Stress and Depression

Long Term Care Columnist / Guide · Oct 29, 2005

Aw, Rain........I'm sorry you're feeling so down. What you are probably experiencing is a bad case of 'reality shock': what you expected nursing to be like while you were still in school is VERY different from what it's like out there in the big cruel world, and you're having to reconcile the fantasy with the everyday reality. That's what a lot of nurses go through in their first year or so on the job, and it's actually pretty normal; but it can definitely contribute to a situational depression that may or may not need medical treatment. Only you and your doctor can decide if antidepressants are necessary.

Just knowing that you are going through a very common (and uncomfortable) transition should help somewhat; it's something I wish someone had told me when I was a new RN. Despite the fact that I was in the neighborhood of 40 when I graduated, I was completely unprepared for how very different 'real' nursing was from the 'practice' version; I spent most of my first year, and beyond, wondering if I'd made a terrible mistake going into this profession, and how I'd ever get used to it if I stayed. Depression? I was convinced I was the worst nurse on earth! I had NO confidence, was always running late on med passes, spent 2 hours or more after every shift on charting and got in trouble for doing so much overtime.

Part of it was working nights when I was more of a 3-11 person; part of it was working in LTC when I'd wanted to work in the hospital where I'd been a CNA during school. (They didn't hire new grads back then.) But part of it was simply making this enormous adjustment from the fantasy world of nursing school, where you never had more than four patients at a time and your instructor and preceptors were always there to save you, to the real world where it was YOUR judgment and skills that could mean the difference between life and death, and four patients was a light load.

Again, it's up to you as to whether you want to try medication to help you get through this rough patch (although once you're on antidepressants, it's devilishly difficult to get OFF them). However, I would hope that once you fully understand that your feelings are very normal, you'll be able to ride it out, because better days ARE coming, I promise! It won't happen right away, of course, but one of these days you'll catch a subtle change in a patient's condition that saves his/her life, or perform a procedure expertly that once intimidated you, and that's when you'll know that RN behind your name means "REAL NURSE".

Hope this helps you.

:)

RainDreamer, BSN, RN · Oct 30, 2005

Adam, jnette, Marla ..... thank you so so much for your words of support, it means so much to me to read those words.

Marla, I know you are a great nurse, so it's nice to read that even you felt like this when you were first starting out. I do think I'm the worst nurse sometimes. I go through my day at work thinking I have no idea how I ever got through nursing school and passed the NCLEX ..... thinking they made a mistake to let me through. I feel so incompetent and stupid sometimes.

When I'm at work I feel like I hate nursing and just want to get out. I feel the same way as MrsMinor ...... I've wanted to be a nurse for so long, I don't know what else I would do if I got out of nursing. But I know it'll get better, that's the only reason I haven't quit.

I hear people say that the first YEAR is really tough and it takes about that long until you feel comfortable. So am I going to feel this way for a whole year? It's barely been a month now, I don't think I could handle 11 more months of this

grinnurse, RN · Oct 30, 2005

Hey Rain-

Here is kind of what my experience has been with it so far. I am now into almost 5 months of nursing and please trust me when I say it does get better the longer you go!! My first few weeks of being totally on my own I would come here and read these posts and ponder if I got into the right field, floor, etc and then I would just hold my breath and tell myself that I had one more day under my belt towards that magic "year" mark of nursing!!

In my circumstance I can say with complete honesty that it really, really does get better with each passing day. Each day you learn a little more, gain a little more confidence (even though you may not see it-others will). I truly think alot of the problems that you may be experiencing are like Jnette and the others have said is b/c of your body clock!! I have a friend that is working nights but is a day person and is struggling with a lot of these same issues and it seems that they are more severe b/c of the difference in the body clock.

Hold on Rain-it's going to get better for you I promise!

TTFN-

Kelly

PS-congrats on the position. You must have gotten it when I was on hiatus from the internet these past months or so!!

MrsMinor · Oct 30, 2005

Hello Raindreamer

Thinking of you as you went back to work today. I hope your day went well. I go back tomorrow--5 in a row coming up. Very anxious about it, but hoping for the best.

