Latest / Nurse Leadership Dumpster Fire / Managing ADHD as a Nurse Leader

Transcript

Managing ADHD as a Nurse Leader · Nurse Leadership Dumpster Fire

• speaker-0: Welcome to the nurse leader dumpster fire podcast. I am your cohost, Cindy Marich. speaker-1: And I'm your cohost, Teresa Higbee. We are both nurse leaders and we created this podcast to share our most challenging mistakes we have encountered in our nurse leadership journey. Hopefully sharing these mistakes and lessons will help you avoid these on your own journey. We welcome all aspiring current and seasoned nurse leaders to tune in as we hope to bring honest, tangible and valuable lessons, tips and tricks, regardless of where you are in your nurse leadership journey. speaker-0: We need to note that while Teresa and I are both employees of the VA that this podcast is not a reflection of or endorsed by the VA. This podcast endeavor is separate from the VA affiliation. Our stories will be adapted to protect the anonymity of staff and colleagues that we've interacted with, but we will do the best to convey the gist of our story and the take-home lessons. We will of course also be protecting any potential patient identities to comply with HIPAA and privacy laws. Thanks for listening. speaker-1: you you speaker-0: Yeah, what we want to talk about today, which is overcoming some challenges that you may have as a nurse or a leader. And I think we've mentioned this a couple of times on previous episodes that both you and I have at least some symptoms of ADHD and how that has affected our journey and how we have been able to work with it and maybe turned it into a superpower. speaker-1: you things that have worked for you and I within our jobs and hacks that we did. One thing we did really well together was like parallel work, kind of like kids when you parallel play. And that one was really successful for us. What did you find with that when we did it together? speaker-0: I didn't even realize it was happening until like after we'd been doing it for a while. I guess we'd work and we used to share an office. And so we'd both be working on our own thing and we were pretty comfortable with just being quiet and doing our own work as a independent task. But then if either one of us ran into a barrier, we'd just be like, Hey, what do you think about XYZ? You know, do you like, and we could just have like a quick side conversation. split from our task for a minute, solve that barrier, and then go back to it. And that worked really well. When you left my office, when I went on my detail and I had to be in an office by myself, I very much missed having that tool. I didn't realize it was a tool until I didn't have it anymore. speaker-1: It's so funny how we just like kind of sometimes adapt naturally without even realizing that's what we're doing. The other thing we would often do, and we did it a little bit, we would sometimes just get on a call and do it when you were in the other office. The other one is like, or just sharing documents back and forth with each other and allowing each other to help each, like you'd be like, I don't know what else to say on this. Can you fix this? And I'd be like, sure. And you would, I would do similar things. speaker-0: But it worked the best if we were both in that mindset of like being very fluid. Because if I had said, hey, can you read this document? And then you're so hyper-focused on something else that you don't look at it for two days, that didn't help me at all. Like that, was like by two days later, my brain is onto something else and I'm not focused on it anymore. So it worked really well when both of us were in that very fluid momentum. Which brings me to another ADHD trait. that you touched on before, which is the hyper focus, which can be then followed by hyper unfocus. And I struggled with that as well, where, you know, there'd be days that we just were like, today is not a productive day, just isn't happening. speaker-1: Yep. And sometimes I accept those days and I just, what I try to do with those days is like, you know, maybe today my goal is to just connect with people. So it's like, today is a wandering day. I'm to go out and wander around. And sometimes I just take candy with me and drop off treats or something, because I'm like, I don't know. This is, this is just where I'm at today. speaker-0: And that's something that I think is another superpower in another way. Maybe it's like a gift that you didn't expect because getting out and making connections with frontline staff and leadership, can, as you get really burdened down with all the tasks and the responsibilities, it can feel very difficult to go back out and connect with people. And so if you're like, well, I'm not getting anything done now anyway, I might as well go out and chat with people that also then that's, it's not like, it's not, it's not unnecessary or it's not unproductive. It's productive in a different way. speaker-1: Well, relationship building is always going to add value to your leadership because the more you move up or even staying in your role, the more you're able to connect with people, staff, others, you get, you build connections, you have more resources and you get better buy-in when you do have major projects and they realize you're the one behind it. They're like, well, I know that person. I feel like I can, and they feel a little bit more like if you are making your rounds next time and they don't like something