There are many things about ADHD that contribute to being a wonderful nurse. For example, individuals with ADHD are likely to have high levels of empathy, they are spontaneous, high levels of courage, the ability to hyper-focus on a task, and amazing attention to detail. Unfortunately, there are also struggles that come with being a nurse with ADHD such as lack of general focus, inattention, and poor time management. As a nurse one of my biggest struggles has been time management. When I was hired into the ICU as a new nurse I was required to work for three months on a medical surgical floor first. I laugh when I recall crying in the storage closet every day feeling completely overwhelmed with feelings of inefficiency trying to manage all the tasks. All eight of my patients needed things at the same time that they felt were most important ranging from pain medicine, medication for high blood pressure, a walk, a bed bath, a turn, fresh water, ordering lunch, and countless others.  

Fast forward nine months and I began a job in a nationally ranked Neurosurgical Intensive Care Unit. This position was vastly different than the 10 bed Medical ICU in the small town I had been working in. The struggle with time management only became more intense. Whereas in the medical ICU it was required to assess the patient every four hours, input and output every two hours, and medication management, the Neurological/Neurosurgical Intensive Care Unit had a much more regimented set of monitoring which included hourly neurological assessments, the amount of fluid they received as well as the amount the patients put out (through surgical drains, urine, etc) every hour, drawing labs at a certain time, changing the rate of continuous infusions to keep patients alive, charting, updating and educating families, changing surgical dressings, monitoring the pressure inside the head hourly, and many more important tasks.  

All the tasks on my “to do” list felt like trying to paint a multidimensional piece of art with the same color grey. Having timed tasks that coincided with urgent tasks starts from the moment I clock in. Trying to organize the mountain of tasks heightened my anxiety and I found I would lose track of time as I was focused on a particular task at hand.  

Once the tasks were (somehow) complete as a nurse I must take time to chart the information for doctors to see on the computer so they can recall it at any point. Charting has always been my bane of nursing because there is always something else I could be doing that (to me) felt more important.  

All nurses have what they call “a brain” which is a sheet of paper that they take notes about the patient that they deem important. I developed a report sheet that worked perfectly for my ADHD mind. Not only did it have defined boxes for each body system, but it has a table at the bottom to put tasks, when those tasks are due as well as the important numbers that needed to be documented throughout the shift (Input/output, intracranial pressure, increase rate of tube feeds, and other similar notations). Once I began using the sheet I created I gained the ability to see the tasks in a more organized way of priority. Not to mention the way it was written on this sheet gave me the ability to use recall that “something” was due at a certain time.  

There have been other things I have learned through the years to help with my time as a nurse. I have learned to set alarms if something needs to be reassessed like pain and blood sugar. Not only do I use alarms as reminders to do a task, but I’ve also found it helpful to set them to remind me to move on from a task. We have the ability to become hyperfocused and get lost in doing something without realizing the amount of time that has passed, so setting an alarm to notify us five minutes before we need to move on to something new is very useful for ADHD Nurse brains. I’ve also started using the Time Timer Watch for things such as IV push medication that I have to administer over a certain period of time like tPA and Lasix. It is easy to second guess exactly what second you began your 60 second countdown, or the exact minute for the four minute IV push. I love having the ability to set the exact time and visually see the time changing. There are many things to overcome as a nurse with ADHD, especially considering our natural struggles with time. Thinking outside the box and utilizing methods and devices that work for us can be empowering as we start to become nothing short of incredible in our field. 

About the Author:

Jami Fregeau is a Registered Nurse who creates educational and supportive content for neurodivergent individuals through her podcast, The Neurodivergent Nurse and lnstagram account. Jami knows personally the difficulties of living and thriving with ADHD. Her diagnosis came in December 2020 at the age of 36. She spent most of her life struggling with social anxiety, lack of self-esteem, and self doubt unknowing much of it was due to being neurodivergent with undiagnosed ADHD. This became a catalyst in creating a safe and welcoming community for individuals to ask questions and find likeness in shared experiences. Jami is nationally certified as a Critical Care Registered Nurse and been awarded North Carolina's Great 100 Nurses. She facilitates diversity education through her local hospital educating Physicians, Nurses, and other staff the importance of recognizing inherent biases and inclusion in professional and day-to-day practices.

