Does anyone else get really nervous before a shift?

[j_tay1981]

I always get very anxious prior to the start of a shift, especially if my group of patients is new to me. I'm always nervous about possibly having to float, or maybe needing to give blood, etc. While at work, I'm nervous to walk into patients' rooms, and feel self conscious while in there. I had this problem while in nursing school clinicals too. It doesn't seem to be improving, either. I used to take a benzo for anxiety but felt like it adversely affected my short term memory, so I quit. I've been off orientation for approximately six months.

Any advice?

[Quit Floating Me, BSN, RN]

Experience and time. I went through that before (no history of Benzos - I did take Vistaril, though). Anxious before a shift. Once I floated four shifts in a row. I hated it at the hospital I worked at. I've been a nurse three years now and I no longer get anxious before work. Good luck!

[RNperdiem, RN]

Some anxiety is normal. If you are new and handling the responsibility for the lives of several sick people and not fully confident in your abilities, being a little anxious is to be expected.

It takes time to build up your nursing skills and confidence. With time, the amount of anxiety decreases.

I still get a little anxious before shift because I am walking into the unknown.

Until that time comes, make use of your charge nurse if you are going under, and take good care of yourself outside of work.

[classicdame, MSN, EdD]

my first year of nursing was miserable. Looking back, I can see that I did it to myself. One day I realized that absolutely NO ONE had died while in my care and I had not broken any laws or rules. Then I began to relax. Try teaching a new hire the tricks of the trade. That will get the focus off you, and it will confirm your own competency!

[Esme12, ASN, BSN, RN]

The first year is the toughest...((HUGS)). I still get the willies every now and then when I hear mass casualty of MVC with multiple and they are kids...it's natural.

[Career2_BSN, BSN]

My prereqs are finally done and I apply to NS this fall so no direct experience myself, but I tend to get anxious and I totally see myself having these same anxieties.

classicdame said:

One day I realized that absolutely NO ONE had died while in my care...

I love your whole post, classicdame, but this part in particular. I think, even more importantly, is no one died as a result of your care. Some patients are going to die no matter what we do as nurses and it is equally important (and perhaps more difficult) to know the difference. Reading posts from seasoned nurses on AN has taught me this. I just hope I remember this when I need it because I don't think it's a matter of IF I need it, but rather WHEN.

J_Tay - at least you know you're not alone.

[Morainey, BSN, RN]

I do sometimes - when I was newer, if I thought I might get floated or get an admission right off the bat, I would be dreading work, and come into work dragging my feet. It would cast a big shadow of doom over my entire shift. I think with time and experience it goes away, for most people.

[ktliz]

Maybe you could ask your PCP about an SSRI for anxiety? I tried multiple SSRIs until I found something that worked really well for my anxiety (Effexor, which is technically an SNRI). I couldn't function in my job without my meds!

[j_tay1981]

\ said:

Maybe you could ask your PCP about an SSRI for anxiety? I tried multiple SSRIs until I found something that worked really well for my anxiety (Effexor which is technically an SNRI). I couldn't function in my job without my meds!

Ktliz, I am actually on multiple meds for anxiety and depression. I have a lengthy history of it.

I've had a couple more shifts under my belt since I started this thread. I feel like I'm just not getting this stuff yet. I'm better organized than I was day one on the job, but there is too much 'gray area' on this floor! Actual policies aside, I can never get a straight, consistent answer from other nurses on what to do in certain situations, especially when dealing with unpleasant or insulting patients.

I look at my peeps I need to see at start of shift and try to prioritize them, but they all have extensive meds or cares that make the order I see them nearly a moot point.

What scares me though, is how quickly I became the type of nurse I never wanted to be: bitter, resentful of my patients at times, short tempered, suspicious of patients that I feel may be narc-seeking. I'm not even at my one year mark off orientation yet!

My shifts having me feeling like I'm holding my breath for twelve hours straight as tasks pile on me, and relief is the only description I have for knowing I don't come back the next night. Not 'hey, I get a day off, what will I do?' But actual relief that I can mentally and physically be disengaged for an evening.

All I do is race from one task to another, not fully absorbing the reasons WHY my patient is having certain symptoms or getting certain tx.

I'm already tired of the constant battle of wills with patients, their families and on coming nurses that question every little thing you did or did not do over night. It's exhausting.

But...I still have much to learn, and this is a good floor to learn on. So I stay. Also, I'm not convinced any other place would be any better.

But right now, after less than a year as an RN BSN, I can say that if I could find a warehouse job that paid me the same, nursing would be a distant memory.

End rant, as they say.

[xoemmylouox, ASN, RN]

I had horrible anxiety when I was new at nursing. I still get nervous when I start a new job or I know it's going to be a horrible day. The main thing is to learn how to cope with the stress once you're done with your day.. Sometimes it's a drink, a workout, a good comedy, venting to my hubby, or spending time with my furry four legged child.

[j_tay1981]

\ said:

I had horrible anxiety when I was new at nursing. I still get nervous when I start a new job or I know it's going to be a horrible day. The main thing is to learn how to cope with the stress once you're done with your day.. Sometimes it's a drink a workout, a good comedy, venting to my hubby, or spending time with my furry four legged child.

Good advice. I've gotten back into running, and it is a huge stress reliever for me. If I had a particularly nasty shift, I tend to run further since I can channel the pent up emotions. So, it does have its plus sides

[nurseprnRN, BSN, RN]

(Hint: you keep putting one foot in front of the other and one day you notice you are walking without thinking about your feet.)

Some of you have heard me tell this story before. I was several years out of school and had been staff in this fabulous ICU for three, and I was actually pretty good at it. One day I was in the break room with Sarah, a nurse of more than a decade's experience in the unit, one who could take every kind of patient that rolled up the hall, who was never flustered, always expert, always willing to teach and explain. I asked her when I would stop feeling scared when I sat in report. She smiled and said that every day before report started she felt a pang of anxiety, but that it passed when she started working. She said that when that little stab of fear went away she would have to go somewhere else, because it's what keeps us awake and sharp. I never, ever forgot that (and here I am telling that story again, smumble-mumble years later), and I am happy to pass it along to you.