ER RN's with anxiety disorders?

Specialties Emergency

Published

I have worked 2 years in the PICU and current work in adolescent psych for the past 4 years. So it's been awhile since I've started an IV, but I think once I get back into the hang of things I'll be ok, I'm a fast learner. I know at the ER I'm interviewing for has a LOT of psych patients that come in, we have the largest behavioral health unit around. So my psych skills will be beneficial I believe. I have only worked with patients 0-18 years of age so learning all this adult business will be a task for me. Ok, for my main question. Do any of you ER nurses have any anxiety/panic disorders? I do. I take Klonopin 1mg three times a day for my baseline anxiety which works well. I'm asking my dr on my next appt for a fast acting benzo for breakthrough anxiety. No, they don't make me sleepy or out of it, I've taken these meds for a long time, I can function just fine. They do not impair me. But I do feel like I may be the only person in the ED with anxiety issues...or am I not? It's kinda of an embarrassing subject because ED nurses are supposed to be tough and strong and nothing phases them right? I'm not a stupid person but if my anxiety gets too high, my brain just shuts down (that's why I'm asking for an additional prn fast acting benzo like Ativan). Please tell me I'm not the only? If anyone can relate, how do you manage?

Specializes in ICU.

I agree. And I think there is a big difference between benzo's/narcotics and SSRI's or insulin.

Not if they're not abused. I had a CNA treat me like a drug addict one time when it came up in conversation that I was on Prozac. Health care professionals need to educate themselves.

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Specializes in Emergency Room, Trauma ICU.
Not if they're not abused. I had a CNA treat me like a drug addict one time when it came up in conversation that I was on Prozac. Health care professionals need to educate themselves.

There's a big difference between taking an anti-depressant and taking narcotics while at work. If you are in so much pain or have such anxiety that you need to take narc while at work, then in my opinion you should be home not at work.

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Specializes in Oncology.

As someone else brought up, the issue could be passing the preemployment drug test. If you search AN, you will find stories of people who had their job offers rescinded after a positive test, even though they had a valid prescription. I also have to agree that there's a difference between working under the influence of an SSRI and a controlled substance. It might be worth seeing if there are any other medications that may help your anxiety and not be an issue on a drug test.

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There's a big difference between taking an anti-depressant and taking narcotics while at work.

Agreed. SSRIs are very slow-acting medications (they literally take MONTHS to reach full efficacy). Benzos are highly addictive medications to which a patient can develop high tolerance. (Needing Ativan on top of 3mg Klonopin and claiming no sedation/alteration could be a strong indicator of a high tolerance). That's kind of the problem with Benzos if used with that kind of frequency... eventually you need more and more for the same baseline effect, and coming down can cause extreme rebound anxiety that's worse than what you initially sought treatment for. The also have street value, and that with the drug-of-abuse issue is why ERs are so hesitant to prescribe them in more than minuscule amounts if at all. I would be very concerned that your performance could be compromised if you were to miss a dose. ERs can be busy places where people sometimes barely have time to pee or eat, much less attend to strict TID plus PRN med schedules. I was recently on a HUGE pill regimen that involved taking pills several times a day even at work. Fortunately, none of them would have affected my mood or job function or even had a significant impact on my immediate health had I been an hour or more late. I can't imagine if missing one would have sent me into a panic attack!

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People who don't have panic disorder, no matter the amount of medical knowledge they may have, will never understand. I have a prescription for lady partsl Valium suppositories for interstitial cystitis and pelvic floor dysfunction and I feel absolutely no systemic effect. Being a benzo, that shows up on a drug screen. For anyone who says if you are in that much pain where you have to take a controlled substance, stay home....well, I can't respond without violating TOS, other than to say, Sure, I'll stay home and let you and the rest of society pay my bills for me. I also take Xanax prn. Luckily with work, I only need it the first few days of a job until I feel comfortable in the place. After that, I still have anxiety, but I'm able to use coping techniques I have learned in counseling. There was a time when I could not take a science class with a lab component, because I would have a panic attack and walk out of the lab and drop the class. I could not bring myself to do it. I attempted 4 science classes, and withdrew each time, before being prescribed Xanax. I started Chemistry and took xanax two times for lab, then felt comfortable enough after 2 labs where I did not need to take it before class anymore. The same happened with my first nursing job. As a patient I would take a nurse who takes a benzo or narc any day over a nurse who will freeze up d/t anxiety or a nurse who is in so much pain (such as myself d/t chronic pain) who is distracted while working because of their pain

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Specializes in Home health.
People who don't have panic disorder no matter the amount of medical knowledge they may have, will never understand. I have a prescription for lady partsl Valium suppositories for interstitial cystitis and pelvic floor dysfunction and I feel absolutely no systemic effect. Being a benzo, that shows up on a drug screen. For anyone who says if you are in that much pain where you have to take a controlled substance, stay home....well, I can't respond without violating TOS, other than to say, Sure, I'll stay home and let you and the rest of society pay my bills for me. I also take Xanax prn. Luckily with work, I only need it the first few days of a job until I feel comfortable in the place. After that, I still have anxiety, but I'm able to use coping techniques I have learned in counseling. There was a time when I could not take a science class with a lab component, because I would have a panic attack and walk out of the lab and drop the class. I could not bring myself to do it. I attempted 4 science classes, and withdrew each time, before being prescribed Xanax. I started Chemistry and took xanax two times for lab, then felt comfortable enough after 2 labs where I did not need to take it before class anymore. The same happened with my first nursing job. As a patient I would take a nurse who takes a benzo or narc any day over a nurse who will freeze up d/t anxiety or a nurse who is in so much pain (such as myself d/t chronic pain) who is distracted while working because of their pain[/quote']