Most often when people hear about ADHD (Attention Deficit Hyperactivity Disorder), they think of children or adolescents. That’s likely because overall awareness of ADHD diagnoses and intervention strategies in schools have increased significantly in the last few decades. Children with ADHD often have difficulty in school and social settings, and positive developments have led to helping those kids succeed academically more than ever before. 

As physicians, educators, and researchers dedicate more attention to understanding the disorder; great strides have been made in approaches to academic interventions, medication management, behavior plans, and much more. 

ADHD is not only diagnosed in children. According to the American Academy of Family Physicians National Research Network, four percent of U.S. adults have ADHD. Many of these adults may have gone undiagnosed as children, leading to a worsening of symptoms over time. This can create significant difficulties with personal and professional relationships, productivity, and self-esteem. 

When children with ADHD reach adulthood, they need to continue maintaining coping strategies and methods for dealing with its challenges in adulthood. For adults, these difficulties may manifest as late work assignments, difficulty with productive time management, forgotten to-do lists, an extremely disorganized or messy home or office, and a tendency to have difficulty finishing tasks at home and at work.  In the workplace, an adult with ADHD may be perceived by co-workers as forgetful, disorganized, disinterested, and unproductive.  

Success strategies that work for one adult, may not work as well for another. Everyone is different and it may involve some trial-and-error. These tactics will evolve naturally as an individual moves through various stages in life. Much like the difficulties children and adolescents may face, adults with ADHD need to work in overcoming struggles interfering with home life, professional achievement, and much more. 

While it may improve somewhat in adulthood for many, ADHD symptoms generally are always part of the “fabric” of a person. The good news--the natural process of “maturing” often provides a boost for successfully dealing with the inevitable ups and downs that come with ADHD.  

That said, just as children need structured support in tackling ADHD challenges, adults too need support from family and professional colleagues, as well (if they choose to share the information). Among those personalized approaches, all of us at Time Timer recommend creating time management strategies designed to make life at home and work go as smoothly as possible! Time management techniques provide some of the best tools for reducing the stress and anxiety that often come into play for adults with ADHD. 

Are you an adult with ADHD? Take control with these time management tips! 

1. Tackle work in “chunks” 

An adult with ADHD may arrive in the office each morning and become quickly overwhelmed with the number of tasks they seem to have assigned to them. As is highly common in those with ADHD, procrastination is likely to follow, which can cascade into a host of bigger problems and job difficulties. The same is true for accomplishing decluttering or other household chores. Perfectionism may also play into this – another common trait in those with ADHD.  

Instead, adults with ADHD should begin their workday in a quiet setting free of distraction, if possible, to review their day and make a realistic list of things to accomplish. From that list, extract the priority items and get started from there. An especially effective tactic here is assigning a specific amount of time for each task – make it realistic and something you can accomplish! Choosing Time Timer, the original visual timer, can make a huge impact in your efforts. 

This way, viewing the workday as one long “stretch” of eight hours can be broken into just a few structured “chunks” of time where very specific items are to be accomplished. Using Time Blasts, a more flexible version of the Pomodoro Technique, time management tool proves helpful to many people with ADHD. When adults with ADHD complete a very specific set of tasks, a sense of accomplishment and satisfaction are sure to follow! Lastly, never be ashamed to ask for help or delegate when needed. 

2. Use a physical planner 

When combined with using Time Timer throughout your day; a physical planner is another great way for adults with ADHD to manage their time, responsibilities, and goals. Many adults find it helpful to use both a physical and web-based calendar, yet a paper planner may prove particularly effective as many with ADHD find various visual cues to be helpful. 

Some planners are designed to be particularly helpful for adults with ADHD. One example is the Define My Day™ Planner and Journal. Its primary focus is helping adults avoid distractions in their lives and create detailed plans and tasks for each day – perfect for adults living with ADHD. 

3. Do not multitask! 

While many people excel in multitasking, it can create huge roadblocks for adults with ADHD. Don’t multitask - stay focused on one thing at a time. Distraction issues may lead to lots of unfinished projects and an increase in low self-esteem. Instead of attempting to complete eight tasks with 50 percent success, focus on completing one task at 100 percent. 

