Is it anxiety?

anonymous1919, LPN · May 22, 2010

It sounds like anxiety to me. I have anxiety and it limits me a lot when it isn't under control. I don't understand why my anxiety makes me just stop in my tracks and literally not do whatever needs to be done, but that's what it does. I'd die before I did whatever my anxiety is stopping me from doing and at the same time I feel like I am going to die if I do what my anxiety is telling me not to do. Obviously that is contradicting which generally gives me a feeling of impending doom... which is a symptom of anxiety! Joy! Just explain everything even if it doesn't make sense. Clearly, my anxiety doesn't. I take a Xanax when I am feeling like I am going to "have a panic attack" and I've been doing fine since.

piperknitsRN · May 22, 2010

I think you are taking the right steps, and would suggest you also try to make an appointment with a mental health counselor or EAP to help "talk it out" and devise strategies for you to cope with your stressors. I agree that speaking with a physician would be helpful as well, in case there are other medical issues contributing to your symptoms.

Sadly, what you are describing seems to happen to many new grads (and more seasoned nurses as well). The job is very tough and stressful.

While you are awaiting your MD appt, etc, I would start to think logically about your symptoms. Do this when you are calm and relaxed; maybe talk it out with your SO or a friend sympathetic to your plight.

Some questions that might be helpful during this exercise might be: Do you have specific triggers for these "anxiety attacks"? For example, is there some situation or person at work that is causing you to feel anxious? What makes your symptoms worse? Is there anything that helps alleviate them?

How long have you been working there? If you are new and on orientation, it can be extremely overwhelming and I think I am not overstepping my boundaries to say that in one form or another, we've all been where you have been.

Get as much ancillary support as you can; you may wish to talk to your preceptor about your fears and anxieties, if you've established rapport with her, and definitely lean on other nurse friends (you'd be surprised how much empathy you'll probably receive!) and use this bulletin board to vent.

Also, it goes without saying: eat healthy, get some exercise, spend time with friends and family, and devote some time to hobbies and recreation. Think of times when you've had stress before, and what you did to cope, and try those methods.

I would be very careful in how you approach your manager. Try to keep it positive, succinct and brief. Maintain eye contact and be as confident as possible. Perhaps you could try something along the lines of: "Thank you for taking time to speak with me. I enjoy my job and am learning so much. However, I am feeling a significant amount of stress with my transition as a new grad. What do you think are some strategies that would be useful for me to become as successful as possible at my job?"

This will help your manager give you feedback, support, and open the way for a dialogue.

If your attendance issues come up (and I would not bring them up unless this is a central concern to your manager), I would perhaps say something like, "I apologize for being absent without advance notice; it will not happen again." And then keep your word. Do not go on and on apologizing and making excuses; that should be sufficient.

Think about what you are going to say, write it down, and memorize it if you need to. Practice it in front of friends and your significant other. That sounds silly, but it will help cement the words in your brain, and help you to practice your tone and delivery style.

Perhaps you are also feeling stress from your partner's lay-off, and this is contributing--but I think I would keep it focused to issues re: your job when speaking to your manager.

Please try to take care of yourself, and give yourself a break-- taking two days off will not ruin your career.

Let us know how you are doing, and take care!

lkwashington · May 22, 2010

You are going in the right direction with everything. Good luck.

piperknitsRN · May 22, 2010

p.s. Another suggestion when you speak to your manager and/or preceptor is to ask for feedback on your performance, "It would be helpful for me to have feedback on my performance in orientation so I can improve my skills." A statement like this shows you are committed to the job, open to constructive feedback, and really want to do the best you can.

Oh, and I forgot to mention: try to get sufficient rest and sleep, especially the night before you talk to your manager.

ktwlpn, LPN · May 22, 2010

If you are in your mid to late thirties(or even early thirties) or older you could also be experiencing peri-menopause. You may not notice changes with your periods but the hormonal shifts cab be brutal.

newtress, LPN · May 22, 2010

I'm glad someone mentioned the menopause factor. I was a pretty smooth w/o fear or trepidation going in to work until after my hysterectomy. It was like everything changed for me. I wasn't as sharp, confused and forgetful. My hands seemed to be all butterfingers. I don't have any tolerance for harassment and viciousness from other nurses and I have verbally tangled with them. Hot flashes come and go right regular through the whole shift and the severe fatigue and lack of energy makes it hard to be sharp and focused. And then the dread of driving in to work and parking the car looking at the facility building makes me lock up, and know I absolutely have to go in. Menopause or not, the nursing profession as a job itself manifests into some really awful physiologic/psychologic hardships for us nurses. My nursing buddy said to me the other day "nursing changes you" and I have to agree with that.

Muffy5 · May 23, 2010

You are definitely handling it the right way! When I was a new glad, I used to have total panic attacks while trying to sleep the night before. I also sometimes had to rely on xanax.The good news is, I rarely have a problem sleeping now. I also missed shifts due to not sleeping and I felt I would do something harmful from being so sleep deprived. It helped me to talk through it with my husband or use distraction. You will eventually feel more confident and realize you can handle what everyday has to throw at you! Good luck to you. I hope soon you will be excited, rather than terrified to go to work. :yeah:

locolorenzo22, BSN, RN · May 23, 2010

I'm a newer nurse as well(graduated in 08 and been practicing for 2 years). I ALWAYS get a little anxious when I go to work. I find myself singing along with the radio, or doing a errand on the way so it doesn't seem like I'm driving right there. When I walk in the hospital, I tell myself "no matter what happens, put one foot in front of the other, nobody's going to notice, breathe, and know that everything WILL get done before you leave."

I've had many stressful nights, where I haven't charted until hour 10 of 12....but those nights happen. It's possible that your anxiety may just be a higher level. do NOT expect the CNO to understand. it's a tough market. Hopefully you work for a good employer that cares about YOU and your well-being. but don't be suprised if they ask you to resign. They may feel that you have become unreliable.

whatever happens, good luck on your journey and I hope that you get to the bottom of this.

lkwashington · May 23, 2010

I dont believe you will be asked to resign. There are nurses who have more serious problems dont even come forward. I give you alot of credit you want this work and trying to solve the situation by doing something about it.

dthfytr, ADN, LPN, RN, EMT-B, EMT-I · May 23, 2010

Excellant advice above, one and all. Is there some conflict you're not able to reconcile? Having you SO laid off must make things tough on you both. How's your thyroid?

As you resolve this, and I beleive you will, remember a funny truth I point out to my health care profesionals when they're patients. Healthcare is a gift, it's better to give than receive.

adlockwood · May 24, 2010

I agree with most of the posts here, however I think it would be good to tell your supervisor you have suddenly experienced anxiety/panic attacks in the past 2 weeks, and that this has never happened to you before. Let her know this was the cause of the absences, and that you have an appointment with a Dr find out why. Panic attacks are just as real a condition as an asthma attack, and need a combination of medication and work with a licensed counselor to over come them. As long as you clearly state you are working to handle the problem, and that this is a recent development, I would think they would be willing to work with you for a bit. Saying that stressful conditions causes them is too easy - many people are under stress but don't have panic attacks. There are ways to handle them, strategies to stop them, but there is no one answer why they suddenly start. Treat it like a health problem, because that is what it is. I work with a nurse who is very open about suffering with depression, and she uses it as a learning opportunity for others.