Anxiety - help!

[SonicnurseRN]

I have a problem & would love some feedback. I have severe anxiety, yet I am usually able to manage it, but yesterday @ Clinicals I was being checked off on my injection skills & I started shaking & sweating uncontrollably! I felt as if I was having a heart attack and the shaking was so intense! Luckily I have supportive peers & an instructor that was very kind. I _think_ I laughed it off pretty well & acted like it didn't bother me, BUT I was so humiliated I went home & cried all night. I feel like this could ruin my career!! I don't have health insurance, so going to the DR is not an option ... does anyone have an suggestions for dealing with this? I do Yoga & deep breathing exercises to control general anxiety. Mainly, if I could stop the shaking I'd be ok. I've read Benadryl can reduce anxiety symptoms ... would love to hear from ppl who have similar problems or any advice on over-the-counter meds I could use situationally.

[Lynda Lampert, RN]

I just wanted to chime in here because I suffer from anxiety, too. Clinicals are a nightmare for me! I'm a very good student and quite vocal in class, so I think that people expect a lot from me. When someone is looking over my shoulder, though -- instant stage fright!

I, too, have a prescription med that I take as needed. I've gotten into taking it only on clinical days and it helps. The problem with taking meds, though, is that sometimes it makes you too tired which can also be a problem. If you can't concentrate, then you can't make your clinical instructor happy -- trust me!

Some other things I've done: don't talk so much. I find the more I'm trying to explain myself, the more anxious I get. Another thing: try to talk through a procedure with someone in your clinical group. If you're going to be doing an injection, just ask them to run through it with you. I find that helps a lot! Get organized is another good one. You can often reassure yourself that everything is okay if you have mapped out all you need to do ahead of time. That way the routine things are accounted for and you can react to surprises -- such as, guess what, the doc just ordered a piggyback and you didn't have the time to prepare.

The very last thing I learned in trying to get rid of anxiety is that we are there to learn. Wow, it's still hard for me to get because I expect myself to be on top of everything -- and I'm not. The head of my department said to me: keep your patient safe, know how to get information you may need, and know when something deviates from normal.

Wow, sorry to ramble. Hope this hard earned knowledge helps someone out there!

Ionafey

[marshgreencohen]

read the bible,meditate,medication might worsen the case and dependency might be the next level...:)

[firstyearstudent]

The #1 thing that I did to help with shaking was very small but it did wonders -- I stopped drinking coffee before clinicals.

I also started taking a precription medication for anxiety/depression. I have had lifelong problems with anixety and just had a grin and bear it philosophy about it. I have learned a lot of coping techniques, but they all just helped me do what I needed to get done -- I still felt like a nervous wreck inside! This med actually helps me feel less anxious.

Despite the med I stilll shake if I'm drinking coffee...

Here are some coping techniques from a nervous wreck:

1. If you have something nerve wracking to do, practice it thoroughly once or twice and then put it out of your mind -- don't think about it!

2. Take a breath and hum (either vocally or subvocally)

3. Do whatever it is quickly. Hesitating with make you more anxious/shaky

4. Talking about /saying you're nervous will only make you more nervous and anxious; don't say anything about it

5. Think, what's the worse thing that will likely happen (not unlikely). Ex: I will not get a successful IV stick and will embarass myself by shaking/failing. Chances are that it isn't that bad.

[mezzano]

Dear Firstyearstudent:

Thanks for the advice! You are so right about talking and thinking about it. I need to stop the negative self-talk because I know I'm more than capable! I also have found that if I think about it, I get more nervous. If I'm really distracted, thinking about something else, I don't get nervous!

[mezzano]

Thank you all for all the advice and support. Just want to add that I've tried meditation, breathing exercises, no caffeine, etc. Although they help me some, it wasn't enough. I only turned to medication as a last resort and use it along with behavior mod. It's the only thing working for me right now. And the medication I use is not addicting so that is a huge plus! It doesn't help that much with the nervousness - just stops the shaking so that I can function.