Hi! I completely agree with you on this one. I have depression and panic disorder. I have had moments where I literally blacked out due to extreme anxiety. Now I've been on lexapro for both depression and anxiety and it is working wonders. I do have Xanax prn but i can't even remember the last time I needed it. I used to also get anxious in a new environment. Nowadays I try to deal with anxiety by using the coping skills my psychiatrist taught me. :-)

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Hi! I completely agree with you on this one. I have depression and panic disorder. I have had moments where I literally blacked out due to extreme anxiety. Now I've been on lexapro for both depression and anxiety and it is working wonders. I do have Xanax prn but i can't even remember the last time I needed it. I used to also get anxious in a new environment. Nowadays I try to deal with anxiety by using the coping skills my psychiatrist taught me. :-)
I'm glad to hear your symptoms are under control. I'm waiting to be flamed for my post because I was pretty offended. To hear that someone wouldn't want me caring for them (although its honest) is hurtful. I too take Lexapro and it makes all the difference in the world. I agree that one should not perform nursing duties ONLY to the extent of not doing so until you know how benzos or narcs will affect you. it does not affect my judgement or care in any negative way. Anyone can rattle off side effects of these meds, but until someone's been in my shoes with pain and anxiety, don't dare judge me. I'm not going to let my medical problems keep me home and not live my dream I fought so hard for in nursing school. I resent anyone saying I should. End rant.
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I have anxiety disorder and found that a few lifestyle changes helped me the most. One caffeinated drink between the hours of 1000 and 1800, limit sugar intake, sleep 8hrs. Im not a big med taker since I tend to have bad reactions.

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Specializes in Home health.
I'm glad to hear your symptoms are under control. I'm waiting to be flamed for my post because I was pretty offended. To hear that someone wouldn't want me caring for them (although its honest) is hurtful. I too take Lexapro and it makes all the difference in the world. I agree that one should not perform nursing duties ONLY to the extent of not doing so until you know how benzos or narcs will affect you. it does not affect my judgement or care in any negative way. Anyone can rattle off side effects of these meds but until someone's been in my shoes with pain and anxiety, don't dare judge me. I'm not going to let my medical problems keep me home and not live my dream I fought so hard for in nursing school. I resent anyone saying I should. End rant.[/quote']

I agree :-) now if people start taking those pills just for the pure fun of it, then it's a problem. I don't think that because we have this condition we should just lock ourselves at home and suffer. I'm glad you are feeling better as well

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EnergizerHoney, you sound very,very, very familiar to what I am going through right now. I have not been diagnosed with Bipolar but I have been Diagnoses with Severe Generalized Anxiety that has unfortunately debilitated me. I have always loved my profession and have always said so without hesitation but these past 5 months have been torture... literally. It started in October out of absolutely nowhere. It blindsided me so much so that i cannot pinpoint a specific source...or trigger. I have since been approved for FMLA for 7 days a month but I cannot go to work. I have used the 7 days and much more. It started off where I would get panic attacks that would literally wake me up out of a dead sleep....the only thing that would calm me down is calling in to work and knowing I did not have to go in. My psychiatrist and I were able to work with medication and therapy enough for me to "get by" and report for duty. But because of this it just created more things at work with administration that I would have to continuously deal with every time I would go in to work. I would feel great about it because these issues were being addressed and dealt with, unfortunately everything just started to get more complex with it and its still ongoing with them, I'm still meeting with directors and the union. But here is where I am at now....I am back to where I cannot go to work....my panic attacks start the morning of the day before my shift and nothing helps except when I make that phone call to tell them I am not coming in. These attacks are not something I can work through because when they happen they effect me physically in such a way that I have to stop whatever I am doing. It starts with my chest starting to feel tight and get tighter, then I start getting the hypercapnia feeling where my face around my lips starts tingling along with my hands and feet and I can't grasps things because my hands are weak, while this is happening I am dizzy and extremely nauseated, I do end up vomiting but most of the time it is dry heaves because there is nothing in there to throw up. I also have this headache that will not go away. I always have it...it is like a pressure in my frontal lobe where my sinuses are but not the type of pressure/pain you get from sinus headaches. It fluxuates in intensity but is always present, When it is at my 10/10 I cannot do anything, I need to be in a quiet and dark place with my eyes closed and laying down. I have told my PCP and Psychiatrist about this...I go for an MRI next Tuesday. I am in the process of getting a new psychiatrist because the current one I feel is not helping me at all anymore. I take lyrica for anxiety along with lexapro for depression which I know are not helping because I cannot function like this. The worst part about it is I don't know what is causing it....I have been a nurse for 6 years and even when I was a new grad I never felt anything like this. I have started several new positions over those 6 years and never have felt this with the "new job" anxiety. And it kills me because I miss my patient's, I used to LOVE going to work, I LOVE being an RN. I hate the thought of my coworkers distrusting me or disliking me or being mad because I have been calling out and leaving them short staffed. Which causes even more anxiety. I feel trapped. But thank you so much for sharing because I am so glad to know I am not the only one who has these feelings. I wrote in a earlier post that I am happy for you that you have found things that work with you to help you cope, but after rereading the thread I realized I read someone's reply and mistook it for your reply, so I hope you have found things to help you cope and if you have then I am also happy that you have.

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