Welcome to Allnurses, Sarah,
First of all congratulations on surviving nursing school and all that other horsehockey. Most good.
To begin with, know the feelings you are experiencing are very normal for new grads and even for those experienced nurses that change specialties. However, where feelings of slight anxiety are normal, it should not be impacting your work/life balance outside the facility. I am glad to hear you are taking action to provide care to yourself and I hope Lexapro turns out to be the right tool to help guide your stability.
From reading your post, I caught two little niblets that seemed to stand out to me:
One, it seems that organization is a skill that has yet to come along (very, very normal for new grads). And two, your anxiety and tension seems to be primarily self fueled.
I wish there was a quick fix for number one, but there is not. Time management and organization are skills best learned through real life application. And yet it is important to note there are many things which may be done that can help streamline the process for you.
I have enclosed a link to a organization thread here on the forums that features some of Esme12's fine brainsheets
. These types of tools are critical for new nurses as they help guide thinking and lay the foundation for organized and efficient thought. Please adapt brainsheets or use them as a building block to make your own. Once you feel a bit less like you're chasing your tail, that nagging "Did I leave the stove on?" feeling should begin to resolve.
Remember that each and every day is a learning experience. Even for nurses with oodles of experience, each day brings a new opportunity to do something better, faster, stronger, shinier--wait, what?
For some, cataloging those moments in a journal of sorts helps, for others finding a mentor or a trusted person you can talk to in order to debrief after each day proves reflective and therapeutic. (Remember HIPAA).
Now let's pause for a second and talk about anxiety management. On a chemical level, yes, there is a part of this that you cannot necessarily control. This is science. On the other hand, there are things you can do to give yourself a fighting chance of kicking anxiety to the curb.
First of all and I cannot bold this enough: Self care
Okay yeah sure, they probably touched on this in nursing school. Well, I'm going to beat the snot out of it now.
Be sure you are eating well, making time for yourself and getting adequate sleep.
And when I say eating well, I don't mean going off the rails and only eating salad. If you want a donut, you know what? Eat that donut. Enjoy it. Savor it. But pay attention to how certain foods make you feel afterwards. You may be surprised to find things that make you feel low or jittery. Example: Caffeine increases that jittery crawling out of your skin feeling as well as wrecking the hell out of sleep patterns.
Make time for yourself. It doesn't take a lot of effort to do so and it can make all the difference in the world. It's not about the grand gestures so much as the little moments. To begin with, Sarah Time begins when your shift ends each day every day. Period. No exceptions. What does that mean? That means work stays at work. It may take time to retrain your brain away from vulture circling the shoulda/woulda/coulda routine of self doubt, but learning to let it go is a huge step to a happier you.
Now let's don't get stupid. If you are driving home and realize that you forgot to hang an antibiotic on someone (been there, done that), taking action via phone call is the right thing to do. Just sayin'.
But take care of yourself: listen to music you enjoy on the way home, sip a favorite beverage of the non-alcoholic variety while you drive, or sit in silence and just breathe. Find a way to build in time for yourself into your day.
Adequate sleep is self explanatory: go to bed at a reasonable time. Aim for eight hours a night. An exhausted brain is like an over-caffeinated hamster on steroids: flighty, temperamental, and a bit prone to biting. You may be amazed at how you feel if you allow yourself to rest.
Secondly: Self awareness.
Be kind to yourself. The world is full of jerks, don't be one to yourself.
Recognize that you do the best you can in the moments are you are in. No one can ask more of you than that.
Become aware of times when you need a breath and be sure you indulge them (provided someone isn't coding. In which case I dare say you are not the one in critical need of deep breathing, know what I mean?) Identify your triggers and brainstorm realistic, practical ways of facing down/dealing with them.
Last but not least, repeat after me: It gets better.
Best wishes to you,