Increased Anxiety Before Work

[flower_n_snow]

I’ve been a nurse for 2 years now at a busy neuro stepdown unit. I’ve never experienced anxiety before work as a new grad. However, I’ve been experiencing increased anxiety recently, mostly before work to the point I cannot sleep. There were many days I want to cry in my car or in the med room. I can say I’m confident at my job. I like the adrenaline pump that comes from taking care of sick patients. But I dread taking care of needy patients who are aox4, rude, insulting, violent. My heart would beat so fast and I would keep thinking about my assignments, all the call bells and beeping noises, racing against time to get my meds and charting done. Just thinking about talking to patients and pretending to be cheery so they can take their meds makes me cringe. My unit is also short staffed and the CNAs are not really helpful. My manager refuses to staff nightshift with 3 CNAs like the rest of the hospital so we’re running short all the time. The CNAs are lazy and they refuse to help us turn/clean/take patients to the bathroom. They don’t help us answer call bells. They’re on their phones all night while we nurses have to do everything. My manager doesn’t want to discipline them because it’s already hard to hire CNAs. We are constantly being forced to take 5 patients instead of 4 because our manager thinks that nightshift is easier than dayshift so she’d cancel nurses when we have empty beds. On my days off I would be so tired and sleep deprived. I get cranky at my family. And I would always think about having to go back to work. I feel miserable at work. I’d think to myself “I need to get out now.” 

I took a week off just traveling and decompressing. I attempted to move to an outpatient position. Those changes took away my anxiety. I was able to sleep and be happy again. I worked at the outpatient office for a week and left to go back to my old job at the hospital because I hate waking up every morning to go to work. At the hospital I only needed to work 3 days a week, now I had to work 5 days. The toxic culture at the office was also another reason why I decided to leave. It was really disappointing because for the longest time I thought I want to do primary care and have a stable schedule. But I was wrong. I hate how little autonomy I have at the clinic. I actually missed the hospital and would rather go back and transfer to ICU. The problem is my old manager asked me to stay for another 6 months before she can transfer me to ICU because of staffing issue. I also need her help to transfer back to my old unit or else I’d be stuck in the OP office for 6 months or longer due to their policy. My anxiety is slowly creeping back. I’m dreading for the day of returning to work. I feel extremely anxious. I feel like I just want to leave nursing in general. But I also want to try out ICU. I have a good feeling that I’ll be happier there. 

I already told my manager that I can stay for another 6 months. But should I start transferring to ICU sooner than that? I feel bad lying to her. But I’ll really have a mental breakdown if I have to work on the unit any longer and have to deal with all the staffing bs. 

For those of you experiencing anxiety before work, how do you deal with it? How do you deal with being in a job that you don’t like? With short staffing? 

[flower_n_snow]

Just to add in. I have a good friend working in ICU and she said she’d put in good words for me. She was so close to sending her manager my resume when I told her to hold off because I made a deal with my manager to stay for another 6 months. I’m pretty sure that I’ll get the position in ICU when my friend vouches for me. Now I’m torn. I want to honor my promise to my manager but also don’t want to pass on this wonderful opportunity. I just need to get out of this unit. 

[Davey Do]

Well written posts, flower_n_snow, for I truly sensed your pain.

I also sense you're an artist, of sorts, who is attempting to manipulate their media to achieve a desired outcome.

Any advice or guidance I could give would not be a quick fix solution, would take dedication and hard work, years of practice, and who wants to do that?

If you're interested in my advice and/or guidance, let me know. Otherwise, get a script for a benzodiazepine from your PMD for the anxiety, and just keep looking for that dream job.

Good luck.

 

[JBMmom, MSN, NP]

Even if your friend can put in a good word for you, as a manager, your current boss may be able to hold you to the six months before you can transfer. At my hospital people have taken new positions but are held in their current ones for staffing issues. You did tell your manager you would stay, so you may not be able to get out of it. But you can try.

Good luck.

[UrbanHealthRN, BSN, RN]

I remember a year into working as a nurse, my anxiety started to get so bad I was having physical symptoms before work- physical pain, GI upset, headaches. I didn't have the words to describe what I was going through yet, so all I did was take Motrin like it was my friend and wait to get a new job. 

That was a decade ago, and now I can use words like "anxiety", "depression", compassion fatigue", "burnout", "secondary trauma". And now I get help- I see a therapist, I practice self care. I do this because you will find that over time, the nursing jobs will come and go. The work you do will change, sometimes for the worse. What you don't want to change for the worse is yourself- you need to stay grounded regardless of where you're working today or in 6 months. 

Making sure I carve out regular time for myself, for friends, for hobbies, for really anything besides work helps me prepare for the Sunday scaries. Having to-do lists while I'm work and sometimes taking items off that list because we're so busy keeps me moving through my day. I've learned my lesson in the past year that healthcare doesn't actually care- not about me, not about anything besides money. I give healthcare what I feel I can give it, I don't take my woes out on my patients because they don't deserve that, and then I go home. I highly recommend learning to put yourself first, and by all means enlist the help of your doctor, a therapist, a psychiatrist, a support group...whatever tools you need to make that happen!

[No Stars In My Eyes]

Best post regarding OP's situation, IMHO:

7 hours ago, UrbanHealthRN said:

I remember a year into working as a nurse, my anxiety started to get so bad I was having physical symptoms before work- physical pain, GI upset, headaches. I didn't have the words to describe what I was going through yet, so all I did was take Motrin like it was my friend and wait to get a new job. 

That was a decade ago, and now I can use words like "anxiety", "depression", compassion fatigue", "burnout", "secondary trauma". And now I get help- I see a therapist, I practice self care. I do this because you will find that over time, the nursing jobs will come and go. The work you do will change, sometimes for the worse. What you don't want to change for the worse is yourself- you need to stay grounded regardless of where you're working today or in 6 months. 

Making sure I carve out regular time for myself, for friends, for hobbies, for really anything besides work helps me prepare for the Sunday scaries. Having to-do lists while I'm work and sometimes taking items off that list because we're so busy keeps me moving through my day. I've learned my lesson in the past year that healthcare doesn't actually care- not about me, not about anything besides money. I give healthcare what I feel I can give it, I don't take my woes out on my patients because they don't deserve that, and then I go home. I highly recommend learning to put yourself first, and by all means enlist the help of your doctor, a therapist, a psychiatrist, a support group...whatever tools you need to make that happen!