New nurse, feeling helpless and depressed

dishes, BSN, RN · Dec 17, 2014

It is an awful feeling dreading work, I remember feeling that dread when I was a new nurse, I talked to colleagues and friends who had similar feelings and they gave me tips on how stay organized during a shift and allowed me to debrief when I had disaster nights. Many of us have been in your shoes, some have found stress reduction techniques such as; exercise, meditation, or journaling are helpful.

Tenebrae, BSN, RN · Dec 22, 2014

First of all. Be kind to yourself.

The transition from being a student to being a real life true blood nurse can be terrifying. I spent most of my first shift when ever someone said "this is tenebrae and shes the RN on duty tonight" inwardly thinking "oh crap thats me they are talking about".

You wont know it all over night. Never be afraid to admit that you dont know something. For the first year out my most common response was "I dont actually know, but let me ask someone and get back to you". Also, I know I hit a wall when I had been out for six months, most of the girls I graduated with also sort of hit the 'six month wall' it seems to be common for new graduates

One thing that was a mega help for me was having regular supervision. Basically the opportunity to sit down with an outside person and discuss parts of the job that were a struggle, discuss coping strategies for myself, ways of dealing with a stressful work load, how to handle difficult patients/colleagues

Night duty on its own is stressful. Your body is all out of wack from working when it wants to be sleeping, sleeping when it thinks it should be awake. Is it an option to start looking for something on the day shift?

Finally, do be kind to yourself. Its a hell of a journey

Curious1alwys, BSN, RN · Dec 27, 2014

Hugs to you. It is SO hard!!!

Lucky724 · Dec 31, 2014

I have been a nurse a lot longer than you however I completely understand and identify with you..I work in a position that I am quickly realizing is not for me..it's a M-F 8-5 position in home health...the depression I already struggle with has increased significantly since starting this job..for you though...being new and in med/surg..well..it's understandable you would feel as you do. Med/surg is tough..patients are sicker, turn over of staff is usually high...I hope you are able to find something more suited to your needs and better mental health - good luck

icuRNmaggie, BSN, RN · Dec 31, 2014

This fear of the unknown will get better in time. Don't let it be all consuming.

I don't know what the disaster nights were like, but we all have one from time to time, and on those nights I tell myself 'I can only do what I can do.' I have given the HS meds at 2:30 in the morning due to things beyond my control.

Awful things are going to happen, and you are going to call a rapid response or code blue and get that person moved to ICU. Don't you worry, you didn't cause it, and you can not fix it all by yourself. Deep breaths.

Remember that you are working in a medical facility and not a restaurant. You are not a waitress who has to jump when people snap their fingers. You do not have to jump like Pavlovs dog when the same call bell goes off for the third time in a half an hour. You need to focus on your professional nursing responsibilities and being in charge of your group. They don't run you. You are in charge.

Focus on patient care. Be efficient. You do not have to socialize with these people unless you really want to. Know who the family spokesperson is and refer everyone else to him or her. Assess, turn pt, give meds snack and fresh water. All in one trip not five. Is there anything else - Here's your call bell - good night. You will soon be a night nurse ninja like the rest of us.

firstinfamily, RN · Dec 31, 2014

And, don't be afraid of using a flash-light to check in on your patients during the night!!! I still do this, and I still get ridiculed for it, but I have yet to have a pt who is coding at change of shifts because I know what is going on with them!!! It will take time before you get your groove on, but it will come. See what organizational strategies work for you, I usually gather ideas from others and come up with my own process that works for me. You are learning a lot at one time, and it takes time to process all of it. You may not feel like you have a handle on things now, but I bet you feel better than when you first started?!! It takes baby steps before you can leap, but you will leap. Treat your patients with kindness and professionalism. Treat your co-workers the same, don't become one of the gossip crowd it will only cause problems later. Go in, get report, get organized and do your thing, make sure you let your patients know you are their nurse and be proud of that!!! The fears will go away when you feel more comfortable, You are suffering from "reality shock" it will dissipate with time. Talk to other new grads and see how they feel. We are here for you!!! Congrats on beginning your journey with a realistic approach!!

Gooselady, BSN, RN · Jan 1, 2015

PLEASE seek out your manager or even an EAP about this -- a perfectly understandable and acceptable thing to do for any newish nurse in his/her first year.

A lot of this stress is in your mind, not in the job. In other words, your lack of experience and confidence 'create' anxiety when you are actually doing just fine. This is inevitable in that hard first year. The people who deny they had much worse anxiety in their first year or so are not being truthful or have poor memory.

