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.
I have been on anxiety and depression meds since before I started nursing school. I had a job where I really didn't want to go to each night. I did it, but I still suffered from the anxiety as it was about the environment I was in. I know work at a place where I love going to work, even with all the variables thrown at me. While I may be second guessing myself on some things yet, 6 months into it, I don't stress about it either. I have cried over this job due to some medication errors, but I look forward to going to work. My anxiety med has not changed over that time period. So, I think there is more to it than what we all think. Sometimes the working environment, such as coworkers and the staff above us, can make a difference in how we perceive our job and how we deal with the anxiety. I have found my DON to be very supportive as most of the other nurses. It is great to work in a place where we do receive that support and encouragement.
There is nothing wrong with being on meds for an anxiety condition. But saying you don't understanding why people have anxiety when your 5HT is so padded neglects other peoples problems and minimizes your own. I am sure that admitting this was in some ways helpful and gave you the feeling of a weight being taken away. But MissMollie, at 6 months into the game you are still a spring chicken (I have 6 years as a RN, and an NP now and I am still a young-nurse)... Time may change, situations may change, and if they do, remember this post and go back to those strategies.
I definitely went thru a spell where I would sit in the car before work and dread going in. Spend my days off dreading going back to work. Crying on my way home. I chalk it up to burn out. Not so much that the work itself was "too much" - but I got to a point where I was tired of watching children die and it began to take a toll on my emotional health. And I had to work to make changes so I was a healthier person and a better nurse.
I promise you if you have not hit that point yet in your career... you will.
I look back on that time now and think of how much I didn't yet know and I realize that my sense of calm collection during that time was a product of inexperience, not real mastery.
As I've become more experienced and seen more of the healthcare system's fundamental brokenness in many areas, my anxiety has risen steadily. I currently work in an environment where due to staffing issues, even with maximum effort from all hands, all day every day, near-misses are frequent, and the new grads are probably the least stressed about it because they simply don't know any better or are so worried about things like making sure their I&Os are done that they don't realize that a disastrous outcome was just narrowly averted- sometimes through chance.
I never worked CC. My worst anxiety ever was when I was a Float RN, working anywhere from the floors to Step Down to the ED- Walking down that hall to get my assignment. I would not sleep the night before. Once I got the assignment? I was fine.
Oh lordy....the worst torture on the planet for me would be to be a float nurse. Well maybe ED....you never know what's coming.
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 patient.
Wow, I think you have that wrong.
When she said that I think she meant it that she was glad she wasn't the patient because they have a lot of stress from being ill.
I don't think she wasn't saying the patient would receive bad care.
As someone who has struggled with lifelong generalized anxiety disorder I totally get the nurses who dread going to work and cry after. I didn't cry but like a previous poster I would will my phone to ring to call me off, I'd always volunteer to be OC. If I knew then what I know now (about stress/anxiety) I'd of worked part time and eased myself into the workforce.
BUT that said. I love your suggestions for focusing on something and mastering it to gain confidence. Love love it. Reminding yourself to be glad you're not the one needing the care is a good attitude towards a cranky patient. These are things I wish that my preceptor had talked about all those years ago.
I wish they'd taught a separate required class on coping and stress management in nursing school. Complete with real life scenarios of the very stressful situations we all find ourselves in. One of the most frustrating things for me as a new grad and longer actually....was being caught off guard by something I didn't expect. Some patient or doctors harsh words or family interactions. All of those things you run into that you're just not aware of them coming. Standing there with my face blank or worse mouth hanging open. Ugh I hated that. Or so busy I felt I could never catch up and leaving feeling as if I MUST have missed something. Which led me to laying awake at night fearing what I'd find the next day. That after shift debrief and coping is also something that would be so handy having learned in school. NOT years later after the damage to my body forced me to learn.
We should have a thread on helpful techniques! :)
And often anti-anxiety meds are necessary before any techniques are truly able to be helpful.
