I Don't Get the Anxiety Part of Nursing

allnurses Guide · Nov 17, 2015

That's lovely. I go to work for the simple fact that I get to spend time with a patient. I have held hands, taken time to explain medical procedures to them, personally made the cot up (complete with fluffed pillows and fresh linens, every single night) for the family member. I bring them coffee, drinks, and the patient and family are the very reason I don't find this job stressful or anxiety ridden.

To me it just seems like if you have the time for that every single night your job is either not all that stressful in the first place and secondly, to simply assume that other nurses who feel anxious should fluff pillows and serve cold drinks to the family so their anxiety will go away is just not something that sounds credible in the least or it's a peculiar tunnel vision about what working as a nurse is all about for others.

KyRNðŸ˜‰ · Nov 17, 2015

Can I just say, "thank you!" To all the nurses who've acknowledged that they don't pretend to know everything and can, *gasp!* feel empathy for their fellow... Lifesavers feels pretty dramatic but REALLY how else do you describe it?! Geeze, some people. I'm so exasperated by the OP I can't describe her comments as anything but,"blah blah blah, I'm awesome, and blah blah blah, I don't know what I'm talking about." Nursing is hard, and you cry a lot, and you suck it up and continue smiling while dealing with the crap assignment you've been dealt.

Horseshoe, BSN, RN · Nov 17, 2015

This is a great reply and I agree 100%! I am a new nurse and I started in an ER. I have cried four times in two months. It's stressful, crying actually is a physiological stress release! You release stress chemicals and hormones in the emotional type tears! There are studies of different types of tears, those from emotional triggered tears, to physical pain, and eye irritation etc. and it's been shown that the other types of tears do not contain these components. And I also felt this post sounded condicending! I feel that being a new nurse is stressful and overwhelming and esp in the ER! And if others do not good for them! But don't tell someone crying doesn't help! Sometimes you can't help but cry!

My daughter has been having severe pelvic pain for weeks. She went to a doctor in her college town last week, and he was rude, dismissive, didn't even palpate her abdomen or ovaries, and said, "what am I supposed to do with all this information?! Your pain doesn't even have a pattern to it!" She said she felt tears well up in her eyes. She'd been in pain, frustrated, and scared, and this bozo made her feel like crap. When he saw the tears he barked at her, "What the heck! Are you crying? Why would you be crying? I haven't done anything wrong!" He ordered blood work and a sonogram, which the technician told her could be done in THREE WEEKS and no sooner!

I soooooo wish I'd been there. I would have taken this guy's head off.

As it was, I had to fly her home to our city the next day, got her in with my gyno, who did a THOROUGH exam and a sonogram in office with kindness and compassion, found 2 large ovarian cysts, and offered to stay after hours to do laparoscopic surgery the same day.

Crying can serve a very good purpose, and though I don't think it's a good policy to cry openly at work on a regular basis, it can be very therapeutic.

IHeartPeds87 · Nov 18, 2015

First off, I want to state that I did not read the entire thread, I read through the first page and then am responding.

I am a new graduate- I graduated in May, got my RN license in July and started a new job at a busy urban hospital on a medical-surgical unit in October. I find the OP's post patronizing. To the OP: you probably didn't mean to be patronizing, and I am happy for you that you don't seem to be having the same feelings about your job as I have about mine.

I am one of the nurses you talk about in your post. I feel overwhelmed and stressed out a lot at work. I too OP am doing what you are doing- focusing on improving my skills, taking it one shift at a time, etc. My anxiety stems from one simple fact: the seriousness of the job. My fear is that while I am focusing on improving one thing, that something that I haven't improved on yet will cause irreparable harm to my patient. I got into nursing for a variety of reasons; one of them was, as cheesy as it sounds, to help people. I didn't really consider that a mistake I make can cause more harm than good....and since I am new, I am bound to make mistakes. My anxiety stems from this fact- and it is, in sincere honesty, a concern.

Couple that fact with the following facts: nursing schools, at least the one I went to I feel, don't do a great job of preparing one for the realities of life on the floor. The orientation that I am getting is not nearly enough. The floor is short staffed so that even my well intentioned preceptor is harried to get all the work done and sometimes the needs of the patient supersede my need to learn- so that my preceptor needs to do it herself rather then give me the opportunity to do it for the sake of time and the patient. Expectations of patients and family members are typically unrealistic. I am trying to learn in an environment where my learning is at the bottom of the priority list- which I logically understand but still makes it that much more difficult to learn. Also, I do not feel that I am getting a long enough orientation.....about 5 weeks doesn't seem like it is enough. New coworkers, not knowing who I can trust and who I can't...all of these things add to my stress level. I understand that I have to power through them, but yes, it does cause me to be anxious.

