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Is this anxiety or should I quit nursing?

UGH. I'm not sure if I should be a nurse anymore.

Career Nurse Beth Article   posted
Nurse Beth Nurse Beth, MSN (Columnist)

Specializes in Med Surg, Tele, ICU, Ortho.

Maybe it is more of an anxiety issue or just completely want to let go of nursing. Please help me!

Is this anxiety or should I quit nursing?
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Dear Nurse Beth,

I'm not sure if I should be a nurse anymore?

So maybe it is more of an anxiety issue or just completely want to let go of nursing. I am a 28 yr old whose got around 5 years of nursing experience. I have tried multiple areas such as LTC (6 months),complex continuing care/palliative care (maybe 2 years and half), neurosurgery (about a year), some medicine (6 months), L&D (4 months) and recently a nurse consultant at a worker's compensation insurance company (7 months).

I feel like I just can't seem to find my niche or if I am interested in it, the acuity of the unit is too much for me to handle. I am a quite shy and introverted person and until now have a hard time talking to people, especially those in authoritative positions. I have tried to practice to be more assertive but my anxieties just get to me.

I have been a charge nurse and even got awarded for a leadership and innovative practice award in my hospital as one of the 9 recipients which was very surprising to me. I am the last person to think of myself as a leader! I kept moving to different units and I really thought that L&D is where I would want to be at. Actually, I much rather want to do postpartum than L&D. It was going to be my plan to be in L&D for a couple months just to understand the basics then move on to postpartum. But it did not end up happening because I received a full time permanent position as a nurse consultant. It is pretty much almost every nurse's dream I guess with the consistent Monday to Friday hours, good benefits and security and no weekends or holidays.

In my current role as nurse consultant, the only interaction  is through a phone. So I thought with my social anxieties it would be a better option for my mental and physical health. Over time I felt like it ended up having the opposite effect. I don't feel physically healthy with the sedentary lifestyle and mentally I am even more anxious because I constantly think about what I should do next or what I should be doing the next day. I feel like treatments are often delayed because I can't make a decision whether I should cover for the treatment or not or if it is within the policy. Clients will be extremely mad at the phone conversation with me if I tell them I can't cover/pay for it or they can't be reimbursed for something. It's all about money. I feel uneasy when I think about health care and money. Even confrontations on the phone I ended up crying about later on. You would think my stress tolerance over the years would increase but I feel like I have gotten worse as a nurse.

I am seeing a psychologist to help me cope but it has helped in some degree. But on top of my anxieties I seem to feel like I am just truly not enjoying it even though I know I am new and almost feel like I miss the hands on skills. I'm not the best communicator and I feel like I am able to truly show that I care for someone if I do things in a more physical manner like changing their wound dressings and giving them their medications and some teaching. I am thinking about going back to school to specialize in something but not sure on what (OB, Dialysis, palliative, OR). OR completely change my career path but still be in health care somehow like medical lab technologist but I feel like this will be a waste of time and become a disappointment to my family.

Truly apologize for the rant... I just don't really know what to do and I panic when I think about work. I know nurses around the world do have it worst than me right now with the Covid because I get to work from home and I shouldn't even be complaining. But I kind of also want to be out there and helping everyone who is suffering. I definitely still have to work on my mental health and don't want to make any decisions I will regret. I have tried to be optimistic every time I choose to move to another unit and hope that this is where I want to be in only to feel even more disappointed

Dear Disappointed,

Your problem is not going to be solved by changing jobs, because your problem is not your job.  Every time you get a new job to decrease your stress or avoid people, some other aspect of the job triggers you.

This is not a career problem. It's a medical problem.

You cry about work, experience anxiety, are worried and stressed. You find it hard to make decisions, avoid people and situations, and fear authority. You have loss of joy.

It's good you are seeing a psychologist and it can only help you gain insight into yourself and perhaps gain some coping skills. It should give you a more realistic perspective.

A psychologist cannot prescribe medications, however, and you most likely have a diagnosable and completely treatable medical condition-meaning anxiety and maybe depression. The important thing is, your medical doctor can help you.

You do not have to keep suffering.

I love what you said about how you show you care for others- by doing things for them in a physical manner, such as changing dressings, giving meds, and patient teaching. I think you describe the love language of nurses very well.

