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Anyone get anxiety prior to their shift?

Updated | Posted

Specializes in ACE.

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As a new Nurse I have been dealing with it. When I was a student it was fine because the instructors were there to help.

I arrive to work early. I sit in my car in the parking lot thinking about the shift and not knowing whats going to happen. I sometimes think management is going to find something about me or make a case where they can blame me for xyz. I have seen that happen many times over the past year.

Do you get anxiety prior to shift? Is it this bad? What can I do?

JBMmom, MSN

Specializes in Long term care; med-surg; critical care. Has 9 years experience.

There's always some level of unknown walking into a shift. I can't think of a time that I've ever thought about management, though, before going into work. I'm concerned about what may happen impacting my patients, but as long as I know I'm doing my best to provide competent care, I don't have any thoughts about management.

You're still relatively new and getting your own practice settled, it will improve with time and experience. 

Davey Do

Specializes in around 25 years psych, 10 years medical. Has 42 years experience.

My mantras that I repeated while going into work were:

"Expect the unexpected." I was never disappointed.

"This shift may be the best, or worst, of your career." They usually fell somewhere in between.

"It's only eight (or twelve) hours." Shifts were never a lifetime.

 

 

Pepper The Cat, BSN, RN

Specializes in Gerontology. Has 35 years experience.

My anxiety has been through the roof since COVID. Instead of my lovely happy Rehab unit we became an acute med unit. Some days my anxiety starts the night before.

I just try to take things one day at a time and sometimes one hour at a time.

TheMoonisMyLantern, ADN, LPN, RN

Specializes in Mental health, substance abuse, geriatrics, PCU. Has 14 years experience.

Anxiety in nursing? HA. There have been times in my career that I have been absolutely paralyzed by it before a shift. It is a horrible feeling and there were literally moments where I thought not being alive would be better than the feelings I was experiencing. For years it was before almost every shift that I would feel this way. My anxiety stemmed from the fear of "What if I can't handle what happens?", "What if I harm someone?", "What if I make the wrong decisions?", These uncertainties plagued me to no end and the intensity of these fears were nightmarish for me. I realized that some anxiety is normal but what I was experiencing was pathological, I got treatment that unfortunately for several years was not effective. My attendance became a problem, I developed profound depression and eventually I had a psychotic break and was unable to work for close to a year. Eventually I received treatment that was helpful and with time I was able to get back to work.

I don't know if the stress and anxiety I had caused my decompensation but it certainly contributed to it. Nursing is just flat out hard, the responsibility we have is enormous and the support we are given to carry out our responsibilities is usually inadequate.

I can honestly say that I no longer stress out about work. I finally accepted the fact that I have survived every shift I've clocked into and short of being struck down by God in the middle of my shift I'm going to survive that one too. It's normal to have a little anxiety or even a mild sense of dread, but if it starts to impair your ability to function, decrease your quality of life, or even starts to consume you than you definitely need to get treated by a mental health professional. Life is too short, and too precious to live in that state of anxiety. 

Good luck to you.

GraduateRN2016, BSN

Specializes in Pediatric, Med Surg Oncology. Has 5 years experience.

Hi, 

You should know you’re not alone as a new grad. I experienced the same thing as a new grad. I would get to work an entire hour before start time due to being nervous and anxious. The seasoned nurses would make fun of me but I didn’t care. Going in early allowed me time to relax and review my patients’ chart. I hated the feeling though. Try to sleep well and remind yourself that ‘you got this’. Don’t allow the other nurses to rush you. Good luck.

JadedCPN, BSN, RN

Specializes in Pediatrics, Pediatric Float, PICU, NICU. Has 15 years experience.

On 2/24/2021 at 3:52 PM, Davey Do said:

My mantras that I repeated while going into work were:

"Expect the unexpected." I was never disappointed.

"This shift may be the best, or worst, of your career." They usually fell somewhere in between.

"It's only eight (or twelve) hours." Shifts were never a lifetime.

I agree with these. My personal mantra is "I can do anything for 12 hours." It helps me focus on just one shift at a time.

speedynurse, ADN, RN, EMT-P

Specializes in ER, Pre-Op, PACU.

