Anxiety & Nursing

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I'm a few months in to orientation on a Med Surg floor, about to go on my own within the next couple weeks. I have been diagnosed with generalized anxiety disorder and panic attacks since I was a kid (thank you long-standing family history of anxiety). I have heard over and over that the first year of nursing is the hardest, and that it is normal to question your career choice....but I have really been struggling with questioning my career choice. Don't get me wrong, I love being a nurse and helping others. I can recognize my good days and bad days. Being new is a reality shock, but I am learning so much. I feel like I am slowly but surely getting the hang of nursing. The good days are happening more frequently, and I am learning to let a lot of things on the "bad days" roll off my shoulders. I know I still have much to learn, but everyone says I am progressing normally. My hospital is great, my nurse leaders are great, and the staff on my unit is awesome. Everyone on my unit is so kind and helpful to the new nurses. I am not trying to complain about my job situation, because I am very blessed to be where I am. I just have a personal issue with anxiety that has gotten way worse since starting my nursing career.

For me, the stress level nursing comes with is huge. I didn't picture rainbows and hand-holding, but I also did not expect this career to be so stressful. I get a lot of anxiety about going to work. For the 12 (more like 13) hours I am on the floor, I feel so wound up. I try to un-wind with a bubble bath or something relaxing when I get home, but working back-to-back 12s usually only allows me time to eat and sleep between shifts. After work, I feel anxious about my actions during the previous shift.

I have done talk therapy in the past and I have anxiety medication. I am looking into starting up talk therapy again, and my mom suggested acupressure. I exercise, eat right, take a lot of "me time", pray about it, hangout with friends and family on off days, and try to make the best of my anxious tendencies. My best efforts to maintain balance have not been working since starting this new job.

I really do not want to feel so anxious and wound up for the rest of my nursing career. The thought of feeling this way for a long time, stresses me out even more! This is not ideal quality of life for me. I don't like making decisions that can adversely affect a patient's outcome. I don't like not knowing what will happen during the shift. I don't like not being able to follow my organized plan for the day, because x y and z happened. I don't like the long shifts where I feel on-edge for 12 hours.

I have a new graduate contract and I want to get at least 2 years experience on my floor if I can. I'm not a quitter and I want a solid 2 years of general nursing experience. But feeling this way is not how I want to spend the rest of my nursing career. Right now, a boring 9-5 office job sounds like a dream. I am learning a lot about myself - like how I think I would much prefer a more predictable schedule. I like nursing, but my current setting is definitely not for me.

Any suggestions from other anxious nurses? What are some ways to cope during these first 2 years? Thinking towards the future, what are some alternative nursing settings that are a little more relaxed?

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Specializes in Critical Care, Education.

Based on your post, you have an admirable level of self-awareness. You are dealing very well with a serious and potentially debilitating illness. Patient care jobs in acute care are stressful - and MedSurg is arguably the most stressful area in which to work.... as evidenced by highest levels of turnover and low job satisfaction for nurses in this area. MedSurg-Tele numbers are even worse.

If you were immune compromised, would you voluntarily work in a communicable disease unit? Probably not - because you know that it would be dangerous for your health. So, if you know how the MedSurg environment affects your mental health status, why are you exposing yourself to this? There are many more stable and predictable areas in which to work. Be kind to yourself.

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Specializes in Neurosciences, stepdown, acute rehab, LTC.

I too have a pretty bad mental health history including anxiety and am a good nurse. I have two pieces of advice for you that work for me. One is continue to eat right, you need tons of fuel to keep your brain going the way it needs to. Second, don't be too hard on yourself about work/ life balance. In the past I used to work out a lot / try to spend time with others / all the healthy stuff and still do. But I realized that for me , these were just ways of trying to gain control and it was even harder when it didn't make me feel better. I personally don't think anything is wrong with needing to just lie around and sleep for 12 hours after binge watching TV, sometimes, many times , you need to go against all recommendations to refuel. For me (just for me, maybe not for you) I try hard to eat healthy but sometimes I just used way too much of my reserve and need a big sugar or fat fix, in which case I eat a bunch of mc Donald's with a shake to catch up. That's ok too. Whatever you need. While healthy habits are always healthy, you know deep inside what you need. A third piece of advice while I'm at it. After a shift, try to debrief all the stuff thats bothering you about the shift. Make a quick plan to improve for next time and then let it go. That's all you can do. Hope this helps

