Anxiety and Ativan

Long Term Care Columnist / Guide · May 4, 2016

Hello, and Welcome to Allnurses!

While we cannot give you any type of medical advice per the Terms of Service, I would suggest finding a counselor or therapist to help you manage your anxiety better. Medication alone isn't enough, and you cannot take Ativan at work or before your shift begins. It is a short-acting anxiolytic, but it is never okay for a nurse to be even minimally sedated while caring for patients. If your employer were to discover you using Ativan on duty, you would not only face termination but be reported to your state Board of Nursing, even though you have a valid prescription.

Seriously, if you're not in therapy or seeing another qualified mental health professional, please do so. Anxiety can be crippling (I know because I live with it too) and life is too short to spend it miserable. I wish you well.

Been there,done that, ASN, RN · May 4, 2016

We ALL had anxiety . Drugging yourself is not the answer. You need other coping strategies. No way in Hades would I take a combo of controlled substances and trust myself to provide nursing care.

Who is prescribing this ? Does the provider know the source of your anxiety and that you are a nurse?

owlcitygirl · May 4, 2016

She is an advanced practice nurse and yes she knows I'm a nurse. She also knows the source of my anxiety. It is quite debilitating.

Trauma Columnist · May 4, 2016

Moved to Health and Stress Management

owlcitygirl · May 4, 2016

I have a few days off work here and will see how the med affects me. I took one today and didn't get a sedative effect from it. I was on klonopin which is similar in effect and never made me tired or feel impaired. My anxiety has always been a problem for me and it's getting to a point where I need something else. I was hoping to hear from experiences from other nurses who do take it and work without any problems.

Been there,done that, ASN, RN · May 4, 2016

The issue is you don't FEEL impaired, but your judgement IS . Also, if a random drug screen is required... even with a prescription it could be a problem. Check out my thread "Do we need to take drugs in order to do our jobs"? There are many more threads on this topic that could give you more insight.

Best of luck with this issue, let us know how it's going.

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CountryMomma, ASN, RN · May 4, 2016

I work with a nurse that has severe GAD, and it was causing her a few debilitating health problems. She was prescribed an SSRI and Ativan. She took her SSRI religiously and the Ativan on off days or, if the shift was really bad, when she got home (provided she wasn't working back to back 12s). Her physician specifically warned her not to take it before shifts or within 8 hours of a shift.

It ended up not being enough anyway, she transferred off the floor. We still talk on a weekly basis, and last text exchange she was talking about the Ativan not being the answer, she was thinking. She had started DBT and psychotherapy, and and it was starting to make a longer lasting difference than 1mg tabs.

You might not feel impaired, but that's often like the drunk guy saying "I feel just fine, I'm not drunk yet." We can see it, they can't, because their faculties are *impaired*.

I wish you much luck, but I'm afraid that things will go south for you quite quickly if you insist on taking Ativan during/before a shift.

quiltynurse56, LPN, LVN · May 4, 2016

There are nurses who take ativan on a prn basis, but usually don't take it while it at work. I know one who is a great nurse and her judgement is not impaired.

I have had to start taking it on an infrequent basis. It does give me the sedating effect so I only take it when I won't be working.

I don't think those of us who do take ativan get it as the first thing to take for anxiety. By the time we get to the point of having it prescribed, we have tried so many things over the years. I have had anxiety for most of my life, but am now just taking the ativan for when it becomes debilitating. I have grandchildren so that tells you I am older.

owlcitygirl · May 4, 2016

Yes I've tried a ton of SSRIs and klonopon as my only other benzo. I got prescribed another SSRI for night time for my obsessive thinking and then ativan prn in the day to help with my social, general and panic anxiety. I wish I could manage without meds but it's becoming too.much of a problem for me. It's making me depressed.

quiltynurse56, LPN, LVN · May 5, 2016

I meant to say we don't get it as the first thing, usually it is one of the last things we go to.

madricka, BSN, RN · May 5, 2016

I was the same way when I started nursing and again when I switched from a regular floor to critical care. I have GAD and some other issues that were causing me to be overly emotional and I wasn't eating/sleeping, etc. I opted to stay away from the benzos (even though they were offered) because they are so habit forming (physically and psychologically), I didn't want to "need" them. Plus, taking benzos on a night shift -- yikes! Psychotherapy, CBT/DBT, mindfulness, guided mediation, breathing exercises, etc -- these are some of the things that helped me a lot (some worked better than others). And some days, nothing will work and you'll just be anxious -- and that's okay! Remind yourself that nothing bad is happening (because it's not) and don't fight against it. Lots of deep breaths (like stick your belly button way out and put your shoulders down). If you feel you're getting overwhelmed, take a breather in the bathroom and splash some cold water on your face (or on your hands/wrists if you don't want to ruin your makeup!) -- it stimulates the "Mammalian Diving Reflex" which will lower your heart rate and help you relax a bit. If you need help at work, never, ever be afraid to ask! I know it's hard when you're new because you don't want people to think you're incompetent -- but trust me, EVERYONE needs help at some point!

Unfortunately I know too many people who chase antidepressants and antianxiety meds and are never able to get off of them. It can be a vicious cycle. Or they never quite find the relief they need -- probably because pills are just a bandaid, they don't treat the underlying issues. Anxiety is not just a physical thing you can cure with a pill, it's much deeper than that -- and yes, it can be managed without meds, but you can't do it alone. I'm not totally against the meds, I'm just saying you won't need them or need as much if you have other ways of coping.

I hope you find something that helps!