Managing pre shift anxiety?

[%63theend]

Any tips on managing pre shift anxiety? I'm already nervous as all get out and it's only Thursday night... My next shift is Saturday afternoon. I know it will only get worse between now and then. I'm new to the ER and a pretty new RN at that. I know I have good assessment skills and I care about my patients so those are my good qualities. I guess my main fears are related to physical tasks like putting in NG tubes, foleys, and even IVs. My small amt of med surge experience did not include these tasks as it was a 23 hr observation floor. I try and tell myself plenty of nurses have gone before and now are proficient. But I hate being bad at something or making mistakes. How do I move out of this mindset so that I can be productive?

[DavidDudley]

In my experience, there's really no way to significantly alleviate the anxiety as a newbie. You will just get more comfortable in due time once you have done those skills so much that it becomes second nature. If I were you I would change your mindset about being scared of making mistakes. Embrace making mistakes because their necessary for the learning process.

Whatever you do, don't show fear or anxiety to the patient. Always act confident even though your terrified and clueless inside and in due time that confidence will become part of who you really are.

[joe812]

You say that you are new to ED and nursing, so you should be on orientation or just got off. If so I would talk with my preceptor or other trusted cowoker for some advice. Do not admit the reason for nervousness but ask them open ended question, like you made that look easy, could you show me how you do it that way? Something simple and gets conversation started, be selective on who you ask, there are alsways the nurse who are so much better, cocky and want to make others feel less than them, Good luck Youll get more confident in handling pt and routine the more your exposed.

Self-affirmation and positive self-talk... everytime you find yourself using words of defeat or self-doubt - or going to a place of fear - simply force yourself stop and speak the opposite... you can't stop yourself from being nervous but you can choose how you deal with it.

As I heard someone say, once, "You can't stop the bird from landing on your head but you can prevent it from building a nest." (Greg Laurie)

As my original m/s mentor told me when I moved to the ER - with very little experience and as the only nurse - "Regardless of how it goes, the patient will be better off for having you there than nobody at all."

And, if there are any other nurses around, take heart in the fact that it doesn't all depend on you... your most basic task is to know when to call for help... and when to scream for help...

[Roy Fokker, BSN, RN]

As long as you do what's right for the patient - nervous or otherwise - you'll be fine :-)

You have to believe in yourself. I told myself when I switched jobs: "Pshaw! I survived 6 Charlie. I can hack this!"

cheers,

[bebbercorn]

These skills will come with time! I second the above posters and would add that you offer up your hands when you have time to complete this tasks for others. If you have a moment, ask another nurse "can I start that IV for you? Could you let me know if you have to put in a foley?" Take the beast head on and you'll master it! Also, even those with experience miss on putting in various lines from time to time. Don't let it get you down. Shake it off and try again! Best of luck to you!

[prnbullets]

There's nothing I can do to help you with the physical skills. It's like riding a bicycle, once you stop looking at the pedals it gets a little easier. I understand that at the beginning you HAVE to LOOK at the pedals.

However, to help yourself, you should know the things that you can prepare for by heart. For example, this is croop season. You should know that the most common interventions the doc will order are racemic epi, decadron po or IM, and neb tx with cool humidified air. You should know that if the doc wants a UA from the kid, put on a ubag BEFORE the IM shot.

Keep a mini notebook, document the procedures above that happen over and over. IE getting nasal secretions, what color is the sample tube, both nares for your institution or only 1. Write down the number for respiratory and pharmacy. If you have a med question call pharmacy. Then get a new mini notebook and REWRITE everything. This helps to organize everything. THEN REVIEW your notebook for 15 minutes before your shift. You will find that you will need to review it less and less.

Familiarize yourself with the your facilities code blue worksheet, so you will not be searching for the location of everything. Go through a mock code in your head from beginning to end. Line started 20G, 1st epi administered by ____ RN, respiratory arrived, 2nd epi by ____ RN, intubation size and confirmation by CO2 by _____ ..... look on your worksheet where these items will go.....because when the codes is done, EVERYONE LEAVES, and no one will sign a blank code sheet because you decided to write all of your notes on a blank sheet of paper because you couldn't find where everything was.....

Write down the meds you always forget. Metopolol you give 5mg initially. Labetalol you can give 20 mg initially and 20-80 mg every 10 minutes for a max of 300 mg until you get a good BP. Those 2 would always confuse me and I would have to look them up.

By knowing all of the little things, it will give you time to ...help other nurses, who will in turn help you, and allow you more time to complete tasks you find difficult.

[mybrowneyedgirl, BSN, RN]

Reviewing skills on youtube actually helped me with things like Artline setups.