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Thank you for the new perspective, anewsns. I have never thought about how trying to have so much balance can actually be a form of control. I do like my job and am not leaving anytime soon, so i appreciate your post. I also think a good amount of my anxiety will decrease once i get more used to just being a nurse. Thanks!

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As you get more comfortable in your role and confident with your skills, I bet your anxiety will naturally decrease at least a little. Self-awareness is huge - that alone is something that can help. I find it calming to be able to identify the source of my anxiety. It helps me prioritize the steps I can take to alleviate some of it. Personally, I find that trying to get all those supposedly relaxing things accomplished adds to my stress level. Sometimes I really do need a few days of overindulging on sugar, grease, and bad TV. I do feel better when I exercise and eat right, but sometimes I need to feel the other extreme to make me understand the value of it and motivate me to make it a better habit. Sometimes my anxiety is how I know I need to slow down and recharge by taking a break from working so hard for that balance.

Things do get better on the job front. I felt sick to my stomach every day for the first several months on the job. At some point, things did shift and I realized I wasn't feeling those awful dreadful things any more. The idea of calling the MD didn't twist my stomach into knots. My assessment skills got better and I started catching things earlier, which meant that I was able to be more proactive than reactive. My time management improved to the point that I skmetrs got out on time, or even had a few shifts with actual downtime.

It gets better. The learning curve is steep, but you'll conquer it.

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Specializes in cardiac/education.

Not to be a downer, but it never got better for me. Some aspects did, but in hospital nursing I just could not get over the anxiety of not knowing what I was gonna get that shift. And let's be honest, on med-surg Tele you usually do have a hot mess of patients so most days I came in to not a good surprise. LOL. Combine that with running all shift, not putting yourself first, lack of sustenance, and staying late, and ......ugh.

You are super self-aware. Very cool. I have struggled with finding a solution to this crazy nursing-induced extreme anxiety since 2006. Something in me really wants to excel in the hospital because I think maybe I see it as the "best of the best" in nursing. But I think I just keep fighting my personality. Like you, I try to self manage my anxiety by doing healthy things/etc but when you add another huge stressor like a death in the family, a crazy schedule, or a NURSING JOB in a acute care....I can't cope. It's coping skills really. In the end, mine suck. LOL. And I'm not gonna medicate on Ativan or Xanax all day so what is a girl to do?

This girl is moving to School Nursing. Yeah I don't really know what to expect every day either (all nursing jobs are gonna be like that I guess) but, it's a change, and hopefully a better fit for me. ;). If not, I'll probably go back to some type of desk job where life or death doesn't have to face me every.stinking.day

Good luck. I hope things work out for you. Maybe it is just because you are new and need to develop your "flow". I gave it a year. I still wanted to puke just as much on that ride to the floor on Day 365 as I did on Day 25. Then I talked to my nursey friends and they told me, "Oh, it's normal! You don't really feel comfortable until about 5 years in". 5 years? 5 years of panic filled, nausea-inducing, self-doubt inflicting *****? Uh, no. Something's gotta give. So either I'm being smart or stupid, I'll never know. But in the meantime I'll get a paycheck at least. ;) Keep us updated!

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Specializes in cardiac/education.

I really like the poster who mentioned activities as a means of "gaining control". I think this is it. People with immense anxiety like to feel in control. I think I am constantly trying to control my environment but for some reason I feel powerless so I keep up with all these crazy activities (intense exercise, cleaning OCD-type stuff, anger issues). Problem is, in the hospital, even if you are a master of your craft, are you really in control? Nurses have the least control! So, yeah, that is why I think it sucks for us GAD'ers. ;)

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