I do know I have dreaded work sometimes or dreaded a shift. Not all the time, but many times. I do think a lot of leadership is somewhat corrupt or maybe that’s what I have seen in the last few years. I tend to look at work these days as just a job, a way to earn a living, and for the most part enjoy taking care of my patients and going home. I think at this point in my life I don’t necessarily invest in a job and that’s OK sometimes. It allows me to leave work at work until I am ready to pick up more responsibility again.

LibraNurse27, BSN, RN

Specializes in Community Health, Med/Surg, ICU Stepdown. Has 8 years experience.

21 hours ago, speedynurse said:

I do know I have dreaded work sometimes or dreaded a shift. Not all the time, but many times. I do think a lot of leadership is somewhat corrupt or maybe that’s what I have seen in the last few years. I tend to look at work these days as just a job, a way to earn a living, and for the most part enjoy taking care of my patients and going home. I think at this point in my life I don’t necessarily invest in a job and that’s OK sometimes. It allows me to leave work at work until I am ready to pick up more responsibility again.

I feel the same. I hardcore threw myself into nursing for the first 7 years, always staying late at the community clinic and helping the pts with psychological and social problems as well as medical, getting invested in their stories and hardships. 5 years in acute care running around trying to do everything perfectly. I didn't make many mistakes, and luckily none that harmed a pt, but I would OBSESS over every mistake. Even if I missed an IV, couldn't get a Foley in, my wound vac wasn't perfect, I went home defeated. 

I tried to take care of all aspects of a pt's health, a lot of listening and then staying late to chart. Comforting families, buying special food for end of life pts. I was so anxious even after 5 years on the job and knowing I did a good job. I began suffering from depression, had an episode of psychosis and diagnosed with bipolar disorder. The psychiatrist said nursing stress made things worse. But my identity was so wrapped up in being an acute care nurse, I keep going. 10 months in an understaffed covid unit, crying all the time watching pts die. Out of nowhere I got a call for a PACU job from a place I applied to a year ago. 2 months ago I left the hospital and I feel SO much better.

The jobs is not as intense, and I do miss getting to know pts and families, supporting them, watching them get better, and helping pts have a peaceful death. I miss the hands on and critical thinking. Now I only have brief pt interactions. I don't regret my time in acute care. I learned so much and gained strength, confidence, resilience, compassion, and life experience. I learned about the struggles of groups I never would have come in contact with otherwise. Now I don't feel nursing is my life and identity. It feels weird but good. How long have you been a nurse? It may just be normal new grad anxiety, but if it continues please get checked for any underlying mental health conditions, and know that stress can exacerbate mental illness. There is no shame in going to a different area of nursing if it fits you better = )

PsychNurse24, BSN, RN

Specializes in Psychiatric, in school for PMHNP.. Has 12 years experience.

No negative self talk, visualize yourself having a good shift, remember that “this too shall pass”, deep breaths, and when your shift is over think of three things that you did well.  If your anxiety persists, think about seeing a therapist to try to understand where your anxiety is coming from and to learn some good coping skills. Sometimes when anxiety is overwhelming meds might be needed.  

CoffeeandibufrofenQ4Hprn

Specializes in General Med-Surg. Has 3 years experience.

Many can understand your feeling as you have seen. You come into work not knowing what or who you are going to deal with especially with brand new patients. You will have to manage days with being slammed with admissions, dealing with doctors, families, and scary “situations” regarding your patients. Yes you do have 12 hours to complete your job. You may or may not have a good shift or like I describe as a”quite tolerable” shift. Plus being a brand new nurse your having to learn many new things and honing your skills all at the same time. So how can you make it? I’ll share with you some things that is helping me. Take it for what ever it is worth. I like to pray for boldness, courage, and strength to help me to be patient and kind  but firm and professional when I need to be. Practice on your critical thinking skills. Who do I need to see first? What is going on? What can I do? What questions I need to ask and where do I need to look? Esp before calling a doctor. Always ask questions when u don’t know. Always ask for help. Try to bundle tasks if your going to a patients room or going down that same hall. “Work smart”. If a doctors gives you orders and your not sure why,  ask and he “may” explain and make sure to read back orders when taken verbally or over the phone. When things get hectic and u feel more overwhelmed and frustrated, step back and take some deep breaths. Then prioritize your task. Also if your still struggling with stress look into stress support supplements and b-12. They can help your body manage all that you have to go through at work. Most of this you may have heard from many. But if you improve on some of these dealing with work can be better to handle. I hope all goes well for you.
“ Hang in there👍

