ADHD, Anxiety, and a Toxic Workplace: My Nursing Journey


Written By: Meg Lambrych, RN-BC

 

I was a rambunctious, bright kid, always running, playing, and obsessed with soccer. I was also the kid in class who got ‘overly talkative’ and ‘bright but doesn’t apply herself” on every report card. So much so that I was diagnosed with ADHD at age eight.

Fast forward 18 years, and I was accepted into one of the best-accelerated nursing programs in my state. I was elated!

Throughout nursing school, I experienced some friction with professors who took issue with my need to get up and go for a walk multiple times throughout our eight hours of lectures. One professor told me he thought I was disrespectful and disinterested when, in reality, I had to move constantly to be able to focus at all. 

I graduated nonetheless and was thrilled to secure a position in a cardiac ICU nurse residency program. I could not have been more excited for what I thought would be a long critical care career. 

Culture Shock


My nurse residency required ICU residents to work on the floor for six months before advancing to the ICU. That’s where the trouble began.

Initially, my preceptor was highly supportive. I explained how I learned best and assured her that my many questions were necessary for me to learn and NOT an attempt to question her authority. I gushed about how thrilled I was to be there and my sincere commitment to learning.

It was a script I had memorized over the years as I learned many people viewed questions as a threat. It didn’t help that I tended to talk over people when I became excited or nervous. But I knew I needed to understand the big picture of why we were doing something to remember the intricate details of the how.

The Day that Took a Turn

One month into my orientation, my patient, who was receiving dialysis at the bedside, experienced a torn fistula. The hemodialysis nurses handed me his bleeding arm and a 2×2 gauze.

They said, “You’re going to need a surgeon,” before leaving the room, leaving me alone and terrified. I called for help, and another nurse from the floor came, but my preceptor did not. We were eventually able to stabilize the patient, but I was left with a mess to chart, and my preceptor was yet to be found.

I did my best to chart the situation with my 30 days of experience as a nurse, leaving the hospital confused and exhausted. The next day, I was pulled into the manager’s office as I headed to the floor.

Missing Constructive Criticism  


The manager and assistant manager sat stone-faced.  “
The other nurses don’t like you,” my manager began. “They think you’re arrogant and don’t want to be here,” she spat. Her disdain for me was palpable. The words hit me like a punch in the gut.

At that moment, I understood how a fish must feel when it’s yanked from the water, gasping for air, in pain. I stammered an apology and insisted I did not feel that way. In fact, up until the day before this conversation, I had received positive feedback from everyone I had worked with, which was documented in my weekly performance reviews.

“Can you please give me some examples of what I’ve done to make people feel that way?” I ventured, pouring through my memories, trying to pinpoint where I had gone wrong. Even at that moment, I was trying to learn, improve, and understand.

“No,” she replied flatly.

“Your preceptor doesn’t want to work with you anymore. So you’ll be working with Ryan today,” she said matter-of-factly.

It was clear this conversation was over, and her disregard was jarring. As if public shaming sessions with zero constructive criticism were a regular slot in her daily schedule.

At that moment, I began to cry. Those tears turned into sobs. Not only did my preceptor leave me out to dry in a medical emergency, but she also fired me? I was filled with confusion, pain, and betrayal. I was devastated.

Looking back now, I can see that this was rejection sensitivity dysphoria, a hallmark symptom of ADHD. I also clearly see a bright, hard-working, neurodivergent girl who struggled immensely, because she didn’t receive the support she needed in a toxic environment.

Out of the Frying Pan, Into the Fire

After that, I put my head down and worked, determined to prove my bully wrong and succeed. The torture she and her friends heaped on me was relentless. I knew I would receive the worst assignment each day and no help when needed. They mocked me for the slightest mistake and did their best to make me quit.

After that, the bullying got so severe that two other ICU residents (who were also being bullied) and I told our residency director that if they didn’t pull us immediately, we would leave the hospital.

They relented, and I started in the Cardiac ICU. I was ready to put the nightmare behind me, confident that things would improve.

Too Little, Too Late

While I was thrilled to have made it to what I thought was my final destination, four months of stress and trauma had left my nerves frayed and my anxiety sky-high. I had developed physical manifestations from the stress, including UTIs, heartburn, and depression. Things I had never experienced in my life.