When you are ready to tackle your own time management difficulties, do what works for you and secure the tools you need to help you feel successful and accomplished! Time Timer offers a range of amazing visual timers perfect for both children and adults living with ADHD. With the right support and planning, it is possible for adults with ADHD to live a focused, calm, and accomplishment-filled life! 

Routines to Set Children with ADHD up for Success at Home  

 
 
If you’re a parent of a child with ADHD, you know how difficult simple areas of the day can often be. Getting out of the house for school on time? Chaotic. Having your child sit down after school to finish their homework? A battle. Getting through the bedtime routine? Exhausting. 

You are not alone. One of the key components of ADHD is that symptoms occur in more than one setting - such as both home AND school - so it makes sense that multiple parts of the day become difficult. 

Children with ADHD have both inattentiveness and hyperactivity/impulsiveness that affects their ability to pay attention, remember items or steps in a sequence, stay organized during tasks, sit still, wait their turn, and carry out verbal instructions. This is not their fault - there are both genetic and neurological factors at play. 

One of the best ways to help children with ADHD across the board is to establish and follow consistent and predictable routines at home. Routines can be defined as a series of steps that happen in a particular order, in the same way, and at the same general time from day to day. Routines provide predictability, which helps your child know what to expect, what is expected of them, and how that experience is going to look. All of these things help the day run smoother! 

Though many parents already follow routines at home, there are four key components of routines that work particularly well for children with ADHD. They are: 

1. Movement - Children with ADHD need to move. Their bodies often require a higher threshold for sensory input (particularly proprioceptive and vestibular input, fancy terms for body awareness and body movement), and so movement that is sensory-based helps provide their body with that “just-right” amount that is needed to stay regulated. Rhythmic, linear movements, such as jumping jacks, and “heavy work” activities, such as push-ups, are the best kinds of movement. 

2. A decluttered space - This decreases the likelihood of distraction, as many children with ADHD are distracted by things that they see in their vicinity. Choosing a set place that is tidy to complete specific routines, such as completing homework, can help your child stay on task. 

3. Using timers - Visual timers, such as the Time Timer, allows your child to SEE time. This helps the concept of time become concrete. Timers can be used to transition to a routine (such as 10 minutes until bedtime) or to allot time that a routine will take place (such as 25 minutes to complete homework). 

4. Using checklists - Checklists are another way your child is able to better internalize their steps or responsibilities of a routine. Children with ADHD often have difficulty following directions that have multiple steps or tend to get lost or distracted in between steps, so writing them down and checking them off as they go can be very helpful. If your child can’t read yet, you can use pictures instead of words. Checklists also help YOU, the parent, from having to repeat yourself a million and one times. 
 

Keeping these four components in mind, let’s go over some sample routine ideas for three key parts of your child’s day. 
 

Sample Morning Routine 

• Wake up - Set a timer for the amount of time until you need to be leaving the house. 
• Wash up in the bathroom (Use toilet, brush teeth, wash face, etc) - Post a checklist in the bathroom to help your child remember what they need to do. 
• Get dressed - Choose the outfit the night before and lay out the clothing to keep mornings running smoothly. 
• Eat breakfast 
• Brush teeth 
• Gather belongings - Keep belongings in the same spot nearby the door so your child knows where they are. Post a list with words or pictures of the items your child needs to leave the house (shoes, jacket, backpack, lunch box, etc) 

Sample After-School Routine 

• Enter home 
• Unpack belongings - Have a clear, set place where your child places their shoes, backpack, and jacket. Use hooks, labels, and checklists to help them remember. 
• Eat snack 
• Outdoor play or 15 minutes of indoor movement - Jumping jacks, freeze dance, Go Noodle youtube video, etc 
• Complete homework - Have a predetermined tidy space, set a visual timer for how long they are expected to work 
• Preferred play activity - This helps them have something to work towards when completing homework 

Sample Bedtime Routine 

• Set a timer for how many minutes until bedtime 
• 10 minutes of movement - Consider whether your child does better with high activity movement before bed or something calmer like following along to a yoga video 
• Change into pajamas 
• Brush teeth 
• Read books 
• Lights out 

There you have it! As you can see, simple routines are best. It does not have to be complicated, but keeping these parts of your child’s day consistent and predictable can truly be a game-changer. The Time Timer is a great tool to use within these three routines and more. Click HERE for my affiliate link. 