TheMoonisMyLantern, ADN, LPN, RN

Specializes in Mental health, substance abuse, geriatrics, PCU. Has 14 years experience.

8 hours ago, LibraNurse27 said:

I feel the same. I hardcore threw myself into nursing for the first 7 years, always staying late at the community clinic and helping the pts with psychological and social problems as well as medical, getting invested in their stories and hardships. 5 years in acute care running around trying to do everything perfectly. I didn't make many mistakes, and luckily none that harmed a pt, but I would OBSESS over every mistake. Even if I missed an IV, couldn't get a Foley in, my wound vac wasn't perfect, I went home defeated. 

I tried to take care of all aspects of a pt's health, a lot of listening and then staying late to chart. Comforting families, buying special food for end of life pts. I was so anxious even after 5 years on the job and knowing I did a good job. I began suffering from depression, had an episode of psychosis and diagnosed with bipolar disorder. The psychiatrist said nursing stress made things worse. But my identity was so wrapped up in being an acute care nurse, I keep going. 10 months in an understaffed covid unit, crying all the time watching pts die. Out of nowhere I got a call for a PACU job from a place I applied to a year ago. 2 months ago I left the hospital and I feel SO much better.

The jobs is not as intense, and I do miss getting to know pts and families, supporting them, watching them get better, and helping pts have a peaceful death. I miss the hands on and critical thinking. Now I only have brief pt interactions. I don't regret my time in acute care. I learned so much and gained strength, confidence, resilience, compassion, and life experience. I learned about the struggles of groups I never would have come in contact with otherwise. Now I don't feel nursing is my life and identity. It feels weird but good. How long have you been a nurse? It may just be normal new grad anxiety, but if it continues please get checked for any underlying mental health conditions, and know that stress can exacerbate mental illness. There is no shame in going to a different area of nursing if it fits you better = )

It sounds like you were an excellent bedside nurse, and that's the thing, we need nurses like that at the bedside. However, right now the expectation is for us to give our all every shift from a well that is dry. If we had the appropriate staffing and resources I can't help but think the toll of nursing on the body and psyche would be less and maybe so many nurses wouldn't be tripping over themselves to get away from the bedside in order to save themselves.

Always keep in mind that in life as whole, and particularly in nursing, things are almost always worse in your mind than they are in real life. 99% of the time I'm nervous about a situation, when I look at it in retrospect it wasn't nearly as bad as I thought it would be. Sometimes it's almost laughable how much we work ourselves up over things that turn out to be nothing.

I'm almost a decade into nursing now, and have recently started inserting PICC lines but still work in the ICU fairly often. When I walk into an ICU room with a patient on a vent and 8 IV drips hanging and multiple drains off the side of the bed, I always feel a little bit of anxiety and uncertainty. But after report, I go in and break down everything individually and realize that it is all within my capability and usually within an hour or two I am in a casual work flow doing the job I know how to do.

My recommendation is first don't sit in your car and dwell on the anxiety and possibilities of what scary stuff you might have to deal with that day. Walk in confidently knowing you have the tools to handle anything, and the resources to handle things you're not sure about. Then when you get your patient assignment, don't look at the whole assignment and long list of meds and procedures collectively, that an be intimidating and overwhelming. Instead isolate each patient and task in your mind. That way you realize it is not one big singular unmanageable task, but rather a bunch of small easily manageable tasks. Then prioritize the tasks and start knocking them out.

It's all about perspective, which you have a high degree of control over.