I Don't Get the Anxiety Part of Nursing

[missmollie, ADN, BSN, RN]

I see these posts where people complain of anxiety. Crying before work, crying during work, dreading going into the hospital.

I'm just thankful that I'm not the patient. I split my weeks into what I want to accomplish. One week, it was to ensure that I checked the orders every half an hour. The next week, it was that I's and O's were okay. Focusing on one item at a time allowed me some mastery over it. Granted, it was during my orientation, but I've built on that, and I don't look at work as something to be dreaded, but rather as an experience to get it all right. I'm at that point.

Nursing is overwhelming. Focus on what you can change at this time, and those tasks that have an immediate effect on your patient. Look at your weakness, and improve it. Work is a challenge, but it's one I'm prepared for. I finished nursing school, I passed the NCLEX. I'm not going to know everything, but I will get better as I go. Much like the dreaded care plans, have a plan for yourself.

Know the areas you need to focus on. Make a list. Get good at the things you occasionally miss. The most important things. When you have that down, go to the next item.

No one expects you to know it all. It's okay that you don't. Don't cry after every shift, because really, what is that accomplishing? Nothing. Have a plan. Become the nurse you want to be in small steps. That's okay.

[annie.rn]

While I know your intentions are good and your post is meant to be helpful, what you've proposed is a lot easier said than done and it comes off as a bit condescending.

You stating,"I'm just glad I'm not the patient" is not nice. You are implying that a nurse who gets anxious about a stressful work environment will take poor care of his/her patients and that is simply not true. I think in a lot of cases, it's the ultra calm laissez faire attitude nurses that are the ones to keep an eye on.

Not everyone is cut from the same cloth so what helps you keep your anxiety under control may do diddly squat for someone else.

As for crying, I don't think you have the right to tell others not to. For some, this may be a great way to release everything after a bad shift so that they can start over renewed.

In summary, thank you for sharing how you handle the stress of being a new nurse. It sounds like it is working very well for you. Hopefully it will help others out there as well. But, for people w/ severe anxiety issues, I fear it will take more than what you've outlined here for them to overcome it.

[Karou]

I made a reply but I accidentally cancelled it. Ugh! I will try again.

I agree that your intentions are good, but you come off as naive and a little ignorant. I am glad that you have developed great coping mechanisms for stress and anxiety, and have found a way to positively channel it. Good for you! This is not easy to do.

Please be mindful that this is not as easy for everyone. Some people struggle with crippling anxiety daily, even outside of nursing/work. This can have been a problem for their entire life and something they continuously seek treatment for. Depression and anxiety go hand and hand much of the time, and it can be difficult to control either. Anxiety is not a choice for most people.

Even for those without clinical anxiety or depression, other external stressors play a role. Family problems, finances, school, illness. Even good stress like pregnancy, weddings, and buying a home.

Nursing has immense points of stress. Difficult patients/family members, rude physicians, high expectations for patient satisfaction, understaffing, patients dying, ect...

Any person, big problems or small, is entitled to a good cry every now and then. I personally cope better with stress by crying. I cry, I feel a little better, I can take small steps to move on. That is how a I cope. Crying isn't a sign of failure or weakness.

Everyone copes differently. It's whatever works for you. You have a plan for yourself and it works, which is very good.

Just please remember that crying is okay, anxiety can be complex, and that no person is weak for having anxiety or crying. I know you didn't say any of those things, but in some ways your post implied it.

[Anna Flaxis, BSN, RN]

The way I see it, each of us falls somewhere on a continuum. On one end is a very low threshold for distress, and on the other end is the opposite. Most of us don't fall on one end of the continuum or the other, but rather, somewhere in-between. Where we fit in the continuum is not static- it shifts during different stages in our lives, when we're undergoing personal stressors such as divorce or the death of a loved one, or when we ourselves fall ill or aren't feeling well, to name a few circumstances. Additionally, each of us has a different set of tools that we are equipped with to help us cope with distress, and new tools can be learned.

For me, when things aren't going as planned and I feel like I'm hanging on by the skin of my teeth, this is "eustress". I find it exhilarating and it brings out my better qualities. For others, variance from the predictable routine is a cause of "distress" (google "eustress vs distress").

