Experienced Nurse Still Has Frequent Self Doubt, advice?

[BettyBoopsRN]

I feel really awkward admitting this but I am wondering if anyone has any insight, advice or maybe experiences the same issue.

I am a fairly seasoned nurse, 10 years in. I have worked in several areas of nursing, as I would often work full time and per diem. I've done hospital (med surg & tele) LTC, home care & hospice, and school nursing. I feel well rounded and feed back from coworkers over the years has been positive.

However I still feel anxious practicing. So much that I am unwilling to branch out in ways I feel someone with my time and experience should. I was offered a supervisor position several years back and I turned it down because I did not think I was experienced or competent enough to handle it. I feel like I need way more practice and support with something before I am willing (though still nervous) to do it on my own. This is especially evident when I have gone into new areas of nursing.

I get anxious about messing up things that I honestly could probably do easily and efficiently. I feel that this lack of confidence is evident to coworkers and superiors although no one has ever brought it to my attention.

I am very meticulous and detail oriented and I stress about not doing everything perfectly, or overlooking something, or making an error.

I understand that to some extent this is helpful so I don't get careless or sloppy, but it's to the point that I want to leave the nursing profession. I am literally sick with anxiety constantly about work, to the point that it effects my appetite and sleep, and it has only been relieved during periods in my career that I have been away from nursing after having babies.

I absolutely love patient care, and building a report with patients and families. I know I struggle with a lot of self doubt related to personal issues surrounding having very abusive and critical parents, and this self doubt is evident in all areas of my life, not just nursing, but 10 years in and I still feel like a new nurse in many ways, wanting to constantly double / triple check everything and ideally get someone else to check over my work too.

Any guidance would be helpful. Thank you in advance.

[blondy2061h, MSN, RN]

Do you feel anxious in other aspects of your life? I expected when I clicked this title it would be someone with two years of experience thinking they should know it all by now. However, at 10 years you should have a certain comfort level with your job. I think maybe at this point you should talk to your personal physician about the possibility of this being an anxiety disorder, treatment of which may improve your quality of life.

[ottersloveoysters]

Have you ever considered talking with a therapist about the way you feel? It sounds like you love working with patients but the anxiety sounds awful :-(

[lovenursing72]

I have also recently returned to Bedside Nursing after being away for 13 years. I work every Saturday and Sunday. Before, I go into work on friday, I get nervous. I think until you are comfortable getting back into the role , it is normal to feel anxious. I check my work often just because I am so use to the old way( paper) , that I want to make sure I have documented in the best place.In many ways, I feel like a new nurse because so much had changed since I practiced at the bedside. If the anxiety becomes to crippling, then I would seek help from an MD or therapist. Keep a journal of your day. Research areas that you may feel weak in such as certain medications, nursing actions, disease processes. I also jot down how i felt about my day. I think after a year in a position is when you will start to feel comfortable. If you still feel like bedside just doesn't fulfill you, there are many avenues in nursing. You could go into case management, quality or work for an insurance company if bedside nursing does not work out. Good Luck and you can do it!

[BettyBoopsRN]

Do you feel anxious in other aspects of your life? I expected when I clicked this title it would be someone with two years of experience thinking they should know it all by now. However, at 10 years you should have a certain comfort level with your job. I think maybe at this point you should talk to your personal physician about the possibility of this being an anxiety disorder, treatment of which may improve your quality of life.

Yes. This is evident in many areas of my life, not just nursing. I mentioned in my post, that I am dealing with issues related to very abusive and critical parents. My mother is undiagnosed narcissistic personality disorder. I grew up with severe physical abuse, neglect and mental abuse, specially gaslighting. I have been on my recovery journey for about 8 years. I do see a therapist. And these feelings are very typical of adult survivors of narcissistic abuse, gaslighting, neglect. Gaslighting is a form of manipulation that causes the victim to doubt their own perception and judgment. People that experience it for a few years with a significant other often have lasting effects, but the damage it does to a child is often life long. To over simplify it, it was a normal part of my childhood, teen years and into early adult hood for me to do something "right" or non problematic, and for my parents to tell me it was wrong. Logically I didn't see the error of my actions, but I was manipulated from the beginning to believe my perception was incorrect and I actually was at fault or making a mistake. So as an adult when I logically know what I'm doing is correct, on a deeper level I believe I am wrong but don't know it or can't see it.