about it, they can tell you and you know that. So I think that's where that value. speaker-0: comfortable say that to you. So you're not just over there going, why is none of these things working? Because nobody's giving you the feedback up the line because they just don't feel comfortable reaching out to you. yeah, doing that unstructured relationship chatting, which might happen to be on a day that you just aren't getting anything done, is serving another purpose that will help save time down the road because the higher the trust level is with your staff, the faster you get stuff done. you don't get as much resistance, you don't have to micromanage as much. that's a not a task, that is a strategy that we both have used, which is recognizing when it's futile to get stuff done and finding something that you can do right now that may serve a different purpose. speaker-1: One of the other things I do to help me with that, so like tasks splitting or whatever, I keep a running list of to-dos. And if I do get stuck on a specific thing, I will move to another project frequently because I'm like, okay, I'm stuck here right now. I don't know how to get around the barrier at this moment. I know I will be able to figure it out. I just can't at this second. And so I'll move to the next thing and maybe get one thing off of my list that sometimes that helps relieve enough of the pressure that then my brain will be like, I have it. The connection and the time and the talking will be like, ⁓ now I know, I see it. speaker-0: Sometimes your brain just needs to have a break of thinking critically. So sometimes, which I do still, I still do this all the time and we used to do this together as well, is sometimes it's like, okay, let's go take a walk around the block or let's turn the lights off for five minutes and close our eyes and just do a short mental reset. Or now I might go sit in my car for 15 minutes and close my eyes and just do kind of like a short meditation. And I find That often helps reset those synapses so then I can come back and I'm calm and I'm ready to focus again. speaker-1: Yeah. One of the ones that we both have done is making the small goals that will help align with our bigger vision. Because that helps with that little checklist mentality of like, oh, I did do something with that today. Right. speaker-0: We also were pretty good about congratulating ourselves when we got small tasks done, because it felt silly. And I think both of us probably don't innately feel super proud of ourselves when we get like, I checked my email today. But we kind of made it into a joke, but I think there's some weight behind the words that you use and the way that you communicate. So we could say, look at us. We got through all of our emails and we got this part of our checklist done. Go us. We did it. And even though it felt so speaker-1: Exactly. speaker-0: it still helped you feel like kind of accomplished. speaker-1: think it's funny how even this morning, for example, we're having challenges with our sound. Our computers aren't working. Your internet was struggling. My internet was struggling. It's just a conglomerate of random things happening for no apparent reason. But in that sense, if we relate it back even to creating this podcast, this is a big project. It's not like, well, yay, we're going to do a podcast. Let's turn on the TV and play with our phones. It's a project. You have to understand a lot of different aspects. So, and we're really passionate about the way we went into leadership and the challenges we faced and the challenges we continue to face. And that's part of that passion and excitement. We want to share that with other people. We want to talk about it. We want to bring things to light. So that part also helped us continue this project. What else do you think about that? speaker-0: Yeah, well, I remember talking about if we start a project like this, we know that this is going to be something that's going to be ongoing and both you and I have trouble with continuing or following through on things. And so we had talked about how are we going to make it easier to continue on. And I think one of the things we talked about was that we wanted to have a strong vision, which started with that passion. We both have a passion for what we're doing and we want to share and make these experiences better for other people. But then we also needed to have some flexibility because if we were planning on doing a recording on, I don't know, like we talked about doing an, future episode we'd like to do is. sort of the dichotomy and walking that line between different elements in leadership, like holding people accountable versus engagement. Like it's a balance and a lot of leaders struggle with finding that middle line. And we want to do a recording on that. And we talked about doing that recording this week, but then we both were like, well, I feel like I need to do some more research first. And I don't have a clear vision of what that looks like. So I want to do that, but we're not ready for that right now. So let's table that and go to something else. And so we've made it pretty flexible to be able to move within the minutiae topics with the overarching goal that we're trying to have conversation. We're trying to build community. speaker-1: Exactly. One of the other things is like, for example, and you'll see with this episode when we finally get it together is the letting go of expectations that