Congratulations on being someone who is able to adapt and cope with the stressors involved in nursing more fluidly than many of your peers. You probably fall closer to the end of the continuum with a high stress threshold, and you probably have some great tools in your coping toolbox.

Unfortunately, as the above poster points out, your post does come across as condescending. Experience will remedy that in time, as experience has a way of humbling us.

Don't get me wrong- I'm glad that you seem to be doing so well in your first year out of nursing school. It's a tough time for most of us- and thank you for the tips you've shared.

But just....maybe tone down the air of superiority just a little bit?

[Here.I.Stand, BSN, RN]

Ack, my computer froze I just lost a lot of post.

A lot of it was discussing my own personal/professional history to illustrate how I am not a stranger to stress. My personal life is not a full plate--it's a full smorgasbord. I have and do work in incredibly high-acuity environments (my former ICU was very heavy on CV and post-heart/lung/heart-lung/liver transplants; my current one is more so on trauma and strokes.) I got glowing performance reviews as a new grad, and I've gotten comments from superiors how well I keep my cool no matter how terrifying the situation is. I would describe my personality as a quiet-but-strong type.

All that said, a few years ago I was working in an environment that "made" me (for lack of a better term) someone that I don't know. It was nothing to have 4-5 pts on ventilators, and/or needed up to 2 hours of wound care--all of which was expected to be done on the day shift. We had no lab, so the RN was also the phlebotomist; quite the pain when the pt is on a heparin gtt. Assessments were more in-depth than what I had done in med-surg because the pt population was sicker longer, prone to delirium, prone to sepsis, more deconditioned, and overall just more medically complex. Families were more stressed, and expected the RNs to be able to do it all. (A lot of these people were admitted from ICUs, so as you can imagine the family was used to a lot of undivided attention from the RN.) All that was in addition to typical med-surg stuff like blood transfusions, mobility, teaching, etc.

I was not a new RN; in fact, I don't think this LTACH even hired new grads.

I cried frequently. I got sick to my stomach the night before. None of it was r/t "fear for my license," none of it was r/t being a weak or immature person...it was 100% r/t feeling like a **** RN, and frustration at not giving my pts the care they deserved. In my head I get that crying doesn't solve anything...but for some of us, tear ducts seem to have a mind of their own.

And then I come on here and see RNs whose employers think it's a good idea to staff a stepdown unit as if it were a subacute unit or an ICU as if it were a floor, be expected to become instant clinical instructors if students are present, and deliver Superior Customer Service that rivals that delivered by Beverly Hills hotel staff... And yeah, I totally get how controlling anxiety is easier said than done.

[canigraduate]

The original post has an incredibly patronizing and condescending tone. "Look at your weakness and improve it." Well, I never thought of THAT before.

I'm glad you don't suffer from anxiety. Good for you!

I do. I have panic attacks sometimes before work. I hate my job 75% of the time. I stare at the phone and will it to ring and tell me I have been cancelled. I hate talking to docs on the phone. Every time I have to page one, I have to talk myself into it.

I am not a new nurse, either.

I am overwhelmed and undersupported, like most people with anxiety.

I haven't always been this way. I have a metric butt ton of life stressors and I have run out of resilience and coping mechanisms.

And my patients have NO IDEA what I go through. It's none of their business, for one. For another, it's not their fault and it would be completely unprofessional and inappropriate to take it out on them. Management, on the other hand...

[vanilla bean]

I had a similar experience to here.i.stand. I'm normally a non-emotional, in control, do well in high stress situations kind of gal, but worked in one hospital unit that brought me to my knees. It didn't take long after starting to work there before I was experiencing physical manifestations of the stress and anxiety associated with working in a dysfunctional, extremely hostile, and high acuity work environment. Frequent migraines, sick to my stomach at even the thought of my next shift, and occasional bouts of tears. OP, I'm glad you have not found yourself in a situation where you have struggled to deal with the sort of crippling anxiety that others have described, and therefor to which you can not relate, but don't be so quick to dismiss the very real experiences that others "complain" about just because they don't mirror your experiences. May I humbly suggest that you put working on your empathic skills on your list of items to master.