Others see that you are a leader, and you haven't yet been the best you can be because your condition is holding you back from the best you.

It's going to be amazing how much better you'll feel with the right treatment.

Best wishes,

Nurse Beth

Related article: Confessions of an Introvert

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Hi! Nice to meet you! I love helping new nurses in all my various roles. I work in a hospital in Staff Development, and am a blogger and author.

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Hi

I agree with nurse Beth. You suffer from depression and anxiety and need the right treatment. These two factors are preventing you to become the best you can be.  Once you take care of these, the best is to come, hang on and be evaluated by the right people.

Dr Madenya

Starting a new nursing position can be very stressful. I know where you are coming from. I have been there. Sleepless nights, anxiety to the point of panic and throwing up before (or during work in the bathroom), feeling helpless, thinking a desk job will be better but sitting still with pent up anxiety adds to the stress because of the lack of activity. It is not easy.

It does get better as you learn the position and feel more comfortable with your ability and decision making. it can take 6-12 months with a new specialty to feel up to speed. This is normal. The overwhelming anxiety is not healthy though and I’m glad you are seeking help. You mentioned working at home. As exhausting as the job can be mentally, try to find some time for physical activity. Walking, running, yoga (I bought a exercise bike, treadmill, and iFit membership with COVID19 around-I look at the equipment and think-really? I can’t-but I paid for it-so I do it-and it helps with relieving stress, anxiety, and sleep-it’s an outlet and it’s time that I’m dedicating to making myself better. This may help you too.

I would not recommend taking on another position while you are getting you anxiety under control. If you truly miss the patient interaction, there are per diem/PRN positions out there to add to you current position when your mental health is under control-but I would wait until then. Better for you and your patients. 

I have been I. A similar position if you need someone to talk to feel free to PM me. I’ve been where you are. I was 27 when I had 7 years in and was at a really bad point with my anxiety. Now I’m 20 years in and glad I didn’t leave nursing all together. It did take a lot of work to get to where I am though. Many of us go through this. Know you are not alone and you will get through this with time and help fro your doctor, family, friends, and peers.

Take care.

I am not big fan of a better life through Pharmacology, when the issue can be resolved in another manner.   I too suffer from work related anxiety.  I love direct nursing care but I have come to the realization that the stress and anxiety that I get is too much.  Yes I have talk to people about getting a medication but then I looked at the side effects of these medication.  I had to step back and look at what was causing the anxiety.  Was the anxiety being caused by life in general or the job.  For me it was the job.  I decided that I need to find other ways that I could use my nursing background that were not typical nursing related positions.  Nursing can be a nasty profession  and folks that are different are easy fodder.   Before taking medication, have someone help you figure out what is causing the anxiety.  Look for solutions to those specific items that cause you stress and trigger the anxiety.  If you feel you need medications, use them.  Chances are, you are like me, it is the people in the profession that is triggering the anxiety.  I have all the skills and all the knowledge (would not have made it out of nursing school) that I need, I just can't get it right in the working environment.  BTW- I have been looking into nursing administration. I like you, am seen as a natural leader.   

Irish Nurse

Specializes in Hospice.

I am a Hospice and Palliative Care Nurse for almost 15 years and I love it. I have a BS in Business and worked for 20 years in the Business World before embarking on a new career and attending nursing school to get my BSN. So I started my nursing job in my 40’s. My message to you is that no one was a bigger nervous wreck than me when I started but I did fine and flourished. Many nurses take anxiety or depression meds. Don’t give up on nursing!! Keep working on your anxiety! I have anxiety and I’m so glad that I stuck it out! Have faith in yourself and you were a acknowledged as a great nurse and leader already!! Best of luck to you!

I don't believe she's spent enough time in one specialty to fully grasp it. We all hate things we don't know when first starting out but learn to like them over time when we master them. Is it OCD, false expectations, perfectionism, etc? I don't know but it's not anxiety. Calm down, slow down, and give yourself time to master it or learn more before writing it off.

lumbarpain, ADN, RN

Specializes in Geriatric/Sub Acute, Home Care.

...This suggestion I will make is what was in my heart since nursing school.......but unfortunately Life got in the way and it all ended. YOU are much younger than I....and you have a tremendous background.  I always wanted to be a Holistic Nurse or along that line of being a Wellness nurse/Alternative medicine and this may be an idea for you at this time of indecision in your career.....even if its a temporary thing...