To the OP: I believe you stated something to the effect of like this week you work on keeping up with new order and the next week you plan to work on I and O's or something like that. Aren't you concerned that the week you haven't gotten to improving on something is exactly what your patient needed that shift? Because for me, that is highly stressful.

Also, I have found the transition to being an RN more difficult then I expected for alternate reasons as well- and I was an aide for three years at a hospital so felt like I mostly knew what I was getting in to. Nursing has impacted my personal life in ways that I am struggling with right now. I have found that a few of my closest friends, who in the past, have understood everything about my life truly don't understand me right now. They are mostly convinced that my fear is in my own head and do not truly understand the immense responsibility and workload nurses carry. This has resulted in me speaking to them less about my work and has negatively impacted my relationships with people I am very close to.

Also, there was a period of time between me obtaining my RN license and me actually being able to obtain employment that was longer than I wanted it to be, between 2-3 months. While I am grateful that I did get the job and feel for my nursing graduates who have not obtained employment, that was 2-3 months that I didn't have income coming in. While yes, I knew that it was coming and had some money saved up, it was still a period of time where I had to tighten my belt and financially "re-emerging" has its own shares of being stressful.

Also, I am adjusting to working full time night shift and haven't figured out yet what exactly works for me in terms of when to drink coffee, when to not, and I am adjusting to the sleeping pattern which means that right now I"m not getting as much quality sleep as I used to, despite my best efforts. I know that it is a process and one I'm hoping improves with time, but for now, it is difficult.

To the OP: I hope I have explained adequately why I am anxious, and have pointed out several reasons why other new graduates may be nervous. My feelings are not limited to those of new graduates either because the fact of the matter is we have other people's lives in our hands. I would expect anxiety to go along with that. The time that I think it is a problem that the nurse needs to fix immediately/held accountable for is if the anxiety reaches a point of crippling performance....if a person is so anxious that it enables them not to think straight then they need to work on that immediately and get professional help because at that point it is impacting the quality of care patient's get.

I am working tonight. And yes, I am anxious for my patients and praying to the universe that my current inadequacy as a nurse doesn't cause harm to my patients. I am at the same time adjusting my organizational sheet so that I am more organized at tonight's shift then I was the last time I worked. Just because I am improving myself doesn't take away the fact that a person can be harmed for something I don't do or don't know or even something I did!

Try to have some compassion please. It's a stressful time.

aqua_clementine · Nov 18, 2015

I agree that it was a kinda weird post. And, I looked back and the author has been an RN for six months or so. Six months. That explains it a little bit to me.

A coworker of mine (new RN with zero experience) was pretty anxiety-free at about six months. Now, a year into it, the anxiety is showing itself at times. Still a well-controlled individual, still an amazing nurse, but it's not as easy to put up with all the stress--it's taking it's toll. I too held it together fairly well for the first year or so, and now three years into a very high stress MedSurg job, it's taking its toll on me.

She's new. She doesn't know. Maybe she will someday, but maybe not.

I find that the ones who think the job is the easiest and the least stressful are the ones who don't practice situational awareness and have no clue that their coworkers might be drowning while they sit in the lounge or the charting area on Tinder.