it will be perfect. We're going to have these recordings in these days, but we can't, we're not just going to be like, well, I guess we'll just not do it. We're going to still do it. It's just going to look a little different this time. Yeah. speaker-0: ⁓ What do you think? So we're both supervisors now. I'm sure that you've experienced working with employees who have ADHD symptoms. How have you helped them be successful? speaker-1: Usually first you have to identify that they're struggling. Sometimes you won't notice until they don't accomplish something or they forget completely about a task you assigned them. That's what I've seen, because they don't always recognize they're doing it. So a lot of times what I do is in my one-to-ones, I have them bring their computers and we go over, I go over how are you organizing yourself and what is your current system? ⁓ is that system working for you or not? Do we need to find a different one? For example, I have a gal who's not great at technology either. And she was struggling a little bit with organization, but she was using her electronic one note to help track her stuff. But she's not used to using her one note. So she wasn't going back to it. So it didn't matter. So she did what I did. She recognized, she saw mine notebook on my front desk and she's like, she went and got one similar. She's been using that and she does the same technique you do. She has to fold it because she's like, if I get rid of it. I'm scared I'm missing something later or I took a note on something that I need. And so that works, right. And she paper clips it or holds it so that it holds her spot for different things using different technologies and then just different strategies. I don't know. What about you? speaker-0: So I have one employee who has some pretty significant ADHD symptoms. She's on meds, but even with the meds, really struggles to, she struggles with deadlines, I'd say, a lot. And she's got really good ideas and has really creative solutions. But if I give her an assignment I've found, like sometimes I come back and I'm like, what's going on with that? What's going on with that? And Sometimes it comes down to, she didn't understand the assignment and so she just sort of didn't do it. And so I say, okay, well, let's stop and talk about what this looks like and what I need from you exactly. And then when I do that, I will send her an email usually kind of breaking down of I need you to do this, this and this, and here's your deadline. She's asked me to try to send her meeting invites to of when deadlines are, but I told her that's not a realistic expectation. can't. I'm not, I'm having a hard time keeping my own deadlines. Like I can't keep track of your appointments for you as well. So you need to be able to do that part. But we have a, she's part of a bigger team and we have on teams, I have a group chat. And so whenever there's something that's related to the whole team that I'm thinking the next time we all meet, I want to make sure we talk about something or we review something that we're supposed to be following up on. I put that in the whole team chat. Because my philosophy is that if her peers who sit in the room with her also know that there's an expectation to have something delivered on, they will help remind her as well. So I kind of also lean on her peers who don't struggle with those things as much. And one of them is very organized and always she's got like charters upon charters of like what project she's doing. And so I try to have the team work together so that they utilize each other's strengths to get things taken care of. speaker-1: That's a good strategy. I had a similar experience with this gal, like her needing me to manage her stuff. And I'm like, I can't, I don't have the capacity to manage yours. Babysitting you is not something I have the capacity to do. And as I've taken on more responsibilities, the less likely I'm able to do that. So just being realistic with yourself and helping them find the things that are going to work for them. Cause it's not always, it's not going to be the same for every person either. speaker-0: And I think if you try to handhold or babysit the person who's struggling with that skill, it's not actually helping them. You're really just enabling their handicap. Like they have to be able to find tools that are going to work for them, which is another one of the strategies that I think I forgot to mention that came up in some of my research. This was from the Journal of Work Applied Management that they recognized that giving people autonomy is actually very important for allowing people with ADHD to be successful. because they have to be able to find their own systems that work. If you try to tell them, hey, you need a planner and you need to do it this way and you need to use my system, like your system isn't necessarily going to work for them. And that's probably going to, I guess, cause them to lose interest or it just, doesn't, it's almost like if you have ADHD, like you have to be the one who's initiating it so that you're bought into it. Right. So I think. giving them the autonomy and then giving them the clear expectation and say like if you want some advice on some tips and tricks I can talk you through that but ultimately like you have to be the one to find a way to be successful I can't make you successful for you. speaker-1: My little doggie right there watching me. speaker-0: Bye! speaker-1: