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Being recently diagnosed with attention deficit hyperactivity disorder (ADHD) at the age of 34 was an eye-opening experience for me.
Suddenly I realised that personality characteristics and behaviours I’d always hated and considered to be self-limiting were signs and symptoms of the disorder rather than a character flaw.
These were things I had no control over. It was not that I was lazy, forgetful, disorganised or had no self-control. I had ADHD and there were ways I could manage my condition that would hugely improve my health, wellbeing and how I worked as a nurse.
ADHD is defined as “an ongoing pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development” (National Institute of Mental Health, 2023). But whereas young males often present with disruptive behaviours, girls more frequently have the inattentive subtype of ADHD (National Institute for Health and Care Excellence (NICE), 2023), which presents with less challenging symptoms such as distractibility, forgetfulness and excessive talking (Children and Adults with Attention-Deficit/Hyperactivity Disorder, no date).
This could be why women have been historically underdiagnosed, although recent years have seen a large increase in females diagnosed with ADHD, particularly younger women aged between 23-49 (Russell et al, 2023).
In the UK around 3-4% of adults in the UK are diagnosed with ADHD, with males out numbering women by 3:1 (NICE, 2023). This still leaves a significant number of women diagnosed with the condition. However, there are no statistics for the number of registered nurses diagnosed with the condition.
“Whereas before my diagnosis I tended to focus on the negatives, once I understood my ADHD better, I could see how it had benefitted my work as a nurse”
As a nurse with ADHD, I had always felt different from my colleagues. I tend to be quick thinking, good at solving complex problems and have high levels of empathy. However, I also lack patience, can be blunt at times and get frustrated at staff who work at a slow pace. Whereas before my diagnosis I tended to focus on the negatives rather than the positives, once I understood my ADHD better, I could see how it had benefitted my work as a nurse.
For example, when working in the emergency department of my local hospital (at that time a major trauma centre), my ability to stay calm under pressure and problem-solving skills really came into their own. I learned to trust my intuition on occasions when I suspected patients were more ill than they first appeared, finding I was rarely wrong.
Department managers often complimented me on how well I managed in high pressure situations, especially in caring for patients who were critically unwell.
Having worked in several different positions and specialties in my 15 years of nursing practice, I have found out what does and doesn’t work for me with my neurodiversity.
People with ADHD have lower levels of dopamine in the brain. If they are not stimulated in healthy ways, this can predispose them to high-risk dopamine seeking behaviours, such as drug addiction, alcohol use disorder, sexually risky behaviours (UK Addiction Treatment Centres, 2024), gambling or eating disorders (Blum et al, 2008).
For a person with ADHD, it is paramount to find a job that is sufficiently stimulating, allows enough room for growth and works with the person’s individual strengths.
To expend the physical energy that comes with my hyperactive type of ADHD, I need a physically active role. If I am sedentary, anxiety and over-thinking can lead to panic attacks and depression.
In my current job as a senior vascular access and outpatient parenteral antimicrobial therapy nurse, I walk approximately 8,000 -12,000 steps per eight-hour shift, as I cover a large hospital site assessing patients on different wards for their suitability for vascular access device insertion. This physical movement seems to reduce my anxiety.
My current role also provides the mental stimulation I need through regular training and teaching. This has included qualifying as a non-medical prescriber after 10 months of learning, helping develop me as a more comprehensive practitioner.
It was when I was about to undergo my final examinations on this course that I was diagnosed with ADHD. I have since been prescribed Methylphenidate, a medication for hyperactive type ADHD that works by blocking the re-uptake of dopamine and noradrenaline in the brain, increasing the levels of these neurotransmitters (Gottlieb, 2001). For me, this has been life changing as it helps me focus, calms my inner thoughts and reduces my impulsive behaviours.
By researching my condition and seeking guidance from others with ADHD, I have also implemented coping strategies and systems to help me manage some of the more difficult aspects of ADHD, such as disorganisation, forgetfulness and poor time management.
Following my diagnosis, I informed my work team who have been incredibly supportive and understanding. I now feel I can be transparent about my needs and ways of working, allowing me to function more effectively and helping the team be more productive. Being open and honest with other staff about how I function best helps me work in ways that enable me to be the best nurse I can in providing the highest quality care for my patients.
Helpful measures have include my team following up verbal requests to me in writing and reminding me to add meetings to my calendar. I am also permitted to carry a notebook to record phone calls, listen to music on headphones to help with concentration (where appropriate) and use fidget toys to help with hyperactivity during long meetings.
Through connecting with others and being open about my diagnosis, I am no longer ashamed of who I am and realise the many strengths and benefits of my condition I bring to patients in my care. I hope that after reading this, other nurses with ADHD will feel the same and be proud of what we can bring to healthcare.
Cassie-Jo Layzell is a senior vascular access nurse at Morriston Hospital, Swansea Bay University Health Board.
References
Blum K et al (2008) Attention-deficit-hyperactivity disorder and reward deficiency syndrome. Neuropsychiatric Disease and Treatment; 4:5, 893-918
Children and Adults with Attention-Deficit/Hyperactivity Disorder (no date). Symptoms of ADHD in Women and Girls, chadd.org (accessed 11 June 2024).
Gottlieb S (2001) Methylphenidate works by increasing dopamine levels. British Medical Journal; 322: 7281, 259.
National Institute of Mental Health (2023) Attention-deficit/hyperactivity disorder, nimh.nih.gov, September (accessed 11 June 2024)
National Institute for Health and Care Excellence (2024) Attention deficit hyperactivity disorder: How common is it? cks.nice.org.uk, April (accessed 11 June 2024).
National institute of Mental Health (2023) Attention-deficit/hyperactivity disorder, nimh.nih.gov, Sept (accessed 11 June 2024)
Russell J et al (2023) Number of ADHD patients rising, especially among women, epicresearch.org, 30 March (accessed 11 June 2024)
UK Addiction Treatment Centres (2024) ADHD and addiction, ukat.co.uk, 12 January (accessed 11 June 2024).
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