There's some great advice & encouragement here on this post! I do feel so much better myself knowing that these feelings seem to be pretty typical for a new nurse. I think I'll try to start the journaling idea. It seems like a great way to release my feelings after a long hard day....and I don't always want to come home complaining to my husband, so this idea may help with that !

I'll make sure to include the things that seem to be going well too!

It will be nice to look back at in a few months & see how I've grown & how far I've come as a nurse.

Anyway, I wish you the very best....hang in there & take things one day at time! :)

nole123 · Oct 31, 2005

On the generalized spectrum of things, yes its normal to feel depressed and be stressed, but it doesnt make it any easier. I have been a nurse for approx. 7 yrs and recently re-entered the hospital again. Oh Boy! I have been stressed and depressed as well. Iam trying to balance and find my way so to speak in my new position and it isnt easy. Iam a person that is my own worse critic and this can set you up to fail if you let it. I often do "reality checks" otherwise, I feel even more overwhelmed. It seems most shifts I work, I have the real heavy patients, ones that require SO MUCH of your time that I wish I could give and I try to give it until Iam feeling completely exhausted emotionally....I then go home and collapse. I try so hard to please my patients, please myself, stay on top of everything, try to cause no waves. When you are new at a job, you want to be liked obviously and not disliked. Sometimes, that is tested when you feel like you are being tested ALL THE TIME. My other nurse friends tell me it takes "time" and eventually you will feel more secure/comfortable in the position... I hope so!!! I get these patients sometimes that are very complex and you dont have the TIME to research their multitude of diseases/conditions, etc. So, sometimes I leave feeling unfulfilled. I am often at home reading up on things to better educate myself. In my opinion, nursing school doesnt prepare you for the nursing world, it somewhat pads the surface lightly and then your'e sent off to swim and hope you make it. Sometimes, I really dont feel like Iam good enough to be totally honest. Iam told the opposite by people, but I dont see what they see, so Iam constantly hard on myself. So, I have to work on this and it will take time.. But, anyone out there feeling similar feelings whether you are a student, new nurse, experienced nurse, whatever......we are HUMAN BEINGS and we have to remember that. We are not perfect and we all make mistakes; important thing is we learn from them and try to be better next time. Make sense to anyone??

Long Term Care Columnist / Guide · Oct 31, 2005

Oh, I forgot to add something, Rain: you should know that being a good NURSE is not necessarily synonymous with being a good EMPLOYEE. Yes, we all have to meet certain minimum standards of efficiency to keep our jobs, but beyond that........well, let's just say that efficiency ain't all it's cracked up to be. I'd rather risk the wrath of management for getting out late, or leaving a task for the next shift to pick up, than to ignore the patient who needs a hug and a sympathetic ear because they're sick and scared and there's no one else they can talk to. Otherwise, our jobs are nothing but means to an end, and that's not what you and I went into nursing for.

So if you're worried about always running behind because you take the extra time a patient needs, you'll just have to grow a thick skin and take the occasional bite on the butt.......it's inevitable. Just be true to yourself and your vision of what nursing should be; I think everyone's familiar with nurses whose skills are honed razor sharp, but who have never given their hearts and souls to the profession. Yes, they win promotions and employee-of-the-month awards, and they look good to administration because every 't' is crossed and every 'i' dotted. But if you're like me and have only enough energy to either be perfect technically or be the kind of nurse every patient wants taking care of him or her.......well, there's no contest.

The take-home lesson here is: Be gentle with yourself. You have just started your career, and it WILL get easier with time. Nobody ever learns everything there is to know about this job; as someone once said, there is no 'there' there---things keep changing and evolving, and anyone who thinks he or she knows it all is lying. Don't be intimidated by the experienced nurses, either; even the ones who've been at it since God was a lad were once new nurses just like you. And frankly, I think it's good to always be just a wee bit nervous going into a shift: heck, I still am, and I think it keeps me on my toes and prevents me from 'assuming' too much.

Hang in there, hon.......one day, you'll be very glad you stuck with it!

nurseinlimbo · Nov 4, 2005

Well lets see.... my nursing experience started with a preceptor who thought I was an idiot and was going to fail me. I took a full-time position straight out of school in psychiatry and the NUM hated me, bullied and harassed me until I found other work. I took 3 casual jobs instead, LTC, a rural hospital, and a facility for severely disabled. I worked back to backs, short shifted and never had a weekend off. To top it off, I rarely did anything right for any of these folks. The nurses would gang up, the aids and LPNs would report me for things that I didn't know because I was new, and nobody wanted to help me learn.

