Anxiety Problems

yooper13 · Jan 31, 2012

Yes, I can relate...I do it alllllll the time! Just last week I was up until 5 am (went to bed around 11:30), had to be at class @ 8 (luckily not clinicals, but still, class from 8-4...exhausting after 2 hours of sleep!)

The thing for me is, my brain will not turn off. I have endless thoughts, and even though my body is resting, in bed, I am not getting the sleep I need. This in turn causes me to function at a less-than-optimal level the next day. For me, it has been going on periodically for years, so I have gotten used to it and accept it. Sometimes I take a (non-narc) sleeping aid, like melatonin or something...sometimes it works, sometimes not. I have tried to find a pattern in it to no avail.

It has been suggested to me to do several things...most of which I've been taught to tell patients with anxiety lol! Things such as: take a warm bath before bed, meditate, eat right, exercise, YADA YADA! The things you already KNOW to be good for you, and I've tried all of those things. They don't seem to have any effect on my sleep, therefore, are useless to me.

I wish I could help you to tell you what will work for YOU, but since it is different for everyone, it's hard to know. Try to put things in perspective...what are you thinking about that is keeping you from sleep? Are those things really reality, or just passing thoughts/regrets/worries? I know I go through a whole continuum of such things that keep me awake...I am trying really hard to just accept them as they are: passing thoughts. Nothing to get so worked up about that I am up until 5 am! It is hard to do, though...especially when there is so much looming over your head in NS...but in the big picture, is it really required for survival? The 'fight or flight' response does not differentiate between real or imagined threats; the response remains the same. So in a constant state of 'fight or flight', imagined or otherwise, you are continuously unable to relax.

Sorry if I can't really help much...just trying to give you what I have been learning. Put things in perspective, and find ways that will help YOU relax. (definitely not preaching either...I am currently working on the same issues lol!)

Good luck to you :)

Band · Jan 31, 2012

What I learned in nursing school so far is that it's almost like a no-excuse zone, I'm guessing that's why it's so stressful for so many people. But,, Professors know that there is this anxiety for students first starting out, nobody knows what to expect at first and when you don't get sleep your mind is clouded so maybe you are over-thinking and analyzing when you have no clue what to expect! which is normal. You don't want them to see that as a weakness that you can't overcome, you have to eventually. Great tips from above. Maybe take Benadryl or practice sleep hygiene(learned in class lol:)). When this happened to you before, did you do any specific activites before going to sleep? Did anything help you relax?

blackandyellow · Jan 31, 2012

I am a huge fan of Tyenol PM. Helps me sleep every-time otherwise I would never sleep.

Scarlettz, BSN, RN · Feb 2, 2012

I am in my 4th semester and I still have trouble sleeping.. Mainly because I am at a new area (LTC) and I really never had to some of the things that I do here. It does get better with practice and experience.

I usually take a melatonin before bed on clinical nights. But, I must say that this doesn't guarantee me sleep. I usually am still thinking about it and get light sleep.

Your best bet is to be prepared. Go over skills that might arise in clinical - suctioning, practicing injection sites, making a bed, or whatever you are learning right now.

If you can do so, try avoid taking naps the day/night before clinical. I would take like 4 hour naps the afternoon before clinical. That will make it hard for you to sleep. Practice breathing techniques. Be a nana -drink warm milk. Say to yourself, "I will do great tomorrow." And realize that you are a new nursing student. Things will be awkward for you. Things may be challenging. But, you are there to learn.

NCRNMDM, ASN, RN · Feb 2, 2012

You will encounter a few brutal clinical instructors who seem to enjoy instilling fear into your heart, I know I have, but, for the most part, your clinical experience will be positive. 99% of instructors are not there to scare you, intimidate you, or demean you. 99% of your instructors want clinical to be full of learning, but they also want it to be fun and as low-stress as possible. This anxiety is normal during your first semester, and it should pass as you progress through the semester and get more experience under your belt.

As for skipping clinical, you really can't afford to do that. I've gone to clinical after being up for more than 24 hours, and forced myself to function. It wasn't something I wanted to do, but I knew I had to. Lack of sleep can't be your excuse to get out of clinical. Also, you can't let your anxiety keep you from even getting to clinical. Missing clinical has caused you even more anxiety than going, and now you're twice as worried.

Just remember that you are a first semester student, and that expectations aren't incredibly high for you. That doesn't mean that you're dumb, or that you have a get-out-of-jail free card, it just means that you don't have to worry as much. No one expects you to go in on the first day and do successful IV starts, NG tube insertions, perfect complex dressing changes, and other procedures. It is expected that you will be nervous, it is expected that you will fumble around, and it is expected that you will be slow and overwhelmed with one patient. That's natural, and it doesn't mean that you are a bad student. It will get better, trust me.

