My anxiety is taking over

[Regn101]

My dream has always been to work in the ER. I have 1 year of med/sure experience and I just landed a job in the ER at a level 1 trauma hospital. I am beyond ecstatic however I am very worried I won't be able to handle it. I have never been grossed out or queezy about seeing anything. However I passed out once in nursing school watching a lumbar tap. I didn't even think it was going to affect me at all, if anything I was excited to see a new procedure. But as soon as I saw that needle go into the back I immediately passed out. I was completely mortified. I thought that maybe it was just a one time thing but then my next semester I witnessed a central line being placed. The physician was having difficulty placing it and after the third attempt I fainted. Again I was embarrassed beyond words! I have realized that I have a problem with seeing skin being punctured. I am completely okay once the skin is open but there is just something about watching it being done that gets to me and I have no idea why. And now whenever I even think about it I get dizzy and a faint feeling. I am worried that I am going to work myself up so much to the point where I will faint anytime I see anything like this in my ER job. I don't know what to do and I don't want this to hold me back in my career but I am not sure how to get over this problem. Please any advice would be great!

[Altra, BSN, RN]

You do realize you'll be drawing blood and starting IVs multiple times a day? Assisting with LPs and central line insertions also comes with the territory.

If you & your preceptor hit it off well early on ... I'd be up front about this.

[Regn101]

I have drawn blood and started IVs on the floor I was working on multiple times and was okay with that. The one incident I did feel faint was when I had a patient that was a hard stick. I had to call our VAD team and was watching their technique and they had to stick the patient 3 times before getting IV access. The patient became very uneasy and thankfully I did not faint but I did have to rush out of the room to cool myself off and to sit down for a few minutes. I have not seen any Lumbar punctures or central line placements however since I graduated. I'm hoping it'll be one of those things that will just get better with time, but it's definitely worrying me that it might not. I don't want my anxiety to take over and have to worry about possibly fainting every time I go into work. I have gone through a lot in my life and have never experienced anxiety until my fainting episode. I'm worried that if I tell my preceptor she will look at me like I'm not cut out for the job. I know that I'm cut out for the fast pace and the pressure of the ER. It's just this problem that I feel like is holding me back so I keep trying to tell myself that it's all psychological and I can do it. I just hope I'm right.

[CharleeFoxtrot, BSN, RN]

I can just about bet that you are standing there with your knees locked and holding you breath-a sure way to pass out courtesy of the vagus nerve :)

The way to get around that is to have a little chat with yourself, sort of an internal pep talk. Remind yourself to breathe, keep a slight bend in your knees and if you have to-promise yourself "I can get sick later but right now I don't have time for this." Repeat PRN and good luck.

[Psychcns]

possibly find a psychologist who does cognitive behavior therapy or exposure therapy...or watch procedures on you tube and see if you can desensitise yourself.

[Regn101]

Thanks for the encouragement and the advice everyone! I actually realize that I give little pep talks to myself to help calm the nerves. I'm glad to know that it's normal and okay lol ?.

[Regn101]

possibly find a psychologist who does cognitive behavior therapy or exposure therapy...or watch procedures on you tube and see if you can desensitise yourself.

Psychcns I've actually thought about seeing a psychologist. I really feel like this has something to do with my psychologically more than anything. Before this happened I would get so excited when I would find out that I was going to be doing something new or seeing a new procedure. Now when I find out I'm going to do something new I immediately start to get anxious and worry about fainting and embarrassing myself and not being able to be there for my patients. I feel like this consumes me now. I actually have been watching lots of YouTube videos so I hope that'll help. Have you ever had experience with anything like this or know somebody that has and saw a psychologist? I really feel like maybe I should see one.

[Nursingluv101]

See if you can volunteer first...trauma 1 you will see a lot... If you cant handle a LP you might be in trouble..

[Marshall1]

You are focused on the past and what might have..MIGHT..as others have posted, be upfront with your preceptor, remember to breathe, don't lock your knees and give this dream job a chance..it will, in the end, either work out for you or it won't - either way you will have tried and will know. You are not the same nurse you were when your fainting spell happened..you are more experienced and while I understand your anxiety about the job/fainting happening again..I suspect you are going to be just fine.

[Regn101]

You are focused on the past and what might have..MIGHT..as others have posted be upfront with your preceptor, remember to breathe, don't lock your knees and give this dream job a chance..it will, in the end, either work out for you or it won't - either way you will have tried and will know. You are not the same nurse you were when your fainting spell happened..you are more experienced and while I understand your anxiety about the job/fainting happening again..I suspect you are going to be just fine.[/quote']

I will definitely agree with you that I'm worried about what MIGHT happen more than anything. I start in 3 weeks and all of my thoughts are consumed with "what if I fail at this?" "What if I faint and they don't want me there anymore" to the point where Im now dealing with horrible tension headaches on a daily basis. I feel like I'm stressing myself out over something that hasn't even happened and hopefully won't! I've really threads about other nurses passing out and saying that through time and exposure they've learned to deal with it. I really really hope that'll be my case! Thank you all for your recommendations and words of wisdom!

[Psychcns]

One more thing. What you are talking about- the anticipatory anxiety-sounds like what people with panic

Attacks go through-the fear and

Dread it might happen again. There are ways you can

Talk yourself through this. I found something on web MD when

I googled "fainting at the sight of blood." Basically relaxation and

Tensing muscles in hands and feet.

[Regn101]

One more thing. What you are talking about- the anticipatory anxiety-sounds like what people with panic

Attacks go through-the fear and

Dread it might happen again. There are ways you can

Talk yourself through this. I found something on web MD when

I googled "fainting at the sight of blood." Basically relaxation and

Tensing muscles in hands and feet.

Thank you! I actually just looked up the article and read it and I'm really interested now. I went to my dr a few days ago and, mostly because my headaches were getting worse (I've suffered from chronic headaches and migraines for the last 10 years). I told her that as soon as I start thinking about this I feel the muscles in my head instantly tense up and get a faint feeling followed by a throbbing headache. I asked if she thinks seeing a psychiatrist for some cognitive therapy would help and she told me she didn't think I needed it. But after reading all these threads and articles I think it might be a good idea. I want to be proactive in beating this and I don't want it to hold me back. Have you had any experience with cognitive therapy? Or know anybody that has had success with something like this?