I'll give you a hint, you'll remember this from your psych nursing classes. Remember cognitive/behavioral therapy? And the list of distorted thinking? What you might be doing is called "catastrophic thinking", where your assumptions, beliefs, conclusions are NOT realistic but driven by fear. It's something everyone does, and ALL newish nurses do :) You wouldn't believe how normal you truly are. In a way, being MORE anxious rather than LESS is a good sign you will be a successful nurse.

It's about the stuff you tell yourself in your own head that drives the anxiety. It's about stepping back and reframing what makes you so anxious in more REALISTIC ways, rather than 'catastrophic' ways. Utilize your mentors/helpful co-workers and give yourself credit for what you do well. This will get better, I promise -- but it will take deliberate action on your part, and some insight into yourself which never hurt anyone :)

NurStud10 · Jan 19, 2015

I am having the exact same problems. I am a new-grad and have been on a med-surg floor for 6 months now and I work night shift. I am already a perfectionist and can be a bit high strung, but then I started nursing it all increased.. and the anxiety was uncontrollable. I finally went to my PCP and got put on a low dose of medication. It helped at first, but I got back from a vacation after the holidays, and now I am back to being extremely anxious. I am even really sad now and randomly sobbing. I know it is a combo of not being on a unit i'm passionate about (I would really like OB or peds), working night shift, I am a type one diabetic, and I am having a lot of other family and legal issues right now that a normal 20 year old would not be experiencing. I am thinking about seeing my PCP again this week to decide what do to. I know I can't live like this much longer. I am questioning if nursing is for me. When I say that to friends and family they can't believe I even question it because they are say I was made for nursing...

I didn't mean to make this about my story; I apologize for that, I just needed to vent. We are not alone. We will either find out niche in nursing or find something outside of nursing. I keep telling myself that this is not forever...

Sincerely,

Sad, but hopeful RN

westieluv · Jan 20, 2015

I am guessing that you, like me, tend to be a type A, perfectionistic type of person. Sometimes our type does not do well in an environment like acute, inpatient med/surg. In my case, when I worked in med/surg most of my anxiety came from the not knowing what work was going to be like from shift to shift because I am an extremely organized person who works best in a set routine and I don't do well when the unexpected comes up and upsets my routine, which happens on pretty much every shift in med/surg.

This may not be for you, and you may not want to switch directions at this time, but I have found that working in a dementia care/assisted living facility works much better for my personality type than acute, inpatient nursing. I have a set routine when I work that rarely gets interrupted unless someone falls or dies on my shift, but even those circumstances are controllable and don't put a wrench in my day like a difficult admission, code blue, or doctors rounding, or IOW, those unexpected things that can happen in the hospital and totally screw up your shift for the rest of the night. In a setting like I work in, you get to where you know every resident inside and out, and it alleviates so much stress to know what to expect from them, as opposed to meeting several new patients each time you work that you know nothing about. I can anticipate if someone is going to give me a hard time about taking their meds or if their daughter is going to come in and drive the staff crazy. Things like that still happen, but at least you aren't caught off guard, and just knowing what to expect can make a world of difference to an organized, type A person who works best in a routine.

I hope things get better for you, one way or the other. I know how difficult and stressful hospital nursing can be, especially for a new nurse, and my heart goes out to you. No one should have to have this much anxiety every time they go to work, life is too short. God bless!

RachRN11 · Jan 20, 2015

Just know one thing, you are not abnormal in feeling this way.

I was much like you when I worked on the floor. I absolutely dreaded going in and would get anxious and cry as well. One thing that helped me was having one nurse that I knew I could go to with any question or for any help. She was amazing and so patient with me. She also told me that "you definitely won't know what you're doing for 6 months, by 1 year you will sort of know what you're doing, but it'll probably take a good 2 years before you actually feel comfortable." Nursing takes experience and a lot of it, so be patient and kind to yourself. You may be out of school, but you are definitely still learning.

My most common answer for that first year was "I don't know, let me ask". :)

As for me, I soon learned that floor nursing was just not what I should do. I was always too stressed out, I hated the fast pace and the intensity. However, others' strive for it, they love it and you may end up loving it too! But I was given a wonderful opportunity to go back to school (only 2 months) to become a certified wound, ostomy, continence nurse and my job now (inpatient wound/ostomy nurse) is so much more laid back. My schedule is how I make it and so much less intense. My anxiety is basically gone.

So, my point is to give yourself the chance to grow into a nurse but don't be afraid to say "you know, this isn't for me" and start looking for other "outside of the box" nursing. You'll be surprised how many nurses there are that don't even work in a hospital.

malamud69, BSN, RN · Jan 20, 2015

Always expect the worst and never expect much out of other humans...make a list of all the things that can and will go wrong before every shift...you'll be pleasantly energized when they "dont" and before long you'll realize you can handle anything!