Desperate for help with anxiety!!

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    I am in an accelerated nursing program and am due to graduate in December. I have had issues with anxiety all of my life. My doctor just prescribed me Serax to take as needed for anxiety, and also Xanax XR, to see which one I like better. I'm just scared to take them while working. I am doing my practicum in the Emergency Room, which I think may add to my anxiety but I love ER nursing. I just started my practicum 4 weeks ago, and I don't really feel like I fit in. My preceptor is really intimidating and really independent, I feel like she expects me to know how to do things after she shows me once or twice. However, I am a really slow learner. I have really bad ADD and take Adderall daily for it (which I know does not help with the anxiety issue but it helps me focus better). Most of the time I am scared to ask her questions about things she's already told me/taught me because I feel like I should know how to do it. I feel like I don't know the things I should know by now that we learned in school. I just hope this all gets easier. I also have a problem with my hands shaking, which is something I have had my whole life. I think it runs in my family because my dad and sister have the same problem. Since I've started doing IVs the patients are asking me why I shake, and its really embarassing for me. I am always on edge when there, mainly because I have really bad social anxiety. Can anyone please give me some advice on how to fit in better while I'm there, what I can do to ease some of my anxiety while working, and maybe some similar experiences if you have any? Thank you!
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    Sounds like you may need to have a chat with your doctor. You should ask if the medications are making the tremor worse, and if so what alternatives are available. Perhaps find someone to talk out your social anxiety & concerns when in your preceptorship. Do you have an instructor at school that you have a good relationship with? Generally your instructors WANT you to succeed and can offer suggestions on how to manage your concerns & anxiety on site.

    If you patients are expressing concerns, this will likely trail back to your preceptor, school, or worse on the patient surveys. Not everyone is cut out for the fast paced, ever changing, organized chaos of the emergency department. Can you practice asking questions with a friend or family member? Perhaps make a list of your questions (if they are not urgent, or related to a patient's immediate care or need) and use the written list to discuss your knowledge needs with your preceptor. If you don't tell her or ask her anything, she has no way of knowing what you need or want to know. Nurses are good but I have yet to meet one that is a mind reader. Good luck.

    to fit in--show an interest, ask relevant appropriate questions, and take a deep breath.


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