Nursing and anxiety

Nurses Stress 101

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I am a new nursing grad, have secured a job in an ICU, and am almost done with orientation. The way my brain is wired, I can be a problem solver and do beginner critical thinking as well as putting pieces of information together. I am curious and ask many questions. However, when it comes to any of the actions, skills, practical abilities, basically the "common sense", I have a lot of trouble. It just doesn't come naturally to me. Some people can watch a skill and then repeat it and they have it. With me, even simple tasks might take 10-20 or so times to do before I feel I've got it. I also have general anxiety disorder, and while I've actually been doing really well (technically I'm in "remission") on the job compared to times during nursing school and clinicals, including a few crises, I know that anxiety also hinders my ability, confidence, and learning with the skills. Does anyone have any advice on how to improve? I know it takes practice but this is also an issue with how my brain works. You could probably laugh at how I'll take so long with simple things. For example, I used to be terrified of even just emptying a Foley bag and didn't know how. It's fine now but see, I can't even figure out something as simple as that on my own, and believe me, with all the tasks that must be done throughout the day, I'm going to have to figure things out on my own; I have been asking many questions throughout orientation, but when I'm on my own people might not answer every simple little thing. Does anyone else experience this problem?

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Specializes in LTC, assisted living, med-surg, psych.

I think you have a vicious cycle going here: you feel anxious overall, which makes it harder for you to absorb and perform new tasks, which only makes you more anxious, which in turn makes it even harder to do the tasks......well, you get the picture.

Naturally, the logical step is to try to break that cycle. I don't know if you're seeing a counselor or a doctor, but if not, you may want to consider it. They can help you develop the tools necessary to deal with the anxiety so that you can become more confident in your job. There is also medication, but that's something only you and your provider can decide on and is beyond the scope of this forum.

Other things that are often helpful include exercise, massage, meditation/prayer, a good diet, even acupuncture. But I can't overemphasize the necessity of seeking help from a qualified professional, because anxiety can literally be paralyzing, and as you've written it is seriously affecting your ability to perform the skills associated with your job. Believe me, I understand how severe anxiety can be and I feel for you; that's why I want you to obtain whatever help you need in order to get past this. Being a new grad is tough enough as it is, but doing it with this albatross around your neck is a feat of almost superhuman strength. You are much more capable than you know. :yes:

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Thank you so much for your encouragement and understanding! Yes you are right it is a cycle. This is actually my milder end of anxiety; in nursing school it was way worse. Guess what, I too had trouble with bedbaths. I never considered timing them that is a good idea. I have also been seeing a professional counselor since 2011 but I guess I just haven't worked hard enough on the therapy, breathing techniques, etc. because here I am 2 years later.

I also have depression which I guess is a given; shouldn't have left that out though. I had a crisis with my depression the last semester of nursing school, had to delay my preceptorship, and it's practically a miracle that I graduated. I will keep that on the down low with my job of course; I was terrified I would have to explain in the interview but I didn't.

I don't think I can go the medication route again because I already have and not sure I can go back. It can also make my mind fuzzy so a tricky balance.

Anyway thank you so much and I will respond again when I have more time!

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Specializes in adult psych, LTC/SNF, child psych.

I developed (or at least finally recognized) my anxiety and co-morbid mood disorder (bipolar type I) in nursing school and being a new grad was tough. I too was afraid of asking questions, worried about ruining things like bed baths or getting someone out of bed. I find myself apologizing for things if I forget to bring something into a room or have to run out or someone needs something from me when I'm in the middle of something.

I have also been seeing a professional counselor since 2011 but I guess I just haven't worked hard enough on the therapy, breathing techniques, etc. because here I am 2 years later.

Don't you dare say that and be down on yourself for being in therapy and for still having anxiety. Recovery is a process and we all have our ups and downs; I consider mental health a spectrum and we're all at different points at any given time and that can change in a very short period of time. I've been in therapy for 4 years now and although I've gained a lot of knowledge, I still go back. There are still things I struggle with every day that I need to sometimes run by an objective party.

Deep breathing is also something that's not automatically easy, even if you practice it regularly. There's practice in a non-stressful environment and then there's practice during crisis. Do both, okay?

I'll tell you what though, I took up yoga in May and my ability to go into self awareness mode and say to myself, "focus on your breathing," has gotten stronger.

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Specializes in ICU, CM, Geriatrics, Management.

Again, agree with Viva here.

An additional comment: You've chosen a highly stressful and very challenging environment for your first gig. I salute your courage in going this route. Usually, there''s a stint in med/surg or step-down to furnish a grounding.

At any time, there's nothing wrong with spending some time in those units, with the goal of later returning to the ICU. Just a thought here... may be a winning strategy for you.

Good luck!

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Just an update: I was fired from the ICU job and now I'm afraid of every nursing job out there. Even med-surg. Even non-hospital. I'm not sure how I will survive. That is dramatic but it's my emotions. So far I've had a few interviews, no job offers. If I were good/competent at basic nursing skills I would be feeling much better but since I'm not, it wreaks havoc on feeling I can get past that "first year of nursing" hurdle where a person feels somewhat competent at a nursing job. Thank you to everyone who commented for your realistic insight and suggestions, and most important your kindness and empathy.

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Iwander I got fired from my first job for the same reason. Severe SEVERE anxiety. To the point where you begin to worry about stupid stuff like in your example of emptying the foley. I was literally worried about every medication interaction and if the doctor prescribed the wrong one and I give it anyways. That's just one example of the things I worried about. Now, of course, ive been off of work as an RN for like 5 or 6 months so landing a job is nearly impossible as people give me a weird look when they see ive been off of work for so long. Maybe we should talk some time maybe our situations are similar. It sounds like it.

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Yes I would love to talk more. I don't know how to send private messages on here as I'm not "allowed to" until I meet the requirements. How do I send you a message?

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Specializes in LTC, assisted living, med-surg, psych.
Just an update: I was fired from the ICU job and now I'm afraid of every nursing job out there. Even med-surg. Even non-hospital. I'm not sure how I will survive. That is dramatic but it's my emotions. So far I've had a few interviews, no job offers. If I were good/competent at basic nursing skills I would be feeling much better but since I'm not, it wreaks havoc on feeling I can get past that "first year of nursing" hurdle where a person feels somewhat competent at a nursing job. Thank you to everyone who commented for your realistic insight and suggestions, and most important your kindness and empathy.

I am so sorry. :( Gentle (((((HUGS))))) to you.

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Specializes in ICU, CM, Geriatrics, Management.

Iwander / Brit -- Hang in there, please. You folks can be great nurses! Have seen this. I know you care so much.

Take time to ground yourselves. Maybe take some courses... CEU credits are fine too. Get back into your training. Review all your experiences and what you've learned. You'll get your perspective back.

You guys CAN do it!

(((Hugs)))...

Good luck!

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