[missmollie, ADN, BSN, RN]

I think those are all good thoughts, and my intention isn't to come off as condescending. When I say that "I'm glad I'm not the patient", I mean I'm glad that I have the use of all four limbs, that I can express my needs through communication, and that I'm not in their position. I'm grateful that I have my health.

I just think that nursing can be overwhelming, and I felt the anxiety and fear of the responsibility we have for the first couple of months. I've worked through it in this way, and I thought it might be helpful. Don't get me wrong, I've shed my fair share of tears. However, breaking down the job into things I need to work on has really been helpful. It's much easier to focus on one aspect and master it than to focus on everything. I also pick up one extra shift a week in order to get the most exposure to my job.

The other thing I negated to mention and probably should have: Don't be afraid to go to your doctor and seek a medication alternative if everything else isn't working. I take an anti-anxiety medication. I needed it, or otherwise this job would've became all consuming.

6 months out, and I feel pretty comfortable. I have more good shifts than bad, and the bad shifts remind me of what I still need to work on.

[nursel56]

I think those are all good thoughts, and my intention isn't to come off as condescending. When I say that "I'm glad I'm not the patient", I mean I'm glad that I have the use of all four limbs, that I can express my needs through communication, and that I'm not in their position. I'm grateful that I have my health.

I just think that nursing can be overwhelming, and I felt the anxiety and fear of the responsibility we have for the first couple of months. I've worked through it in this way, and I thought it might be helpful. Don't get me wrong, I've shed my fair share of tears. However, breaking down the job into things I need to work on has really been helpful. It's much easier to focus on one aspect and master it than to focus on everything. I also pick up one extra shift a week in order to get the most exposure to my job.

The other thing I negated to mention and probably should have: Don't be afraid to go to your doctor and seek a medication alternative if everything else isn't working. I take an anti-anxiety medication. I needed it, or otherwise this job would've became all consuming.

6 months out, and I feel pretty comfortable. I have more good shifts than bad, and the bad shifts remind me of what I still need to work on.

Sounds like you're telling everyone how to be you, which they are not. The title of your post comes across as dismissive as well, but taken literally it's accurate. You don't get the anxiety, so it's a bit puzzling why you contributed your list of things for people to fix their anxiety problems.

Just as an aside I find our patient care to be generally top notch due to OCD tendencies and not at all something the patient needs to worry about.

I strongly agree with one part of your post, though. Crying happens but it should be avoided if possible owing too the burden it places on other staff when someone has a meltdown.

[Farawyn]

What cani said. Every word. And to start a post and place "anxiety" in quotes as if it doesn't exist is patronizing.

I'm glad you are doing well, OP, and I hope it stays that way for you.

As far as the nursing aspect, again, I'm worried that many of these schools re not giving their students enough clinical time, which can contribute to feeling overwhelmed once you hit the floors.

[tsm007]

Wow. You clearly have no comprehension of anxiety. It can be completely irrational and people who suffer from it often know they "shouldn't be anxious". Yet they still are. Your post sounds like someone stroking their own ego. Good for you. I'd take an anxious nurse over an arrogant nurse any day of the week. I don't even see this post as having well intentions. You sound like someone who finds people who cry or are emotional as annoying. What do you do with patients who have clinical depression or anxiety? Tell them to suck it up you have a great life? Compassion and caring are a big aspect of nursing, not just nursing knowledge and clinicals skill.

[roser13, ASN, RN]

OP, I'm happy for you. Truly I am. You have seemingly managed your profession admirably.

But I am taken aback by your naïveté. Your posts seem akin to telling a clinically depressed person to "just cheer up. Let me show you how to be cheerful by organizing your life." Not only useless advice, but those words can actually be harmful to the one who is depressed.

What bothers me most, however, is concern that you might convey this attitude toward any patients of yours who might suffer from depression or anxiety. I do hope that you read all of the previous posters' experiences & struggles and make an effort to understand the true nature of depression and anxiety.