Day 2 anxiety attack, is it the end of the job?

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Hello folks,

I am writing because I need some encouragement.......

What happened was that I had an anxiety attack on my second day in the ER. I have been a nurse about a year, and had a good first day, but the second day I started to freak out in my head and started convincing myself that I could never do this job and didn't know anything about nursing, and didn't know my surroundings at all! It wasn't the intensity of a trauma or anything, but just doubting my own abilities and knowledge. It got so bad that I quietly said I needed to go home and walked out to the car. Where I sat, breathing, and eventually convinced myself that I HAD to go back in there and "get 'er done". Which I was eventually able to do. I just walked back in and finished out the day, and held it together. Although I had to try as best I could to explain what had happened....

So my question is: Will I be able to live this down? I don't want to ruin my reputation on Day 2, and have them think I'll never make it, and spiral down into losing my job!!! (Notice the tendency for catastrophic thinking here)

I have dealt with anxiety my whole life, and similar incidents like this have occurred at the beginning of each new clinical setting I find myself in, starting from my very first clinical rotation in school. However, I graduated school with Honors, and managed to do well in my first job despite anxiety in the beginning. I know this is a pattern for me, and I just hope the ER can understand.

Any thoughts or advice or words of commiseration would be greatly appreciated.... Thanks!!!

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Specializes in Peds/outpatient FP,derm,allergy/private duty.

It's tough coping with anxiety disorders in "normal" life, it's tougher to be a nurse with anxiety disorders because we are constantly aware of the high stakes possibilities of catastrophe if we should make an error. Throw in a specialty like Emergency and wow!! All I have to say to you is kudos for going back in to finish the day! People with "normal nerves" don't really understand what a true butt-kicker a panic attack can feel like.

On the plus side, it does make us hyper-aware and hyper-vigilant most of the time and our co-workers do value those traits. I'm not sure what your personal background is as far as counseling/meds etc., but what I have found very helpful is to explain to unit managers that you have a tendency to these things when you start something new, that you aren't asking for special treatment- you just want them to be aware of it. Very few people will jump on you for that, but if it comes out of the blue they won't have a frame of reference to place it in and may judge you unfairly.

If you are like me the situation will just de-escalate as you familiarize yourself with the new environment, but the fear of a panic attack actually makes them more probable. I hope you have a supportive working group- that's an immense comfort if you do.

Again, huge atta-girls for walking yourself back in to finish the day. I know how hard that was, and to me that is a huge indicator of your spirit and ultimate success. Best wishes to you!! :)

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Nurse156,

Thank you! This is what I was hoping to hear. I just feel so embarrassed and lame now, and wish I could have just avoided the whole thing!

But I appreciate you taking the time to write to me, So thanks again :nurse:

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Specializes in Plastics. General Surgery. ITU. Oncology.

Same thing happened to a new nurse on my Plastics ward once. We were so unfamiliar, so new that she went into meltdown and was found crying by Sister in the bathroom.

Sometimes it is all overwhelming. Folk react in different ways. Each to own.

This nurse (I was her mentor) went on to become one of the best nurses on a famously good ward. She's a Sister now.

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The fact that you walked back in and finished your day says a lot about your ability to get beyond this. Most people will commend you for that. I think that action will help you to get things together and keep the job.

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Specializes in behavioral health.

Congratulations for going back in. Really, you are to be commended for going in and finishing the day. :up:

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I've been there, done this, got the t-shirt. I used to take benzos every night before bed for the first two weeks I was a nurse. I was scared to death that I would kill someone, that someone would just die, that something awful would happen and I wouldn't know what to do.

Eventually, someone did die, something awful did happen, and I did know what to do. And it was all after I stopped taking my anxiety meds.

You're anxious because you're new, you're doing things in an unfamiliar environment, and you're around a ton of unexpected situations. I'd be far more scared for you if you thought you had everything under control and you weren't nervous.

There are anxiety meds, like I believe a previous poster mentioned. They can be discussed with your doctor. My doctor and I found that antidepressants made me feel better, and I was weaned off of my benzos. And as you get your new job in hand, and as you get more accustomed to things, you may find that your anxiety lessens and you don't need meds anymore. And that will be a wonderful day for you... it was for me.