….This  was a dream of mine because deep in my heart I felt people needed a lot more during illness to effectively BECOME a WELL HUMAN BEING AGAIN.........it may not pay well, but at this time I don't know what the going rate of pay is ..but its a suggestion you may consider....I wish you the best of luck and happiness in your endeavors and hoping God opens up a Happier door for you in Nursing. Ps...although I never went in Holistic nursing and was directed back several times to LTC and it made me very upset because it wasn't what I really wanted to do, I had to deal with it....Bills called out my name!!...At least I did it, I tried, but God directs us where he wants us in life,  I am sure He will do the same for you and you have one important thing on your side now....YOUTH!  Good luck again.. 

It’s tricky, this anxiety thing... it haunted me most of my career, even as I got older and understood the impact we had on the patients,,   But the worst anxiety was watching bad, lazy docs get away with substandard care.

get some solid counseling... which I know you are doing.  And let go of everything you can’t control.  Which is 80-90% of the crazy job!

there is no black and white. Do your best while you are at work,   You can’t control the patients response, the finances, the hours or the cut in hours. You can’t control your co workers or the docs... 

you simply can’t FIX everybody or everything.! So don’t expect that of yourself...

take care of YOU.. stay in touch with friends, ....get a massage.

 Be sure you get some exercise...walk your dog..

you are not the job.  If someone is unhappy it’s not your fault!   
if you can fix it then fix it.... but so much is broken in the medical field now...

Wishing you the best...

 

 

 

With at least 6 different positions under your belt and not having found your niche (or really felt fulfilled in any of the roles) it is less likely that just another job or just leaving the profession is the answer or the  correct next step. First, make sure you understand the underlying issues and have an opportunity to optimize your health (physical and mental) before making further major decisions.

I agree with Nurse Beth, you should seek a thorough evaluation by a medical provider.

Best wishes ~

geminilua

Specializes in Case management.

Don't get discouraged. I too work as a nurse case manager for workers' compensation. When I first started, I had lots to learn. Fortunately for me, I worked for a great company with excellent training. It does take time to become a pro. I would say give yourself at least a year. And even when you think you know what you are doing, things change. Learn to go with the flow. I think what helps me the most is staying organized. Figure out a flow that works for you and your workday will go much easier. when you turn off your computer, don't think about work. This is particularly difficult, especially when you go on vacation and start thinking about all the emails, calls, diaries/tasks you will have once you return. Fortunately for me, I don't have to make treatment authorization decisions as all the treatment requests go to utilization review; however, when I worked for another company, I did have to do your, and sometimes it is tricky. Use your resources (ODG guidelines, dial-a doc, colleagues, manager, talk to the ordering provider) to make the best decision possible. Negotiate treatment- if you are not able to approve 20 PT visits, are you able to maybe approve 10? When you let the injured employee know that a treatment was not approved,  let them know that it is based on guidelines and share the guideline with them. Also, the claims adjuster is really the person who makes decisions about what they will pay for or not whether it is within the guidelines or not. If you can, let them be the bearer of bad news!   If you build a good rapport with the injured employee from day one, there is less of a chance of them yelling at you. Be nice, be kind, and be understanding of their situation. They may not like it when you give them bad news, but they will be nicer if they like you. You will have bad days and some people will yell and they will get an attorney, but don't take it personally. Do the best you can and remind yourself that you get paid well, you don't work holidays, you work M-F (probably 9-5) and you can't save the world -unless you have a magical power we don't know about :) 

booter512

Specializes in Diabetes, Transplant, CCU, Neurology.

Dear Disappointed,

First, as Beth mentioned, you probably are not staying on a unit for long enough to show your strengths or to get to know your patients' characteristics well enough.  Second, not knowing how your hospital manages orientation, I think you may not be getting hooked up with right preceptor.  I was a shift resource nurse on a neuro/stepdown unit, so I got to precept nearly all of the new nurses for at least part of their orientation when they came to night shift.  I've precepted shy, overbearing, introverted, extroverted, new and experienced nurses.  Each nurse brought their own strengths and weaknesses.  My goal was to get them to take advantage of their strengths while improving on their weaknesses.  Just reading your letter, it sounds as if you've had preceptors that instructed you, or at least pushed you, into doing things the way they did them.  When I precepted, I generally allowed a new nurse to communicate with their patient the way they felt comfortable, but sometimes, before the nurse entered the room, we would go over each thing that needed to be addressed.  I'd allow the nurse to even make a list if that was what was needed.  I introduced them to nurses on other units, told them who they could go to if they needed specific things or help, and allowed them to do the most hands on clinical treatments that I could.  