Yeah, he's a good boy. Figure we've, Doggie has to make a cameo. speaker-0: Yes, let's see. think so. Another thing I feel like we are doing with this podcast is that we try to check in with each other multiple times per week, which keeps it on the front radar of our brains to just say, what about this idea? What about this post on social media? I got this question. We should talk about it. I think that that accountability back and forth between each other has been very helpful so far. speaker-1: One thing for me that also is helpful, and I don't currently have this set up where my current station is, but whenever I have a vision, what helps me is seeing it regularly. So we've done that in our personal lives a couple of ways. We usually make vision boards for our year. At work, I have a whiteboard that sits across from my office and I have the VA's big vision and mission written up there, my personal department, and then my individual team's vision. speaker-0: Huh. speaker-1: and or mission written up there. And then I have projects and then I have goals within my own things kind of written down. And then in the center, I have a thing, it's called the growth mindset. That is Carol Dweck, believe wrote that book about it. So I just want to give credit where it is due, but I have a brain, a picture of a brain on my thing and it says, ⁓ fixed mindset and growth mindset types of statements that you could be saying. So, and that's just like right there so I can see it all the time. And I think that- is helpful to see those visual reminders. speaker-0: So question, did you draw the brain or did you print it out and tape it on? speaker-1: This one I found, it was a image that I had bought and I bought it for a couple of people and I gave it to them and I have the poster. I am not super artistic in drawing. My creativity comes in seeing bigger picture, how to, can see a room and rearrange it in my brain or different things like that. But creativity as far as like drawing, not super great at it, but I have other things that I'm good at. speaker-0: Well, I remember you've made really awesome visual concepts. So when Teresa and I were managing together, one of our big challenges that we had to take on right away, which was a really awesome innovation project that I feel very proud of to this day, which was that we had to redefine the way we were doing education in the ICU. And so we got together a group of people and did some innovation brainstorming. had all these different people kind of contribute their little strengths to create something. I didn't know exactly what it needed to be, but I knew that we needed to be able to educate faster and more efficiently because we were losing all of our experienced nurses at the height of COVID. People were retiring, they were going to travel. We had very high risk patients and very low amounts of people that knew how to do all the things. And so we created this program called the master preceptor program, which meant we had two people we dedicated as education specialists. One focused on didactic education and the other one focused on simulation. And then we created a critical care class that was based off of the ECHO modules. And Teresa was a huge backbone of this because she had also developed a simulation-based training program in a previous job. And so had already seen how this had been successful. And I think you kind of were like a little bit of the buffer around this, like where this project was going. But then when we got to the point that we were like, what is actually that we're doing? You made that really awesome visual framework. I don't remember what program you put it on. speaker-1: I want to say it's probably on Microsoft Publisher because I can move things around and kind of design it how I want to. That, Vizio works pretty good. Sometimes PowerPoint is the best one to make it in, but Publisher, you can like really move things around and edit them how I want. So. speaker-0: It didn't look like a Venn diagram, but it had the concept of like a Venn diagram where it was like, here's all these different roles. And it was like the manager of the unit, the educator of the unit, the staff person of the unit. And we had a different position called the education coordinator. And it was like, what are each of these people doing? But then there was this overarching that if these people aren't working together, this program is not going to work. And so when we went to expand that program, which is now Teressa's baby, by the way, she is like her whole job now, because she just like took it and made this into a whole hospital wide program. But that's what we were you were finding, right? Was that sometimes the managers were like, well, that's the educator people's job, and I don't need to be involved. And whenever that happened, the concept kind of flopped, right? speaker-1: Yeah, one of the big things when it comes to education, if the manager doesn't make it a priority, the staff aren't going to make it a priority. I don't care if the educator is working and putting a hundred hours in trying to make something work. If the manager doesn't set the tone and the expectation and be like, Hey, this is what I want to see out of this everybody or Hey, we need to do this. Now it doesn't have to be a, ⁓ the managers have to be heavily involved. They just need to set that expectation. And then once it's set and they. If they have any issues, now the educator can be like, hey, and