CHESSIE · Nov 18, 2015

First off, I want to state that I did not read the entire thread, I read through the first page and then am responding.
I am a new graduate- I graduated in May, got my RN license in July and started a new job at a busy urban hospital on a medical-surgical unit in October. I find the OP's post patronizing. To the OP: you probably didn't mean to be patronizing, and I am happy for you that you don't seem to be having the same feelings about your job as I have about mine.
I am one of the nurses you talk about in your post. I feel overwhelmed and stressed out a lot at work. I too OP am doing what you are doing- focusing on improving my skills, taking it one shift at a time, etc. My anxiety stems from one simple fact: the seriousness of the job. My fear is that while I am focusing on improving one thing, that something that I haven't improved on yet will cause irreparable harm to my patient. I got into nursing for a variety of reasons; one of them was, as cheesy as it sounds, to help people. I didn't really consider that a mistake I make can cause more harm than good....and since I am new, I am bound to make mistakes. My anxiety stems from this fact- and it is, in sincere honesty, a concern.
Couple that fact with the following facts: nursing schools, at least the one I went to I feel, don't do a great job of preparing one for the realities of life on the floor. The orientation that I am getting is not nearly enough. The floor is short staffed so that even my well intentioned preceptor is harried to get all the work done and sometimes the needs of the patient supersede my need to learn- so that my preceptor needs to do it herself rather then give me the opportunity to do it for the sake of time and the patient. Expectations of patients and family members are typically unrealistic. I am trying to learn in an environment where my learning is at the bottom of the priority list- which I logically understand but still makes it that much more difficult to learn. Also, I do not feel that I am getting a long enough orientation.....about 5 weeks doesn't seem like it is enough. New coworkers, not knowing who I can trust and who I can't...all of these things add to my stress level. I understand that I have to power through them, but yes, it does cause me to be anxious.
To the OP: I believe you stated something to the effect of like this week you work on keeping up with new order and the next week you plan to work on I and O's or something like that. Aren't you concerned that the week you haven't gotten to improving on something is exactly what your patient needed that shift? Because for me, that is highly stressful.
Also, I have found the transition to being an RN more difficult then I expected for alternate reasons as well- and I was an aide for three years at a hospital so felt like I mostly knew what I was getting in to. Nursing has impacted my personal life in ways that I am struggling with right now. I have found that a few of my closest friends, who in the past, have understood everything about my life truly don't understand me right now. They are mostly convinced that my fear is in my own head and do not truly understand the immense responsibility and workload nurses carry. This has resulted in me speaking to them less about my work and has negatively impacted my relationships with people I am very close to.
Also, there was a period of time between me obtaining my RN license and me actually being able to obtain employment that was longer than I wanted it to be, between 2-3 months. While I am grateful that I did get the job and feel for my nursing graduates who have not obtained employment, that was 2-3 months that I didn't have income coming in. While yes, I knew that it was coming and had some money saved up, it was still a period of time where I had to tighten my belt and financially "re-emerging" has its own shares of being stressful.
Also, I am adjusting to working full time night shift and haven't figured out yet what exactly works for me in terms of when to drink coffee, when to not, and I am adjusting to the sleeping pattern which means that right now I"m not getting as much quality sleep as I used to, despite my best efforts. I know that it is a process and one I'm hoping improves with time, but for now, it is difficult.
To the OP: I hope I have explained adequately why I am anxious, and have pointed out several reasons why other new graduates may be nervous. My feelings are not limited to those of new graduates either because the fact of the matter is we have other people's lives in our hands. I would expect anxiety to go along with that. The time that I think it is a problem that the nurse needs to fix immediately/held accountable for is if the anxiety reaches a point of crippling performance....if a person is so anxious that it enables them not to think straight then they need to work on that immediately and get professional help because at that point it is impacting the quality of care patient's get.
I am working tonight. And yes, I am anxious for my patients and praying to the universe that my current inadequacy as a nurse doesn't cause harm to my patients. I am at the same time adjusting my organizational sheet so that I am more organized at tonight's shift then I was the last time I worked. Just because I am improving myself doesn't take away the fact that a person can be harmed for something I don't do or don't know or even something I did!
Try to have some compassion please. It's a stressful time.

I hope that the PTB will extend your orientation for at least another six weeks or more if you feel that you need it. Ten years ago, when I was working, I found that many new grads, without a background as a LPN, or ADN, were unable to function independently even after a six week orientation.

After I retired a young woman moved into the house across the street from me, she was a new RN who had formerly been an elementary school teacher. She was a wreck as she was supposed to work independently after a five week orientation, where her preceptor was stretched to the limit with her own assignments. Staffing was dangerously inadequate, and there was insufficient time for a complete orientation. My neighbor has since left the hospital setting to work in a free standing endoscopy center. She makes less money, but the stress is less and the staffing is excellent.

I hope that you can "hang in" and receive the orientation that you need. You sound as if you are well prepared academically, and have the determination to become all that you can become. Best wishes for a successful career as a nurse.

nynursey_ · Nov 18, 2015

On another note, consider this, OP:

When you have to call a Code Blue on a patient because they've stopped breathing/gone pulseless, and despite your best efforts (along with an extremely experienced code team), that patient dies unexpectedly, and you hear the screams of his/her grieving spouse (grieving the loss of a person who wasn't supposed to die on this admission), you may then understand why nurses have so much anxiety over their job. You will walk away thinking one simple thing: "What did I miss?" You will ask yourself if you did something to cause the code, or if you could have picked up on a subtle change, and you may also find yourself pausing in front of your patient's rooms waiting for them to take their next breath. Everyone has a reason why their position causes them anxiety. Some anxiety is crippling. Other anxiety makes you keen; propels you forward to continue to do your job to prevent that next unexpected Code Blue. But it never goes away. You learn to exist with it. And there's no shame in that.

KyRNðŸ˜‰ · Nov 19, 2015

I wish the OP would acknowledge all the feedback she's getting. Her post was met with a lot of negative backlash, and she doesn't address it, or concede that possibly she is in the wrong (she apologized for "offending," people and assuring us that it wasn't her, "intention," but that's hardly the same thing) not owning it gives the impression that she disagrees and is therefor unable to validate her fellow nurses feelings and thoughts. Which in itself is condescending. Maybe that's why I find this thread so... Just unsettling and disturbing.

NursesRmofun, ASN, RN · Nov 23, 2015

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. i
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.

