fixing my problem and she wants me to fix/solve the problem... I guess it was a crutch to me and it's a crutch I'm not allowed to use anymore...I was struggling with productivity even with the crutch - but I will say it is nice getting home earlier in the evening - sometimes I got home so late it was almost time to get ready to go to bed so I could get up and do it again...
dont know where to start
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ADD meds dont help, struggling in life
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I feel alone in a full room.. 