I had hoped that continuing on my personal recovery plus gaining experience in nursing would help. But I've reached a point that I just don't want to feel this way anymore at work. It's definitely worse at work because people's lives depend on us. Prior to health care I worked in food service and felt the same but not as intense because I was not responsible for people's lives. I know nursing is a high stress job. I had thought maybe other nurses were experiencing similar stress over work and that mine wasn't quite as unusual as I thought.. And I know it's not burn out. I guess I was hoping people would say that it's normal to feel stressed throughout our whole career. Though no one I've worked with seems to be that nerve wracked, but I don't think I appear that way either. I keep it to myself. I shared a lot in this post to explain, but I certainly can't share this kind of TMI with coworkers or supervisors.

[blondy2061h, MSN, RN]

Honestly, I had a fair bit of anxiety that stopped me from moving out of my comfort zone, and thus, stopped me from moving toward my full potential. Medication helped a lot with it. I had a lot of hesitation toward going on it, due to all of the stigma, but once I did I wished I had sooner.

[llg, PhD, RN]

I am sure it was difficult for you to share so much of yourself and your past in your previous post. I send you warm hugs and a sincere hope that you will find a counselor or therapist who can help you. As I think you realize, this is not common -- and is probably something that you should seek professional help with.

[Jules A, MSN]

I guess I was hoping people would say that it's normal to feel stressed throughout our whole career. Though no one I've worked with seems to be that nerve wracked, but I don't think I appear that way either. I keep it to myself.

So while I don't think the anxiety you describe after 10 years of what sounds like an excellent track record as a RN is a common experience to this extent I do think there are likely significant levels of anxiety in many of us. This is a field where a mistake could harm someone or even kill someone and as humans we know we will all make a mistake at some point in practice.

Without attempting to diagnose or treat anyone here what I can say is anxiety often has not only an environmental component but also a biologic one. It is very, very, very unusual for someone to present with severe anxiety and not report a close relative with it also. Therapy can be crucial for helping heal trauma and reframe flawed logic but there can also be a fairly strong indication for medications especially if a reasonable amount of therapy, with a skilled clinician, doesn't result in marked improvements.

Thank you for sharing your story. I guarantee you have made someone who won't have the courage to respond feel less alone.

[Workitinurfava, BSN, RN]

I am sorry to hear you were abused. I was abused for years by my step mother. Lots of other chaos happened in my life. It would take too long to explain and this post is about you. Based on that I grew up feeling I had to be perfect. That view was changed many years ago. After you seek help you will need to move on with life with greater confidence in yourself. I have more fear of staying stuck somewhere than I do from moving on and trying something new. At least there is a chance things can get better etc. That is how I view life. There is saying, sometimes you need to just get out of your own way. You are blocking your own progress by over analyzing and doubting yourself constantly. Don't let your past dictate your future. Create a new path to help you become successful. You can get better and do better. I wish I had your amount of time and experience. I went from a nursing home( almost a year of experience) to rehab hospital (9 months exp) to a busy inner city hospital working on oncology-medsurg unit (9 months). Many people around me thought I was crazy for taking the previous job (city job). I was a little nervous at first (about the city job because the hospital is tough to work in, very super high turn-over rate) but I ended up slaying that job. I work on a ICU step down unit now and am learning so fast. I am taking 3 of 4 patients, plus discharges/admissions (it is week two) and I still have 6 weeks to go. I am training for this new position and taking two more classes (to finish my BSN). The city position prepared me for this current one that I have. If I was too afraid to take the previous job. I would not be where I am today. Good luck!