JMederich · Feb 7, 2012

Thanks for all of your advice! I tried it all the night before this weeks clinical (I took benadryl, drank milk, and reviewed what I was most nervous about). I finally fell asleep at 1:30 but I sucked it up in the morning by having breakfast, coffee, and a B12. I felt pretty good all day and felt way more confident. Close to the end I was asked to start a Foley (something I hadn't reviewed), and I confidently said, "Yes!" My instructor was very helpful during the whole procedure and I successfully inserted it! I did get very warm and red :) but I was very happy that my hands weren't shaking and I didn't forget anything.. which is my fear that keeps me up at night. Hopefully now my mind can rest at night knowing that it really isn't that bad. I still haven't started an IV (The biggest fear) but next week I get to go to the ER and I have a feeling I will. AHHHH!! It's exciting, but a little nerve racking.

nurseprnRN, BSN, RN · Feb 7, 2012

focus on the "exciting" part. a little anxiety is good for you-- it ramps up your neurological system to be more alert and think faster, and it kicks extra glucagon out of your liver to pay your brain for all that extra work and keep your muscles ready to do their best. see, you're all ready to go!

read the mayonnaise jar: keep cool, do not freeze. :yeah:

NCRNMDM, ASN, RN · Feb 8, 2012

I started my first IV last week. They aren't nearly as daunting and horrible as they seem. I managed to get mine in on the first attempt, and I wasn't nearly as nervous as I thought I would be. It's just another procedure, and there isn't anything special or incredibly menacing about it. If you can insert a foley, then you can initiate IV access and start fluids.

Just remember to breathe, remain calm, and seem confident. If you are calm and confident, the patient will usually be calm and confident. If you are a nervous wreck, then the patient may send you out the door before you even get to attempt to start the line. And, who knows, you may be an IV pro.

sandyfeet · Feb 9, 2012

And don't forget that you are in clinicals to learn! You aren't expected to know everything 100% because then you would already be a nurse! Keep your great attitude like how you approached inserting the Foley and it will get better.

I have 2 suggestions for falling asleep that haven't been mentioned. I have the same problem: I can ruminate over things all night long, or try to plan for the next day all night long! No good when you have to think critically in the clinical setting the next day. So I have 2 tricks to clear my mind.

One is to play Sudoku on my phone. I just focus on the numbers, placing them in the right boxes, and that helps me get to sleep. The other is visualizing something. I guess you could call it guided imagery. It sounds funny, but it totally works: I imagine rearranging or redecorating something. Before clinical this week I laid in bed with my eyes closed imagining how I would redecorate my bedroom...moving furniture around, getting rid of things, adding a ceiling fan, etc. For some reason this is totally relaxing to me and I will fall asleep in the middle of it! I've also redecorated my house for the holidays in my head. I think it just has to do with focusing on something non-important that has several steps, which allows me to relax.

Stcroix, ASN, PhD, RN · Feb 13, 2012

If your anxiety and or insomnia are that bad, I suggest you see your physician. I myself have had these issues and when needed, I take a sleep aid prescribed for me. It works great, and as I say I use it only as needed. Knowing I can get a night's rest when I need to has taken my anxiety down 3.4 notches.

MJ_14 · Feb 13, 2012

This very thing happened to me last week as I started my first clinical day! Monday night I stayed up to preplan and was so nervous about the next morning that I, too, only got an hour of sleep. I was SO exhausted, but once I got to the hospital it was like all the exhaustion just magically disappeared. I was alert and attentive and never even thought about sleep again until the second I walked out of the hospital doors! I'm so thankful that it happened that way, but I'm also hoping, like you, that it won't happen again! My advice for you, based on my own experience is to try to have everything done the night before as soon as possible... that way you can at least get in bed at a decent hour even if you are still anxious. It may sound cheesy, but I have to listen to music to put me to sleep sometimes. Not only does it contribute to how fast I fall asleep, it also relaxes me as long as I choose slower-paced songs to listen to. Try classical music maybe!? I like to listen to classical music when I study and right before tests because it seems to help my test anxiety. I've found that it helps me sleep some nights as well. Don't worry about missing the first day.. you did the right thing by not putting your patient in harm! It's now over and done with so don't let it hold you back! I find myself dwelling on things like this, but you have to keep your chin up and keep pushing! I'm a first year student as well so we can keep each other going!:hug:Hopefully, you have gotten tons of tips from our posts and will be able to relieve some of that anxiety! Good luck on your next day!