This past year I worked 2 jobs in my local community and it was better, but most weeks were 55-60 hours because they both demanded my time, and once again, worked every single weekend. I have not had a family life in the summertime since I started school in 2000, and in the winter I sit here and pick lint and wait for the phone to ring. Can't pay the bills on that.

I just started a .47 position (temporary/PT) and since I am new they treat me like I just got out of school. The LPNs are nasty, they tell me "wait til you've done this fulltime for 31yrs" and try to take what little positive I have left to give my patients away from me. The patients can't stand them, and have reported them to me. I am being watched like a hawk by the nurses, who expect me to make a mistake, and as a consequence become more nervous d/t the scrutiny.

I don't really want to do this anymore, even though the work itself is not the issue. There is something wrong with the nursing profession and it needs to be addressed.

I don't think I'm depressed, but I've definitely had to become very assertive in the past few years, and that "*****" in me had a hard time coming out. I'd really rather just go about my business and do my job.

Gail-Anne · Nov 4, 2005

I must agree with the replies that say to get to a Dr if this is continuing....I want to add... WALK to the Dr! No I don't really mean walk 12 miles, I mean get some exercise! We all think the last thing we need when we've been on our feet all day is a walk. It's totally different going for a walk by the river, lake, through the fall leaves etc (or even to the store).

So before your next days off arrange a coffee and muffin meeting with a friend you haven't seen lately and get thee to a gym or out for a walk! Good luck

jenlynnrn · Nov 4, 2005

I am so glad to see that I am not the only one! I have been a nurse for 3 years, started in critical care but that was so stressful, work was all I could think about....basically how you felt, I won't rehash. Now I have moved to Denver and I am trying to figure out what I want to do. I am working agency, but I work very little and THAT is even more depressing then work itself! I feel like I have no reason to get out of bed sometimes. Not working at all, is even worse than working...uhhhh..... :uhoh3: I am just venting. Hope I get more work soon.

luvubaby · Nov 4, 2005

Hi RAin.I'm new in the forum. But I want to say a bit of what I felt when I was just starting nursing clinically...I struggled...been bullied, & been really watched over for mistakes to come my way so they can report me. All these considered a challenge to me so I tried to compose myself...just concentrate on my work & if I don't really know what to do I asked because I am dealing with a life not a piece of paper...I don't mind if other nurses think I am some kind of idiot or what..When I have free time ,I make sure I study...read,read,read because it helps a lot to do research on skills I feel I sometimes lack...believe me this works.It adds confidence because we know the rationales for such decision-making.I hope I'm making sense , I have problem expressing self in English . What I am stressing here is...continous education is vital.

elle62 · Nov 5, 2005

Man, I was wondering if my feelings were related to depression. I checked out your letter because I saw myself in it. I've been thinking of talking to my doctor but,......I'm just not sure. It sometimes gets to me dealing with so many difficult situations in the unit, and then I go home and worry that it could happen to me or a loved one. Then there are days where I'm ok. and those thoughts are in the background somewhere. do you think its depression?

pie123 · Nov 18, 2005

Hi RainDreamer!!
I suppose I feel like this as well....I feel as though I always have PMS now since starting as a new grad :chuckle (I usually seem to be more emotional during this time...).
Anyway, since starting at my hospital, I've been very emotional (Just posted to time mangement....I broke down at work today....in a meeting with my nsg educator....I was so embarrassed!!).
I am so stressed out, but I also feel so down about things. I hope things get better; for both of us!! I've wanted to be a nurse for sooo long, but now, I wonder somedays if I've chosen the right career. But I'm not sure what else I would do since this is what I've always wanted! With all my heart I'm hoping things will all come together for me & just hope & pray that things will improve in the coming weeks!!
I wish you the very best. You are certainly not alone with these new grad feelings :)

I feel the same way. I am a new grad and I'm still on orientation. I still ask myself if I made the right career choice. From what I understand, it gets better with time. Good luck to us all.