New nurse anxiety

[SarahWRN]

New member to site, and Have a question for you all. I am a new grad RN, and am working at my first Job at a Rehab institute on the brain injury unit. I have been at this job for about three months now, and am beginning to experience a great amount of anxiety, and even slight depression about my work. Every time I leave I'm constantly thinking I missed something, or that I did something wrong. I decided to get on an antidepressant/anti anxiety medication to control these feelings. I am now on Lexapro 10 mg, and am hoping this helps.

My question to everyone is, is this a normal feeling? Have any of you new, or even veteran nurses had these feelings, and if so, do they improve with experience? I hate going home wandering if I picked the right career field, I know I love being a nurse, but I believe the stress is just overwhelming me. Any input would be greatly appreciated!

[Blue Roses]

Is there a circumstance at work that is stressful? I had alot of the same issues at my first nursing job but it was related to a very toxic work environment. By the way, I also am on Lexapro and I have had very satisfying results.

[Lev, MSN, RN, NP]

I've heard that these are totally normal feelings for new nurses. It takes about 6 months to get comfortable with your practice.

[SL2014]

I know exactly how you feel, I was there for my first job and the other nurses made it so much worse. I didn't realize that the "culture" was the problem until I transferred to a different unit.... it made a world of difference. I don't know your situation but a change might help.

[CheesePotato, BSN, RN]

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?

::ahem::

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,

~~CP~~

[BrendaH84, BSN]

CONFIDENCE will take away the anxiety.

To GET confidence: During your shift there are things you have to get done;

1. make a LIST of those things

2. At the end of your shift and during, you can make sure you've done what you need to do.

This will give you confidence

[Emergent, RN]

I think this is normal to have anxiety when learning to be a nurse. It's a high pressure job. Give yourself time to adjust.

Like a couple of posters said, there might be a possibility that there is some unsupportive toxicity where you work. You might not realize it because you are still insecure as a brand new nurse. Some nursing units have more than one nurse who only thrives by making others look like idiots. This can be very anxiety producing for their victims.

[iPink, BSN, RN]

I agree with others that anxiety is normal for new nurses. It will improve over time. You may even see a big difference 6 months in. If you feel your depression is getting worse though, definitely seek help. Hang in there and wish you the best.

[Lola RN]

Hey SarahWRN. I can't say that I will be much help to you, because I too, feel the exact same way. I am 3 1/2ish months into my nursing job in the ER and I just feel like I can't get my bearings. I have anxiety every time I go into work and when i leave I always seem to recap my day and just think of all the things I feel like I could have done better or different.

Every one tells me that it'll take at least 6 months to a year to feel like you know what you're doing. I am trying my darnest to stick it out before I throw in the towel. So I hope you will too!

Everyone keeps telling me to try and find a good mentor but it's so hard on my unit because there are so many nurses and you don't always work with the same nurse every day/week. But I know that there are those who I can ask questions.

But I am relieved that I am not alone in how I feel. I hope that we can recap on this post in a few months and just laugh at ourselves. If there is one thing I take away from these feeling it's always remember how I struggled in the beginning so that when I do become that experienced nurse who one day has to work with a new nurse. I will try my hardest to guide and help them and not be one of those nurses who "eat their young."

I am sorry if this doesn't help you but at least know that you are not alone!

[FutureResearchRN]

I would get extremely anxious for the first 2 months or so off of orientation. I dreaded going to work. I'm 8 months in and I still get nervous for work but the anxiety is bearable. It's good to be nervous but don't let that get in the way of getting tasks done. I'm still overly cautious at 8 months and ask a million questions but I think we can all agree it's better to be cautious than arrogant and unsafe. Hang in there, it gets better :)

[Newrn22]

I'm a new nurse too and I have been on my own for about a month now. Every day that I leave I have such bad anxiety that I did something wrong or forgot something and to make things worse there's an older nurse on my unit who looks for things to complain about the new hires about. She always complains the new hires have no idea what they're doing and r horrible . She makes me feel terrible and like I don't know what I'm doing . I always leave work feeling anxious, depressed and like I'm going to get fired for something insignificant. I guess it's good to hear I'm not alone

[NurStud10]

Hi,

I see that this was posted awhile ago, and I am just wondering if your anxiety is better now. I am typing this because I can't seem to fall asleep; all I hear are alarms beeping, I keep thinking of IV meds, interventions, patients, documentation, etc. I am a brand new nurse. I still have four more shifts on orientation and I am very anxious about going off orientation and I am very anxious before and after shifts. I have even been crying a lot lately. I have a lot going on in my life outside of work, so I am unsure if this anxiety is related to that plus the stressful job, or maybe nursing in general, or is it just being on a med-surg unit (I feel like peds is where my heart is, but I wanted to get some experience first)? Hopefully your anxiety is down, and so will mine after 6-12 months.

Sincerely,

The new nurse who needs some guidance