An anxiety attack isn't the end of the job. It means that you're a nurse with a Type A personality who cares enough to be that concerned and realizes that you don't have all of the answers. That's not a bad thing... it's just an intimidating thing at times. You realize it, and now you can harness it. Go forth and learn. You'll do great.

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Specializes in Cardiology.

You can do it!!!

I had a similar experience on my first clinical day with patients as an LAII years ago (not as a nurse) and I found I just had to force myself to do it- things were fine after that.

I have had a panic disorder for 11 years now- it runs in my family- and as everyone else said, just walking back in there was the hardest and best step for you to take. You got through the day, and that will make all the difference. Now you know you can do it, because YOU ALREADY DID. Every single day, your anxiety will lessen and your confidence in your skills will grow.

Nobody expects you to be able to do it all in the ER on your first day or two. Give yourself time and remember to breathe. Focus on the fundamentals- you know them, you have done them since nursing school.

You can do this!!

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Specializes in Education, FP, LNC, Forensics, ED, OB.

Please note posts removed for TOS regarding medical advice.

As the OP stated, "I am writing because I need some encouragement......."

Please do not offer medical advice. Thank you.

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I wanted to say that I really understand how this Nurse feels. If also I may ask a question?

There have been times where I want to leave the unit as well. I feel like I want to cry, and tell myself "I can't do this". There have been a handful of times where I actually was crying. But mostly it's all bottled in and I manage to hold it together until the end of the shift.

The OP stated that she has a pattern ofthese panic attacks while being on the unit and having to walk off. My pattern is a little different because I get this problem before I show up to work. I usually end up calling off because I just can't go in. Something in my mind keeps telling me that I can't go to work. I feel very uneasy, nervous, and want to avoid the entire world. This has been a pattern for years and years (10+). As a result I accumulate too many absences which in turn causes me to get written up. Verbals become writtens, and 1st writtens become 2nd writtens, and so on until eventually I am told that if I call off again I will be terminated. I usually have to quit and find a new job. No matter what I do I can't stop the pattern. No matter what job I have, the problem returns. I always think "it will be better at this job" but it never is. It's also a problem because when I am truely physically sick (flu, cold, etc) they expect me to get Dr's notes for the absence. As Nurses we all know how annoying it must be for a patient to come in and ask for a note for work because we had the flu. I can't talk about this problem to anyone because it is so embarrasing and I feel like a loser/failure.

So to make a long story short, my question is this: Is what I am experiencing a panic attack as well? I have been diagnosed with Major Depression and Anxiety (see my other post). When I try to talk to my psychiatrist about what's going on with my Anxiety, it's almost as if he doesn't believe me. They always want to talk about how I'm a nurse. I don't like them knowing that because it seems like they treat me differently. I guess Nurses aren't supposed to have mental disorders. We are all supposed to be perfect!

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Specializes in Peds/outpatient FP,derm,allergy/private duty.

I feel for you pippylockstocking! Anxiety and panic attacks can run the gamut from merely annoying to crippling! I have to be careful not to sound as though I'm giving medical advise, but it seems as though the psychiatrist treating you now is not listening to you, and the idea that nurses and other healthcare providers "shouldn't" have mental health issues is absolutely ridiculous. Normally the rule of thumb is that if a particular symptom is bothersome enough that you exhibit avoidance behaviors it needs to be addressed. It's unacceptable that your doctor doesn't take these symptoms seriously!! Having to quit jobs over and over as a consequence of absences related to anxiety disorders must be horrible, and that is avoidance behavior! I feel for you - what you've been living through as a result of this so {{hugs}} this is very common in nurses to one degree or another.

As I said, we can't offer medical advice but if I were in your shoes I would sit down and give some serious thought about what I need in a doctor, counselor - whatever. There are more options (some are pharmaceutical but many effective therapies use other methods) out there than ever before.

Last never ever feel embarrassed or ashamed!! Lord knows we didn't choose to feel this way! It's in the "wiring" in my case many of my family members have anxiety problems. Best wishes and - don't settle for treatment you aren't happy with- !

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thank you so much for your kind words and encouragement... the clinic I am a patient at has changed management 3 different times since I started there in 2008. I have seen 2 different therapists and 3 different doctors. You get so far with one and then the next one comes in and you have to explain everything from point A to point Z all over again. It's difficult to tell them my problems because 1) I am ashamed 2) I feel like they judge me because being "educated" as a Nurse 3) It's difficult for me to admit failure.

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