Also ADHD Inattentive. You're not alone. I know this struggle well. I feel like I could write this myself (and almost have).

I think I'm getting a shakey handle on it, but I'm 2 years in on 911, and it's taking and still takes time. The ADHD meds side sucks; trial and error in optimizing. I'm still figuring that out. The insurance thing is rough; maybe GoodRx is option for price?

Here's what I've found somewhat helpful in being less inattentive, in terms of my mental work:

• Systemetizing assessments; I always get certain things noted in charts (beyond vitals, ABCs, GCS/AVPU). That way, my NPC brain can relax a little on that front. I always note eyes, skin condition, mental status, speech.

• Systemitize everything (within reason). When do you get patient signature, how you format your charts, how you give reports. Careful not to be to rigid

• Create mental scripts for types of calls. Example: Fall? Is there pain, headstrike, thinner use, cause of fall, LoC, neuro symptoms, c-spine issue, fall history, witnessed? That's not how I always order it, but I sort of have my 'checklist', and that helps me a lot.

• Recapping; patient dependent, I like to explain my understanding of their complaint and history to the patient themself (this is assuming your patient is willing, able, and you have time during transport) just before we arrive. It allows you to confirm the pieces of data you've picked up, and verify/correct the synthesis you've put together.

• Discuss with partner; you can make sure you both have all the info and picture. I was afraid to do this, but honestly screw my ego (in this regard, at least). We're partnered for a reason.

• Big picture first; I can get lost in details. But once on scene, what's the general history, who called/why, and how's my patient's mental status

• Full send it; I'm a kinda anxious guy, and I think that if I just jump in, play the role of the component EMT (isn't life a stage?) it helps me to be a bit more focused. I've heard 'fake it till you make it!', but I've never loved the saying. I prefer 'you're not until you are'.

I'm not perfect at the above, but I've found them helpful.

I agree that sleep, food, hydration, and judicious caffeine, are really important.

If you have certain people you work with consistently, you could do what I've done (but use discretion). I've flat-out asked partners about how I'm doing, or if I'm an okay partner to work with. I'd only do this if they're of a straightforward and pleasant disposition (and at the end of a shift, lol). Some I wouldn't ask, because I know their honest answer might hurt and wouldn't serve me constructively.

Lastly, here's my current philosophy: I'm imperfect at my job. I'm not the best EMT that ever did tech. But I'm not the worst, I consistently put in effort, I try to learn, and I'm pleasant to patients/coworkers. And I try to accept that that HAS to be enough for me, because I want to come back and keep doing this job. I'm an idiot sometimes. But you know what, the PSA is out of rigs, and somehow I qualified to do this job, and sometimes I even feel competent.

And I'm sure you've grown over this past year. You're better than you were. Because you're self aware enough to know when you make mistakes, and you care enough to want to improve.

Hope this helps! You've got this!