Advice on how to handle extreme anxiety

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Hello everyone,

I am in my second semester of a 2 year program and am having intense anxiety issues in med surge clinicals. I try to be as prepared as I can, but it just seems so daunting and when the anxiety prevails, my body and my brain lock up and it is as if I did not know anything. I can rationalize that the fear is unnecessary, but somehow that old sympathetic nervous system just takes over. Thanks for any help....

Yes. I was always very concerned about taking something before clinical. I timed it right and usually took something the day before clinicals about 3 or 4 pm. This enabled me to relax and get a good night sleep and be plenty alert for clinical at 8 am the next morning. Plus, I feel it still took the edge off for clinical. (that may have been just psycological). I just took 0.5mg of ativan. It was just enough and did not leave me sleepy. But, you do need to give yourself some slack. We are not perfect and mistakes will be made. Heck, I even caught my teacher almost make a med error because of inaccurate math. Whatever does not kill us, makes us stronger. I feel I am much stronger a person than I was 4 years ago. Another thing I do is take things way too personally. It is not a personal attack when the teacher criticizes you. Just say "I understand and will not make that mistake again". Teachers love that. I think I am my worse enemy sometimes. I get very mad at myself when I make mistakes. Teachers get over it quickly, I take it home and dwell on it for days. Really stupid thing to do. Metfan

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Wow metfan, You're telling my story.....I do the same thing....I go home and worry worry worry.....I have sacrificed so much to get to the point that I am at that I'm scared of messing up and failing. I take things very personally and get my feelings hurt way too easily. I saw in a previous post that you bought a devotional book that helped.....where did you get it? Online?

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Specializes in IMCU.
I too suffer from extreme anxiety during clinicals. I am in my mid forties and have suffered with anxiety most of my life. I perform very well with my theory classes and tests but when I get to clinicals in the hospital, I "stress out". I feel very intimidated by the instructors and even though I know what to do theoretically most of the time, my hands sweat, I "blank" when asked questions that I know from the instructor and I look foolish. I find myself being ridiculed by fellow classmates and would like any helpful sugestions please.

Thanks

I don't like that your colleagues are so unsupportive. Frankly, if they ridicule you, you should speak with them about it when it happens. Just ask them if it is really so amusing that you are struggling a bit.

See my post above -- if your anxiety is hindering your performance you need to get some concrete skills to deal with it. People overcome this problem all the time -- you aren't alone. Often colleges have staff that you counsel you on this type of thing. Try that.

Ignore your classmates. I guarantee they are not perfect.

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I have the book "Streams in the Desert". It has daily devotionals. For example "Never look ahead to the changes and challenges of this life in fear. God will deliver yuou out of them. Hasn't He kept you safe up to now? So hold His loving hand tightly, and He willlead you safely through all things". This is from Feb 8. I know it is a bit corny, but it helps me and I am not really religous. I actually have it on my Kindle so I can take it with me easily. I also like this quote from "Stories from the Other Side of the Bedpan"...for anyone who has had a difficult rotation or instructor. "...in nursing school know that a rotation only lasts as long as it lasts. Survive it and move on to do the nursing you were meant to do. Don't let a single rotation or instructor or patient be successful in keeping you from helping to promote healing in thousands of others". Metfan

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Thanks Dolce and metfan, I appreciate the encouragement and support. I only have five months left of program and am thankful for this forum to be able to share, encourage and support one another. :redbeathe

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today i had a bad situation at clinical and am so mortified. i had a patient who is in isolation who i gave a head-to-assessment to and after telling me i did a beautiful job, i later heard him complaining to the occupational therapist of "all the crap that he had to put up with all morning." frankly, i was stunned. later, i went to my instructor and told her what i heard and she said i would need to have a new patient. i asked the ot when she came out if the patient was in fact talking about me and she said yes, he doesn't like students. the rn said we need to respect the patient's wishes. i looked at my teacher------ and started to cry! i was so embarrased and moritified, i can't tell you. my instructor whispered,"don't do that, don't do that, don't do that. go to the break room." one of the rn's was down there and my instructor came and i apoligized but still could not control the tears. not so much because my patient didn't want a student, but because i have already spent over 5 hours on researching this patient, all his meds, and organizing his 12 page care plan. now i will have to do the same for a new patient, what we call a supplemetal patient and it is a massive amount of work. meanwhile i have two tests on friday and a 75+ page case study that i have no time to work on that is due in three weeks. i feel so overwhelmed but am very embarrassed about the tears. later, i was telling my 4 fellow classmates about it in the charting room-----and broke down again! these people are not even my close friends and here i am with tears streaming down my face. of course then i had to listen to them tell me that it doesn't bother them when they have to do a supplemetal patient (right--some of them are barely passing right now) and i know i have lost major respect from my instructor, the rn's and my classmates. i simply could not stop myself from crying and am so frustrated by my lack of professionalism and control. i apoligized over and over again but my son said doing so just makes matters worse. i have been taking the inositol for a couple of weeks now with pretty good results so i am appalled at where this emotional stuff came from and very disturbed that i could not prevent my self from crying in front of anyone who looked at me. all i can think of is what if it happens again??

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First of all stop beating yourself up over it.

And second of all- yes, some patients are not going to like students. I had 2 of them my first clinical rotation. It made me feel horrible- like I was doing something wrong. One lady was not very nice with me- but all pleasant and happy when my instructor came in (and my teacher told me this- she also said this lady had other students as well and she didn't like them. Made me feel better).

And then I had another patient who was dealing with end-of-life issues. The day I had him. He said NOTHING to me the entire 3 hours I had him. Then it came time to check BG and wouldn't you know it I forgot how to do it LOL. ( I know now after doing it a zillion times on a postpartum diabetic LOL) He just stared at me. UGH. Felt like I could do absolutly nothing right.

What kind of bothers me is that the instructors really don't do a very good job at screening who would like a patient. I realize that in the "real world" we aren't going to get to pick and choose- there's going to be nasty people, and nice people. But- when you throw in the whole stress of being a student- well wouldn't you think the staff would think a minute before saying "Oh yeah, you can give so-and-so a patient" if they've seen this patient on the floor for the last 24 hours and gee- they've got a bit of an ATTITUDE.

Cheryl

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