COVID Hazy not Stupid Lazy

[TADHD69]

I started in my new position when COVID hit. I'm in Healthcare and manage a team of nearly 200 nurses and CNAs in a very busy emergency dept. This is my first job managing a team this size. At first I was excited about advancing into such an important cause, but then things became overwhelmingly difficult. My mentor became ill and couldn't train me. There was no one else due to how fast and furious the virus conquered the teams. I've been doing my best with what little support was at hand. Self taught, I learned to survive and keep my team floating.

2 years now I've been running in survival mode and I finally have a new director. He's great. Super smart, a visionary with a ton of non covid ED experience. I want to learn from him but I'm really having a rough time. My ADHD had fully over run my ability to think, sort, learn, prioritize. I've been surviving but now I'm falling down a rabbit hole.

I keep hearing "you've done this job for over 2 years...why don't you know...." I don't want to give in or make excuses. I know I can do it. But right now my old tools for managing my ADHD are not working. My stress management is on overload. I'm so buried in work arounds... I'm having trouble unlearning my bad habits so I can make sound decisions. COVID is killing my Career! Managing a team of 12 in non covid times could never have prepared me for this warzone. Now with the staffing crisis due to a mass exudus of experienced nurses, the team I pulled through this deviation is looking at me to stop the hemorrhage of expert nurses. I can't even Remember my meetings, doctors appointments, child's recitals.... I'm losing my train of thought constantly and when I snap back to reality I feel like I've missed a lot of information. I missed a very important deadline and I know my boss thinks I'm lazy and incompetent.

Does anyone else feel this pandemic had exponentially exacerbated their ADHD symptoms and the meds and tools that worked a year ago are not helping? Does Does Gabe advise on how to stop this derailed train and get me back on track?

[GatsbyCat]

Hello TADHD69

Wow! Sounds like you've really managed to help pull your team together during these tough times of COVID.

I know that I've effected by COVID- first my job, then having to stay in all of the time, wearing masks everywhere, handwashing all of the time. It's been rough for me with ADHD and all of the new protocol and procedures.. So yeah, in answer to your question, COVID definitely has had an impact with meds, no routine, nothing "normal". I'm feeling a bit like things are just starting to get back to normal..whatever that is..

You've also lost your mentor, and really had to "wing it" during these past 2 years. Don't beat yourself up! I think with everything you have dealt with, that you have done really really well. Work arounds are not ideal, but you have made everything happen. GIve yourself some credit for keeping everything together.

Can you have someone to help you in your role? An assistant? A team lead? If you can get someone to help out with all of the administrative portions, it would really help a lot! Maybe you should tell this new director a bit of what's occurred- mentor gone, COVID hit... no execuses..just that no training..then wham! pandemic. He could be more understanding of what happened.

Seek out a new mentor or Coach, and also look into training courses offered through your work. That way, you can get the skills you'd like to succeed!

Your environment is changing AGAIN. People are burnt out from COVID, and I bet a lot are healthcare workers. Is there anyway you could take some time off for a mental break? We all need time to refresh and get away. Treat yourself and allow yourself to relax.

When you feel ready, it sounds like you already know that you need to change habits. And yes, we all need to find new processes that work for us. Here's some things I have learned during the past couple of (yeah COVID) years that help me (maybe you too?

1. My morning routing always calls for meditation: You can do a short 10min or a 20 min if I'm more stressed. The Mindful Movement is a group I like.

2. Excersize - about 30min or so depending on how much time I have. I skip weekends.

3. Get clothes ready the night before ..that way you're good to go

4. Daily planner- it could be electronic or paper- but do USE IT and update it everyday otherwise I know I will forget whatever I agreed to do..

5. Small notepad in purse or use app on cellphone for reminders.

6. Alarms set in morning for each meeting on a smartwatch or cellphone. 10am meeting set, noon lunch plans with co-worker- set.. school play with child at 6pm set alarm Get them all done, so that your day is accounted for.

7. I like deep breathing to help myself stay CALM. If you've stayed afloat and kept your team with you for these past years then you're doing GREAT!

8. No one is perfect, so don't beat yourself up.

A couple of good books:

Taking Charge of Adult ADHD- 2nd edition by Russell A. Barkley and Christine Benton

ADHD 2.0 New Science and Essential Strategies...by Hallowell and Ratey

Just some ideas for you.

Thinking about all of the people leaving- be a bit more proactive- don't wait until they leave-

Talk to your experienced people now- ask them - 1. How they are doing? 2. Are they happy?

3. Any changes needed-wanted? Listen, listen and after you've heard your people see what is common to them all. Is there something that can be changed to help everyone? If it can be changed then help do that. If they're leaving then something needs to change NOW. Maybe a more flexible time off schedule? What did you want in that role?

Just like you, I'm an ADHD person, trying to do better daily. I hope these ideas helped you.

Best Wishes

GatsbyTheCat

[Gettingittogether]

You want to get to therapy, so you can give your brain and your stress ... a good break! ... Therapy with a really sharp therapist who can dig into your workload and responsibilities and help you determine what's reasonable to expect of yourself and what's totally not reasonable.