I agree to some point; however, I did get coping suggestions during both my PN and BSN programs; I used them to help with my test anxiety issues and I have a mood disorder trait; so I think that there are schools giving out those suggestions and it is up to people to take those petals and use them as they see fit; also, many of us have horrible coping skills that can't always be helped, even when help and information is readily available-some student abhor mental health rotations instead of embracing it as a way to help identify their own particular maladjustments and embrace some new ideas and transition that when working with peers as well as patients, for example.
One of the things that have helped me transition was goal setting and self-study along with a critical thinking book to keep things in perspective, along with finding the right fit at a particular job; while I was finding that fit, I used every opportunity at a dumpy job to goal set what I was lacking and master it when opportunities were presented; plugged along, and got the job and specialty that fit me.
The beauty of nursing is that there will be a fit for as many personalities as it can; however, it is up to the newbie , whether it be new to practice or new to specialty to advocate for themselves as much as they can, along with be comfortable in know that don't know what they know and bug the boo-boo out of people when they don't know, study and retain what they need to their practice, and not to be ashamed to not know-knowledge is power, and not knowing doesn't make someone weak, especially when they want and need to know in order for their practice to grow and flourish.
I definitely went thru a spell where I would sit in the car before work and dread going in. Spend my days off dreading going back to work. Crying on my way home. I chalk it up to burn out. Not so much that the work itself was "too much" - but I got to a point where I was tired of watching children die and it began to take a toll on my emotional health. And I had to work to make changes so I was a healthier person and a better nurse.
I promise you if you have not hit that point yet in your career... you will.
It is hard to watch patients die. I work in oncology and there is something about watching certain people wither and thrive and how they handle it. They all touch and take a piece away when they die. Other patients get better, but then you are always holding your breath for a relapse...
LOL, love these replies.. I am not normally an anxious person or a cryer and I have never taken anti anxiety meds.. But I have worked on floors/units that would suck the life out of anyone including me.
It's all good when on orientation when you have the time to ponder on your next move (and some orientations won't even offer that - it's sink or swim after you read a few manuals), but when on the real floor and you have 1000 things happening at once the anxiety can get the best of almost anyone. And I agree with an earlier poster - If I am the patient I'd rather have the RN that's anxious about getting everything perfect with my care than the one that's 'chill' and figures it will all work out eventually. :)
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.
Why did you forget to mention that you suffered from anxiety and crying and actually went to your Dr in the first place to get medication to help you cope. Then you wouldn't have seemed condescending, but instead another fellow nurse struggling with the same issues. I agree meds can work usually combined with therapy. But not all Dr's are willing to prescribe anti-anxiety meds other than prozac as the catch all mental health aid like birth control pills are the remedy for all women's problems! Personally I have struggled with anxiety and even panic attacks in my life before I even became a nurse. I was once prescribed xanax for only six weeks and some therapy and it helped tremendously as well as making plans to leave the situation that was causing my anxieity! But I don't feel nurses are supported by most Dr's and management in general.
I struggled for years with anxiety as a new grad and finally overcame it for the most part. I don't stress over what to do or making a mistake. I feel very confident from my years of experience, but that doesn't mean I don't still occasionally find myself anxious or dreading work. Unfortunately I have struggled with insomnia unable to sleep for over 24 hours and if I would have went to work I would have been up for 48 hours. I did not feel safe to do this and had to call in. I was extremely upset about work and personal issues to the point where I couldn't calm down and sleep.
What I find so frustrating is that we have so little control over our job. We don't even have control over staffing ratios and support staff. Any day they can turn around and raise ratios and take our aide and we are just expected to deal with it. Also difficult patients and families who blame us that we can't cure them. It is very frustrating to deal with family members berating us because their loved one is dying and they won't accept that but instead want everything done, and it's our fault their loved ones isn't getting better is still paralyzed or can't swallow. We are not God.
Farawyn
12,646 Posts
She's fine. She has a plan.