so doesn't want to participate. Cool. Let the manager deal with that issue and let the educator move on and focus on other things so that they're not like chasing people and like, which I think is still going to be part of that process. But the diagram did help. still use that diagram today. I've added and made some edits and when new leaders or new managers come in, I usually take the time to go over how do you make your teams function well together? speaker-0: learned the importance of using visual aids from you, from you making those diagrams. And since then in this new role, I've found I'm often asked to help coordinate processes that have multiple stakeholders across the facility. from different service lines and they all have a different expectation about how this process is supposed to go. And so I'm trying to like get, I don't know, 30 people with differing opinions to come together on one consensus process. And the only way I've been able to do that is to use visual diagrams. And so I've made flow maps and, you know, I'll say it's kind of like, you know, okay, what's the first step that happens and then what happens? And I'm like building it as we go. We finished the meeting. I go clean it up. I send it out multiple times for feedback. Is this correct? You know, do you like this? Did I say this right? And that has helped me get people on the same page and help improve communication and efficiencies and processes. if you want to know about building visual aids, you should email Teresa and ask her to send you some examples because she's really good at it. speaker-1: Yeah, I can. can take this is actually an ADHD symptom of mine. When you say a bunch of words to me or give me a bunch of things that I'm supposed to understand, I'm like, what? And so the diagrams is a way that my brain takes that information as like, okay, so I have to do this, this and this and this, but is all of that my responsibility? And so then that's kind of how my, can't always verbally explain everything that's in my brain, but I can in a diagram. did it actually with a, one of our, team members in executive leadership had an issue pop up that was an unintended consequence type of a thing. And she was like, I don't know what to do about this. And my brain was like, ooh, I have four or five ideas right now. But I don't know how to correctly give her those ideas. So I made a diagram of this is your problem. You can do this depending on X, Y, and Z. Or you can do this depending on X, Y, or Z. Or with five or six different solutions. to her problem, but I didn't know how to tell her I have five or six solutions without just giving them to her in a diagram. each one depended on whichever barrier or process she may have needed. So I don't know. speaker-0: And you made some really good communication trees, decision trees like that when we were working together as well that was like, here's your problem. Do you need to do this or this? Go this way to this person or go this way to this person? Did you try this yet? Yes or no. And so then you had like sort of this feedback loop. Didn't you make like a big poster of that and put it in our conference room? Yep. speaker-1: And actually I did some walking around recently and that poster is still being utilized. It's actually moved out to the main station area so that staff can see it more and providers can see it because it includes how nurses communicate with providers and at what point the nurse is allowed to go above the provider in front of them and use the chain of command. It's essentially a chain of command tool on how to like, I'm going to my charge nurse, I'm going to the doctor, I'm going to this person and now I'm both the charge nurse and the Like at what point you go straight to the attending. Because sometimes staff don't know when to do that or when it's appropriate and they were struggling with that and communicating issues about patients effectively. It's like no, if they're not understanding you, you need to ask for help. And this is the way to do it. So they still use it and refer to it. speaker-0: Anyway, speaking of tangents, we just want to mention about diagrams, but I think that it's a good tool to have if you are struggling with figuring out what the heck you're doing and how to communicate that to the people around you. so hopefully this was a little bit helpful to you. The, my hope from this is that a, you learn to embrace your ADHD symptoms, understand that they actually can give you some superpowers and just learning how to harness those in and hope. Hopefully, we gave you a couple tools if you're struggling, especially in leadership. think it can be challenging as a bedside nurse, but once you sit down at a desk after you've been a bedside nurse for a number of years and you're used to just thinking while moving, it's a big transition. so hopefully, this gives you some ideas on how you can be successful. speaker-1: Yeah. Thank you guys for joining us on this ADHD episode. Thank you so much for tuning in and listening to us and joining our nurse leadership dumpster fire podcast. If you have any ideas on topics or want to connect with us, you can reach us on Instagram at nurse leader underscore dumpster fire underscore podcast or via email at teressa at aria and nurse circle.com or Cindy at aria and nurse circle.com. speaker-0: If what we've been talking about resonates with you, please like and subscribe to support our channel. Thanks and bye!