Finally, try to think about introvert and extrovert in a little different way.  I was an avid tennis player, so I watched tennis frequently.  Have you ever heard of Jimmy Connors--one of the brashest, feisty, taunting players ever.  I read that he was actually an introvert.  I wondered how this could possibly be true.  The author said that what makes him an introvert is that he draws his strength, his emotions, his passion, and his sheer determination from within.  Extroverts draw energy from their surroundings, their peers, the situation, etc.  Neither is better or worse than the other, but it's from where you get your drive.  Who is harder on you?  If you're an introvert, you're probably your own worst critic.  But you need to be you own best motivator too.  Instead of saying, "I'm not sure I can do this or that", say, "how can I do this or that better next time".  Push yourself.  Stay in a unit for at least a couple of years.  Push yourself to better yourself, and to better those around you.  You can do it.  Give yourself a chance.

 

Robmoo, ADN, BSN, RN

Specializes in ADN, BSN, RN.

You'd be hard pressed to find a nurse who has not shared your feeling at some point.  A psychologist is good, but a psychiatrist might be better.  If they recommend medications then give it a try.  It might be that something as mild as Wellbutrin would take the edge off your feelings of anxiety to the point where you can give your current career path a fair shake.  What would your next career jump be?  Nursing Informatics?  One of the great things about nursing is that if you don't like what you are doing there is always something else to try, but I think that in the long run that you would be happier with some better treatment.  Depression and anxiety are a demon that eats one from the inside out.

Thank you for all your comments and words of encouragement and support. I just feel like I find myself really really not liking case management and/or sitting in front of a computer for long periods of time looking and reviewing so many medical reports and meanwhile everyone is waiting for a decision to be made. I have lost a lot of my confidence partly also as you have mentioned I have not stayed long enough to really grasp the role of my position. I just don't find joy and I am trying to find the positives but I feel like I don't like the desk/sedentary job with so much paperwork to go through or electronic paperwork in that matter. But I do enjoy moving around and doing things hands-on. I find I learn better that way as I am a visual kind of person. Or maybe its really not meant to be and I can't handle the pressure and expectations of this career. I really admire everyone who really pushed through and flourished. 

geminilua had some great suggestions for you to try while you are in your current position. May I also suggest having lunch at your desk, then using your lunch hour to exercise? I have been doing that since I started case management. One of the great things about a nursing desk job is the regular lunch hours. I will miss that when I am gone.

And in the meanwhile, why not apply for the postpartum position that you really want? Send out resumes like crazy and see of someone bites. If not, and you really feel that you don't have interest in any other nursing field, then leave nursing. It doesn't matter who will feel disappointed. Whoever they are, they can't live your life. I don't think I read in your original post that you suffered from anxiety/depression prior to becoming a nurse. Why should you be miserable, getting counseling and possibly taking meds because of a career that's not right for you?

Robmoo, ADN, BSN, RN

Specializes in ADN, BSN, RN.

On 7/9/2020 at 9:06 AM, elomi18 said:

Thank you for all your comments and words of encouragement and support. I just feel like I find myself really really not liking case management and/or sitting in front of a computer for long periods of time looking and reviewing so many medical reports and meanwhile everyone is waiting for a decision to be made. I have lost a lot of my confidence partly also as you have mentioned I have not stayed long enough to really grasp the role of my position. I just don't find joy and I am trying to find the positives but I feel like I don't like the desk/sedentary job with so much paperwork to go through or electronic paperwork in that matter. But I do enjoy moving around and doing things hands-on. I find I learn better that way as I am a visual kind of person. Or maybe its really not meant to be and I can't handle the pressure and expectations of this career. I really admire everyone who really pushed through and flourished. 

There are no great gains without great pains.  Good luck in whatever you decide!

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