-- 

Jessica Rapp Irwin, OTR/L, is a pediatric occupational therapist, childhood routine expert, and lover of all things child development. She founded Rooted in Routine, an online parent coaching platform, to help parents learn simple, easy to implement routines for optimal child development starting at age one. She is passionate about educating parents on NORMAL, HEALTHY development, which is often simpler than we think. Jessica’s approach is largely rooted in going back to the basics to help you establish solid, age-appropriate routines for your child for things like eating, play, and sleep. She believes this is the most important foundation you can provide for your child - and she wants to help you do just that! Learn more about Jessica at https://www.rootedinroutine.com/about and follow her on Instagram at @rootedinroutine.

Research tells us that adding choices, visuals and hands on activities are beneficial for students diagnosed with ADHD, but what does that look like in our classrooms? Here are 4 tips for applying research and supporting students with ADHD. 

ADD IN CHOICES 

When students are able to make choices about their learning, they feel valued and invested. Giving choices doesn’t have to be disruptive to your classroom. These examples allow the student to feel in control without being disruptive: 

• Would you like to write the sentences on the computer, paper or whiteboard? 
• Do you want to work at your desk, standing by the table or on a beanbag chair? 

• Would you like to listen to music while you work? 

None of these choices will create havoc, but they all will incorporate the movement and input our students sometimes crave. 

VISUALS 

Use visuals to support sequencing, initiation and following directions.  Visuals could be pictures, clip art, photos, text or a combination of all types. One of my most favorite things about visuals is how they are able to be faded. 

It's important to remember that we need to have a plan for fading any prompts we add in. Without fading, the student will need help lifelong. Read the blog posts below to help create plans for fading supports and helping our students to be more independent. 

• Using Visuals To Reduce Prompt Dependency 
• Visual Supports Improve Behavior and Classroom Management 

ORGANIZE MATERIALS 

Students diagnosed with ADHD often struggle with organization, so this is an area students may need specific teaching and help.  This is a great time to add in choices and talk about what is or isn’t helpful. Here are some ideas for systems for organization: 

• Color coded by activity or class 
• Use an expandable folder divided by class or activity 

• Have a small tote bag for each class or subject 
• Teach students to use a drawer system where each drawer is a different class or subject 

If your student is somewhat able to remain organized independently, a binder system with dividers may also be an option. 

ORGANIZE TIME  

Initiation and sustained attention and participation can be an area of struggle. Adding in supports such as a visual schedule, visual timers or checklists can help. Click the links below to read more about classroom organization strategies. 

• Tools for adjusting the environment 
• Implementing visual schedules

As you begin to think about and plan for supporting your students with ADHD, remember that most of these ideas and supports are helpful for all students. Teaching your whole class about these strategies and tools can develop lifelong skills for your entire class. 

About the Author  
Pam Petralia has been a special education teacher for over 20 years and has worked in a variety of settings (self-contained, resource, k-2, middle school, etc.) She is the owner and creator of Mrs. P's Specialties which helps teachers easily implement and apply research based practices through tips & ideas, resources and consulting into their classrooms.   
 

Links to follow: 

Blog: www.mrspspecialties.com 

Instagram: @mrspspecialties 

FaceBook: https://www.facebook.com/mrspspecialties 

Tips for Managing ADHD 

By Jessica Rapp Irwin, OTR/L of Rooted in Routine 

October is ADHD awareness month, and as a pediatric occupational therapist, I have worked with many children with an ADHD diagnosis over the years. Let me tell you - they are some of the smartest, most creative, and most caring children I’ve ever met! However, in terms of learning and attention, they often struggle simply because their brains work slightly differently. 

Children with ADHD have difficulty with focusing and concentrating on certain tasks. There is a difference in the brain that causes this difficulty. They may have trouble staying focused on one task for long periods of time, they may be more distracted by things in their environment (sights, sounds, objects, etc.) than other children their age, or they may appear “fidgety” and have the need to move their body often.  

