New grad panic attack

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Specializes in Tele/PCU.

Hello,

I'm a new grad nurse working in the ER. I'm off orientation and working on my own now. Things had been going fairly smoothly until the other night I had a crippling panic attack, which I've never experienced before. All day before my night shift I'd been dreading going to work, which isn't like me at all. When I finally got to work I felt my heart start racing, I made it through report and as I was giving meds to my first patient and discussing what the plan was for her. I started pouring sweat, having trouble concentrating and my heart was POUNDING. She wasn't even that sick and my zone was full super easy patients so I had no reason to be as scared as I was. I came out of my pts room and the other nurse in my area took one look at me and got them charge nurse. Labs, EKG, and other various test followed and found nothing other than a fast heart and some HTN. We concluded, that it had all the elements of a good ol fashion panic attack. Which, I'll be visiting my doc just to make sure. But is this common? What do you all do to cope? And am I crazy for thinking I should change units? Now I'm the new grad that had a panic attack on the floor for no reason and was sent home for it...my pride took a major blow and my confidence is shot. Sorry for the novel.

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Specializes in CICU, Telemetry.

You're not the first, and you certainly won't be the last. Definitely see your primary MD and decide if therapy/a psychiatrist is a good idea. The ED is a tough place to be as a new grad. Things can go south in an instant and you don't have the same background about your patients as a floor nurse who has had the luxury of reviewing the H&P, etc. It can seem like you have no help because you don't want to bug your co-workers for something stupid, and all the floor nurses hate you for not doing every little thing. (I know, because I've been one of those floor nurses hating you. Sorry. I get it now. Sort of.)

A thick skin is a must-have, and it's not a sign of cowardice if you go talk to your manager and ask to be placed in a less-acute setting for a few months/year until you get your sea legs. Nursing is hard, and it's difficult to be prepared after school and a 3-4 month new grad orientation, especially in a critical area such as the Emergency Department.

I work with critically ill patients. It scares me more than you'll ever know that I hold these people's lives in my hands. I scrutinize every little decision that I make. I don't become attached to my patients because it helps me stay objective, even though some think I'm cold because of it. I LOVE my job, but the anxiety and doubt will overcome you if you let it. I was basically in SVT my first year of practice on a stepdown/telemetry floor I was so scared I would mess up and kill someone.

It's normal to have some worry, but if it's affecting your personal life or ability to function at work, it's definitely worth at least talking to a therapist/psych about it. Xanax (never before or at work, mind you) made my life as a new grad tolerable. It's not for everyone, but it worked for me. You're not alone, you just have to figure out what's going to be best for you, and figure out how to cope with feeling incompetent for a few months/sometimes several months.

If you trust any of your co-workers as mentors, ask them what things were like when they were new grads. Tell them how you're feeling. Ask them what helped. Sometimes your best advice comes from those who know exactly what your department is like. Some will caution you against being close friends with your colleagues. Others will tell you it saved their lives and/or careers. The truth is probably somewhere in the middle.

Good luck, and let us know how you make out

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Honestly, it's the new grads who DON'T have the occasional freak out who make me nervous! It's totally normal and good on you for being so open about it with your peers.

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Specializes in Pediatrics.

You are not alone, nor are you crazy/different, and you should not feel ashamed. I am a new grad myself just a few weeks away from coming off of orientation - and it is scary! We, as new grads/nurses in general, put a lot of pressure on ourselves already - let alone the enormous amount of stress we receive when we have complex patients or a high stress environment. I wouldn't say that you necessarily need to jump to a psychiatrist.. I mean unless of course you feel this would be your best route based on you knowing your mind and body better than anyone, I do think it would be really great if you had someone professional you could talk to, either a manager or co-worker who may understand based on your work location, or a counselor - someone who is detached from the situation and can hold space for you as you vent. ED nursing is no joke - I personally could never do it - but I do know it is possible to start here as a new nurse and grow in confidence, so I encourage you to not give up on yourself! If you are hating the ED however, there is no shame is transferring to another floor. Floor nursing is not picnic either, its a different world, but the grass isn't necessarily greener. Nursing is stressful in general - finding that solid way to vent out your emotions and build in your confidence is the key. I wish you the best of luck!

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Honestly, it's the new grads who DON'T have the occasional freak out who make me nervous! It's totally normal and good on you for being so open about it with your peers.

This wasn't just a "freak out" that is typical of new grads reacting to a situation in which they feel they are not competent-he wasn't in a stressful situation when this happened. This did sound like an authentic panic attack, with all the physical and mental symptoms. These can come on suddenly for no *apparent* reason. They can escalate into some serious problems. The good news is that they can be treated successfully with professional help. I wouldn't necessarily make the immediate leap that he needs to see a psychiatrist, but if he experiences this again, it would definitely be a good idea to make an appointment with a psychiatrist or psychologist.

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Specializes in ICU / Urgent Care.

What you describe is normal. I was a new grad at one of the craziest ICU's in the North East where we get only the sickest of the sick. I've been there a year now and while I still get a lot of anxiety it fades as I go into work and lingers only the day before I have to go in. As a new grad straight out of orientarion it was borderline crippling and I'm still not quite sure how I made it

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Specializes in Tele/PCU.

Thank you for the comments and reassurance! Saw the MD and she doesn't think it was cardiac realated, which isn't a surprise but it still relieving to hear :) but does however think I had a panic attack. Which, I guess with everything going (new grad, getting married, recent death, moving, so on so fourth) isn't out of the ordinary. So I was prescribed some anti anxiety meds which I'm a little worried about taking but more worried about that happening again at work, say during a code o_O So I'll give these a shot and maybe try some yoga and see how it goes.

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Specializes in Psych ICU, addictions.

A panic attack or two as a new grad is normal. It's good that you saw your PCP about it and are working on a plan to manage your anxiety.

However, if panic attacks become a recurring trend, you may want to see a psychiatrist and/or evaluate whether the ED is the best place for you to be starting out. It could be an anxiety disorder, it could be you're overwhelmed with everything, or it could be both.

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I would not go so far as saying having panic attacks is normal for new grads. Being nervous, yes-- having symptoms that mimic a cardiac event for no apparent reason, no. Most definitely no.

I don't mean to make you feel bad, OP, but it is kind of crazy that other posters are making it sound like your experience is a universal one. I would keep a close eye on it and would talk to others who experience actual panic attacks (not just anxiety or nervousness) to see how they manage. Best of luck.

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Specializes in Psych, Corrections, Med-Surg, Ambulatory.

I still think it's a sad commentary on our profession that panic attacks or unrelenting anxiety are considered a normal experience. Why should any profession be so incredibly stressful that our bodies stay chronically in fight-or-flight? This is ongoing evidence that nurses routinely work understaffed and under-supported.

We should be able to regain equilibrium after a period of high stress. But when the stress level is incredibly high and ongoing, it gets harder to settle down even after we go home from work.

OP, you are unfortunately a sign of the times. By all means do what you need to take care of yourself. Meanwhile, we should all be advocating all the time for safe staffing levels and appropriate support.

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Specializes in Tele/PCU.

I had forgotten about this post until one of the new grads started talking about having panic attacks. I think it’s time I gave an update. 

 

Shortly after the last post I moved to an tele unit and thrived. I was made charge probably a little too quickly but it worked out. I then transferred to a medical/surgical/trauma unit and became CL and have since moved on to managing two inpatient units during COVID. Due to my experience, I was able to guide my new grad to get help and am looking into several option to ensure they succeed. Thank you for those that had previously commented. I hope everyone is staying safe. 

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That's wonderful. Good for you!!

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