I also think you might need a mentor and a coach, as GatsbyCat says. You might need to call around to other hospitals or contact your local nurses association and ask to be put in contact with someone with the equivalent responsibilities you have. And you contact that person (hopefully several) and you pick their brain. Part of picking their brain is picking up how much they assume they SHOULD do.

You face several challenges. One, all the duties you're juggling. Two, that you think you're not doing a good job. Three that you think you SHOULD be able to do a better job.

One answer might be that everyone in your position is getting burned out, ADHD or not. It's just that your ADHD makes things even worse! Increases your stress above an already unhealthy stress level.

Any chance you can move to a job that does not involve overseeing 200 people? Or any chance you can get approval to hire a hyper-organized assistant who helps you with the details and with reminders. Heck you might need two assistants, and this is something you want to ask other nursing administrators about. Again, this is where therapy comes in, because asking for an assistant requires a certain level of confidence. You also want therapy to help you regain your balance when you get negative demoralizing comments. There are good therapists doing online work this days, via zoom. So it's much more convenient for busy people like yourself.

Hang in there! You're in a really difficult situation.

[Hidden]

I can totally relate to the mental state you’re in and the feeling of knowing you can do your job because you’ve succeeded before until the ADD took over. I work for a medical device company as a senior product manager and we worked from home for 14 months. Been back in the office over a year. It feels like the workload never goes down and for every one thing I finish I have 3 more. My boss speaks to me the same way, I’ve been in this role for 4 years and in the field for over 30 years. I know how to do my job, but all the BS that comes my way takes away from any project focus. My boss is very difficult to work for and is all over the place. Last, I get nothing but negative feedback, it’s the management culture. That’s why we have so many people leaving. I won a disability claim because I was at the breaking point and my boss knew I had ADD and did nothing but do things that he knew I’d struggle with. I’m pretty certain they will have an exit package for me when I return.

[quicksite]

Hi TADHD69, ( Part 1 of 2 )

This feeling of overwhelm and feeling like you're falling down a rabbit hole is both familiar and terrifying, especially when you have heavy responsibilities managing close to 200 nurses. As a way of being supportive, I just want to ask a few process questions because I think your answers will help point the way.

1) At work are you a Mac user or a Windows user?

2) What about at home?

3) Is your own smartphone android or iOS?

4) Do you use, either at work or at home, a Notes app on your phone? One which lets you either tap out a note, or also does voice-to-text where you can tap "New Note" and just speak the notation and it's transcribed into text?

5) If yes, do you know if this Notes tool syncs its notes between phone and a computer (whether at home or at work)?

6) Do you ever voice-record (using your phone's app) complex or dense conversations? I do, and it allows me to relax more in fielding a big information dump just knowing I can go back and review the audio and clean up or add to my notes.

Because it's the stress of trying to keep up that actually impedes the absorption of information. It's due to the whole fight or flight syndrome which dumps too much cortisol (the "stress hormone") into your system which in turn shuts off access to your cerebral cortex. (If you're not familiar with this, here's a short article primer: additudemag.com/stressors-a... )

7) Do you use software apps to manage TO DO's (and/or prioritizing) ? Or do you use a traditional dated calendar? Either way, do either of them work well for you?

8) Do you use any of the "cloud services" to have easy access to documents, conversation or meeting notes, wherever you are?

For example: For Apple users, it's iCloud. For Google users, it's Google Drive. For Microsoft users it's called OneDrive.

No real thought needed here, it's just a small inventory. If you answer, I'll reply with a Part 2. Hang in there!

[quicksite]

SIDENOTE on ABSORPTION OF INSTRUCTIONS from boss or co-workers:

I don't know if other ADHD people share the following problem I have: My real-time processor is very slow, but it's very powerful. It would be like an older computer which doesn't have enough RAM, so there is sometimes a lag time between what you're typing — and then seeing what you typed appear onto the screen.

In my case I often have significant lag-time between what someone is saying to me in real time — and my really absorbing what was just said. So when someone is either talking fast, or with a lot of specific detail, or a large string of sentences in a row, this compounds my own absorption lag, and I literally cannot hold on to all that was said in my brain, and then respond to boss or other person. This, for me, is a prime causer of overwhelm.

I know it's not always possible to be forthright with a boss, especially when they don't have the empathy gene and thus could care less about whatever's getting in the way: "that's your problem, either get faster or this job isn't right for you" etc. If your boss tends to focus on topics like "performance" and "efficiency", you may be able to make a small bit of headway by combining some honest candor framed as an efficiency argument:

Drop-in chat, or hallway pass-by conversation:

"Oh hey can we chat for a sec on process efficiency? Not now necessarily but when you get a moment?"

Later if you get a minute or 5, make it casual vs "an issue I'd like to talk to you about".

(positive frame) "I did some testing a while back and found out a few interesting things about my brain processing style..."

"Turns out I'm more of a visual processor than verbal. I absorb data most efficiently when it's on paper and I can notate on it. And way less efficient when it's all verbal or a lot of information all at once. They could actually see a processing lag."

"I'll adapt to whichever way works best for you. I just wanted to share that because it could make information exchanging more efficient, and cut down on my having to ask you to repeat part of an instruction, which I know can be irritating..."

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It's just a thought and may have zero relevance to your situation.