While my experiences with my ICU preceptors were more positive, the culture was clearly the same. In my first week, I was introduced to the crying room. A storage closet with a chair in it where preceptors sent their pupils to cry… it was so commonplace, they needed a dedicated room for it.

While I received praise for my critical thinking and calm under fire, the stress plagued me through my charting.

Other key symptoms of ADHD are an inability to accept verbal directions, poor working memory, and difficulty paying attention–critical components of efficiency and timely ICU charting. These symptoms often get worse under stressful conditions.

I saw my fellow nurse residents constantly get verbally abused, bullied, and fired. In addition to the high-octane pace of the Cardiac ICU, these conditions wore me down.

Finding My Place

I decided to leave the Cardiac ICU because I knew it was destroying my health, mentally and physically.

Eventually, I began writing to process my traumatic experiences in nursing, and I discovered a passion for the written word.

Years later, I started my freelance writing business and have never been happier.

While my experience in nursing has been brutal, it has provided me with my dream career, and I am incredibly grateful for that.

My advice to any new graduate nurse is this: Trust your gut and go where you are celebrated.

There are many strong opinions about what you should do, where to start your career, and how to advance it. But know this: nursing is an ocean of possibilities, and you’re the only one living your life.

Be open to new opportunities, but never stay anywhere that is toxic because you feel you must.

The world needs nurses like you, so keep going until you find a community that fills your cup and builds you up.

About Meg

Meg Lambrych is a freelance writer who left the bedside to start her own business in 2021 after experiencing bullying, institutional issues, and burnout as a new graduate in the ICU. She’s a passionate author of trauma-informed, evidence-based health information. She’s an avid advocate for all healthcare workers navigating the complex American healthcare system.

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6 thoughts on “ADHD, Anxiety, and a Toxic Workplace: My Nursing Journey”

  1. Too many times we see fresh and eager talent subjected to an environment where ‘nurses eat their young’. Rather than correct this flawed way of thinking and acting, we accept this is not only the norm, but the standard practice of which new nurses are forced to endure. Even now as our healthcare system is in such a compromising position, collegiality is a rare gem to be discovered mostly by luck rather than common practice. Thank you for being brave enough to share your story. I can only hope this helps support those entering the nursing field to truly trust their guts, and indeed go where they are celebrated.

  2. Too often, nurses lose their memory of what it’s like to be new on the job. Since the task is mastered for them why can’t this person catch on? That’s when the cruelty begins. It becomes a lonely place for a new nurse. The compassion we show to our patients must also be shown to each other.

  3. Thank you for your story. As a nursing instructor, it appalls me and makes me hurt to think any of my students might be treated that way in their first job after graduating. As a nurse, I can relate. I started my career in the 90s with mostly good staff and preceptors. I spent many good years in the coronary ICU with few issues. The last few years were different, and I am left struggling with how to spend my last few years in a career that I love. Thanks for sharing. It helps me not gaslight myself about the toxicity I experienced.

  4. They did you a disservice in many ways. Going to any ICU, after only 6 months on the floor, does not help a new grad surviving in a high stress environment. No matter how smart, fast and dedicated a person is, new grads should have at least 2 years experience on a med/surg floor. It is imperative to learn, not only the routines, but also to apply your book-knowledge, improve your skills and time management to the variety of problems one encounters on a daily basis. It really does take at least a year until one feels somewhat comfortable with ones own skills and interactions with patients, families, other nurses, doctors, etc. on any unit.
    Also, there is an extreme pecking order in nursing. Much like in the military. However, in nursing, we are not taught to rescue each other, or fight for each others survival, or work as a team. It is a sink-or-swim mentality often brought to the surface by enormous stress, workload and responsibility. A supervisor once stated in a meeting that “the beatings will continue until moral improves”. She did not make a joke. I had never heard anything so mean-spirited and counter-productive in my life. The moral, the culture comes from the top.
    It is not done with a yearly “Nurse Appreciation Day” plastic mug or koozie with the hospital’s logo on it.
    I have left the nursing profession.

  5. I struggle with similar symptoms. Thank you for writing about this. I’m so glad you were able to find a part of nursing that speaks to you and you are happy in. I hope we can all find that as well!

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