However, children with ADHD are able to focus, but they often focus on what’s not important at that moment. Therefore, we can modify the environment (something OT’s do best!) to help them focus on what is important for the task at hand. They may also require modifications to help their body remain calm in order to help promote focus and concentration. 

Here are some evidence-based tips to help your child with ADHD succeed at school (in-person or virtual) and at home: 

1. Keep a consistent routine. This is the number one tip that can transform both home and school life for your child. When tasks are done in the same way and in the same order, it provides a sense of predictability and stability for your child. This in turn limits distractions and deviations from the routine. For example, each morning try to go through the same steps in the same order: eat breakfast, brush teeth, get dressed, pack backpack, put on jacket and shoes, and leave for school (if virtual, replace with sit at virtual learning space. 
2. Create a visual schedule. This is where you write down, in order, exactly what your child is going to do, and then have them mark it off as they complete each step. You can create a schedule for the entire day, or make one for the span of an hour or two. For example, your child’s afternoon schedule might be “eat snack, do 20 minutes of homework, play outside”. Writing this down will help your child understand what is happening next and know what to expect, which is one of the most important factors in reducing distractibility, difficulty focusing, or refusal behaviors (those “I don’t want to!!” moments). Simply get out a piece of paper and write your child’s schedule as a list. If they’re old enough, have them help write it with you!  
3. Set up a consistent “learning space” or “homework space” with limited distractions. Try to have your child sit in the same spot each day when they are logged into virtual learning or when completing homework. Help promote better focus by removing any toys or objects nearby that could cause distractions. If your child is sitting in a chair, make sure your child’s feet can touch flat on the ground (if not, use a stool or stack of books!) - this helps your child’s body feel more supported. However, don’t be afraid to try alternate positions such as having your child lay on their belly or even stand up while completing school work. Sometimes these alternate positions can actually help with better attention, particularly for those kiddos with ADHD! 
4. Use a visual timer. This can be a sand timer, a kitchen timer, or the Time Timer! Visual timers help children understand the concept of time because they can see how much time is left to complete a task. This is so important for children with ADHD because they are often visual learners. Give your child the “job” of setting the timer before a task, which gives them a sense of control and purpose. For example, before beginning homework, have your child set the timer to 20 minutes. This way they know how long they’re expected to focus and know they will be getting a break when the timer goes off. 
5. Include movement breaks and/or outdoor time within the day. This is very important! All children need to move their bodies, but especially those with ADHD. Staying still is particularly challenging for these kiddos, so building breaks into the day is imperative. Movement actually helps your child pay better attention when done as a preventive measure. Build movement breaks into your child’s routine, rather than using them as a reward or something that only happens if they get “X” amount done. Getting outside for even 5-10 minutes can do wonders, but if that’s not possible, there are plenty of ways to move inside - put on music and have a 5-minute dance party, do 100 jumping jacks, or play a GoNoodle video on YouTube… all great ways for your child to move his or her body!  
6. Use your child’s interests to your advantage. Whenever possible, try to include your child’s interests in the activity you want them to focus on. Children with ADHD are actually very much able to focus on things they are interested in, so go with it! If your child has favorite characters, try to include them in activities at home and encourage your child’s teacher to do the same at school. If your child has a competitive side, try making things into “races” or “challenges” so they are motivated to complete the task at hand. For example, have a race to see who can put on their shoes faster! 

Remember, children with ADHD are smart, capable, and creative - they just might need a few slight tweaks to shine! Try out these tips above to make things go a bit smoother for both you and your child. 

 
 
 
About the Author: 

Jessica Rapp Irwin, OTR/L, is a pediatric occupational therapist, childhood routine expert, and lover of all things child development. She founded Rooted in Routine, an online parent coaching platform, to help parents learn simple, easy to implement routines for optimal child development starting at age one. She is passionate about educating parents on NORMAL, HEALTHY development, which is often simpler than we think. Jessica’s approach is largely rooted in going back to the basics to help you establish solid, age-appropriate routines for your child for things like eating, play, and sleep. She believes this is the most important foundation you can provide for your child - and she wants to help you do just that!  
 

Learn more about Jessica at https://www.rootedinroutine.com/about and follow her on Instagram at @rootedinroutine.