You were being nice and polite in your answer, but I consider the OP very condescending. I agree 100% that, "... it's the ultra calm laissez faire attitude nurses that are the ones to keep an eye on.."

kaylee. · Nov 25, 2015

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.
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.

Preface: havent read all the posts yet.

While I do see that you didnt mean to be condescending, what struck me is that the responses have been constructive in suggesting how the post came across...and the post right before you here hit the nail on the head:

To empathize is a profound gift that everyone needs to reflect on, and in your case it seems that it could be an area to focus on.

To empathize can give you skills to better understand the point of view of others--in this case--in how others might react to your op.

The thing is: knowing "its ok to cry" reflects being in touch with ones emotions. it means identifying how you are feeling and then allowing yourself to express the feeling.

When you suggested to stop crying over things--it revealed an aversion to expressing emotion. Speaking for myself, i was not offended because insight into emotions is a great strength.

There is always room to grow, even if you are feeling on top of the world. Its a lifelong thing if you let it.

chacha82, ADN, BSN · Nov 27, 2015

Didn't read all of the replies, so forgive me for what others have most likely said.

Nursing is a low control/high stakes profession. You can practice at a high standard and patients will still tank. Or a very stable, perfectly mentating patient can go south at shift change, right after you've told everyone he was your easiest patient all night (I will never say that again). Situations like this make me anxious. EMTs who mean well but do things like turn bed alarms off "because the patient said they wanted it" make me anxious. Family members who write my name down in a little book, along with every other staff member, make me anxious. None of this may make YOU anxious, was your post designed to be clickbait? I am not trying to be rude at all, just curious. Is your floor very low acuity with all walkie-talkie patients? Do you have a full staff of techs to answer call lights and take them to the bathroom? Only other these (and other ideal circumstances) would I be as nonchalant as your post comes across, but even then I would never presume to tell others how to do their job. To me it's the same thing as just telling people "I don't know why you are worried about money. Just save your money" and walking away.

It reminds me of when I was in school and spent several days on clinical in the STICU. I was paired with someone else from my class who acted bored and told me there was "nothing to do." I looked at her like she had lost her mind. There was no shortage of tasks to be done in between med passes: patients needed to be turned, suctioned, fluids replaced on bags getting low, junky IVs could be taken out, toileted, fed, resevoirs checked on CADD pumps, trays cleared, help with a new admission...just to name a few. But because she didn't see medications being passed, on the surface, to her, there was nothing to do.

If you truly feel like you have it all together, and you don't understand why nurses are anxious, offer to help one of your colleagues with their patient load. Do someone else's admission database. Give flu shots to everyone who doesn't have one yet. Or take on an off service extra patient. No snark intended, I just think this may be a case of you don't know what you don't know.

nynursey_ · Nov 27, 2015

Didn't read all of the replies, so forgive me for what others have most likely said.
Nursing is a low control/high stakes profession. You can practice at a high standard and patients will still tank. Or a very stable, perfectly mentating patient can go south at shift change, right after you've told everyone he was your easiest patient all night (I will never say that again). Situations like this make me anxious. EMTs who mean well but do things like turn bed alarms off "because the patient said they wanted it" make me anxious. Family members who write my name down in a little book, along with every other staff member, make me anxious. None of this may make YOU anxious, was your post designed to be clickbait? I am not trying to be rude at all, just curious. Is your floor very low acuity with all walkie-talkie patients? Do you have a full staff of techs to answer call lights and take them to the bathroom? Only other these (and other ideal circumstances) would I be as nonchalant as your post comes across, but even then I would never presume to tell others how to do their job. To me it's the same thing as just telling people "I don't know why you are worried about money. Just save your money" and walking away.
It reminds me of when I was in school and spent several days on clinical in the STICU. I was paired with someone else from my class who acted bored and told me there was "nothing to do." I looked at her like she had lost her mind. There was no shortage of tasks to be done in between med passes: patients needed to be turned, suctioned, fluids replaced on bags getting low, junky IVs could be taken out, toileted, fed, resevoirs checked on CADD pumps, trays cleared, help with a new admission...just to name a few. But because she didn't see medications being passed, on the surface, to her, there was nothing to do.
If you truly feel like you have it all together, and you don't understand why nurses are anxious, offer to help one of your colleagues with their patient load. Do someone else's admission database. Give flu shots to everyone who doesn't have one yet. Or take on an off service extra patient. No snark intended, I just think this may be a case of you don't know what you don't know.

I agree with this wholeheartedly. Whenever I see one of my colleagues yawning with a bored expression and their cell phone in their hand while I'm drowning in a patient assignment, I want to scream. There are full hallways of people that need assistance to ambulate their ordered TID schedule and/or plenty of people on a q2hr turn and reposition protocol. I know it's off topic and a bit irrelevant to the original post about anxiety, but it was worth mentioning (and by it being off topic, I mean my post, not yours).