I am a new nurse, graduated last December and I have been working on Cardiac/Respirtory Unit (CABG's, Vents, Dysrhythmias, Vtac, kinda like setting, MI).
I have been a nurse for the last 4 months and I am so Stressed out "overwhelmed". I can do the job just fine and finished my shift just fine as well. But with lots and lots of heart palpitations and anxiety and it's dragging me down.
For the last 4 weeks, it had been difficult for me. As I mentioned, my situation: 3 pts having way too elevated Blood pressures, calling rapid response team, on top of that admissions then having an MI. I kinda know what to do but I am scared. I thought I was actually doing ok. But everytime there's an incident, it drags me down again and increases my anxiety thus I don't even want to go to work anymore, not that I can't do the job, but I can no longer tolerate the stress level, it's affecting me and my family now, simply because of this stressful, dragging, tiring, draining feeling.
Is this still normal? I know some of the things I have learned at school. But I kinda studied it myself to figure out what my problem is, and it boils down to me experiencing an incident I never had before, Like MIs, or two of my patients having super HIGH BP which was happening at the same time, plus an admission. So to me, I just need more exposure, I guess.
But how will I get rid of the "anxiety". I am so so anxious, there are times that I just wanted to scream and cry. I know I'm guy. But it has been a hell of a ride for me since I became an RN.
What keeps cropping up is the acuity of your patients. My guess is that you are carrying the weight of the world on your shoulders because you're afraid that you could make a mistake and kill someone.
While that's technically true, walking around with that thought just below the surface is NOT a good way to work or to live. Too much pressure. And it could become a self-fulfilling prophecy by keeping you so preoccupied with worry that you miss what's right in front of you.
How do you escape this horrible place you are stuck in? And by place, I don't mean your unit. I mean the mental quagmire that is slowly sucking you under.
You escape by determining what is true and choosing to believe it. This starts with assembling facts and realities. You are well-trained and well-prepared for the job at hand. You have all kinds of resources at your disposal--other nurses, monitors, docs, labs, even Google, for pete's sake--to help you ascertain what is happening with your patient. You are a go-getter kind of person who will not sit around waiting for answers to present themselves. The patients will tell you plenty--by mouth, by actions, by history, through family--if you are wise enough to listen. I'm sure you can think of many more.
When a little kid learns to ride a bike, he starts out wobbly and scared to pieces. He has all kinds of head knowledge about what to do, but for those first couple of attempts, the only thing he can remember is to panic early and often. Eventually, through anger, fatigue or sheer stubbornness, he steps down on the pedal and this time he doesn't fall. Pretty soon, he has developed the level of trust he needed all along to be able to ride down the street.
You don't have that trust level just yet, but it's coming.
So you round up the truth and then, with an act of your will, you choose to believe the facts. Little by little you let go of the death grip on yourself and your job and replace fear with trust. At some point, you will realize that you forgot to be scared for a few minutes. Then an hour. Then a couple of hours.
You'll still freak over things that deserve that kind of reaction--a patient crashing, for instance--but you won't have that free-floating kind of terror that can leave you paralyzed.
Even if this isn't the right unit for you, as others have said, this newbie neurosis is a part of transitioning from student to practicing nurse, and you'll go through it to some degree no matter where you end up.
DO take good care of yourself across the board so the main part of your energy can be used on this process.
You will come out of this with strength and confidence. And the ability to encourage those behind you on the path.
Hi... so what I'm trying to figure out is. Why am I stressed-out?
I've looked at different angles and couldn't figure out what it is.
Would you recommend that I switch to a med-surg unit? Because a friend of mine recommended it.
It might depend on the unit. I work on a med-surg unit, and I can tell you, after 6 months I still feel anxious. Not as anxious as I did a month ago, but still anxious. It is going away by degrees, though.
I also am a perfectionist, so it is hard not having the answers and not being able to do my job perfectly. Once I realized that even experienced nurses screw up sometimes, my nervousness diminished quite a bit.
Maybe switching to med-surg is right for you, but then you will have to be a newbie all over again on a different unit. Only you know for sure if that's the right decision for you.
To everyone answering this post, I value the experiences and opinions you shared to newbies like us. Just like NewDude, I have only been an RN for about 7 months. I went straight from school to Medical/Surgical ICU where we take care of fresh CABG patients. The acuity of such patients are very high that nurse:patient ration can be 2:1 at times. Very stressful and can be frustrating if patient is going down on your shift despite all the nursing interventions you are implementing.
Despite the pressure, tension and gravity of the work, I still somehow manage to survive the shift (in the same way that NewDude is able to get through his shift). I believe I can take all the pressures because I chose to be in this type of unit. I elected to be in ICU. I understand that in order for me to learn, I have to get exposed to difficult cases (cases of higher acuity). I feel all the tension and anxiety but knowing that I have a supportive environment, and with the reassurances from my colleagues and Doctors that I am doing the right thing -- I am slowly building the confidence and trust that, ok -- I wasn't that bad after all. In fact, just like most of you mentioned -- my charge nurse saw me as calm, confident, and very capable despite the very limited experience I possess.
As a new grad, I dread the idea of a full code patient dying on me. But my preceptor once said, sooner or later -- that's gonna happen. When faced with that situation, the only way to protect yourself is to follow the hospital guidelines and protocols and always work within those guidelines. Sometimes, despite the wonders of medicine and even with quick interventions, it is just impossible to save a patient. If this happens, my preceptor told me to just remember that I did all I could and that it is not my fault...
Those words somehow provided me with a sense of peace and calmness. She is right. When I come to work, that situation might just happen to me -- but now I know what I needed to do...and I know my colleague are gonna be there for me too.
I still have that sense of anxiety -- but just enough to keep my guards up all the time. It is good to have a certain amount of anxiety -- I think all conscientious RNs will always have this. It keeps us alert and more keen with our observations and assessments. We share the same type of personality -- wanting to give out the best care to our patients at the expense of our breaks, our backs, and our kidneys...that's how dedicated we are to our profession and to our patients.
So now when I go to work, I pray to have the presence of mind all the time. I prep myself that even if I get a patient whose acuity is high -- I will do everything to manage his/her care to the best of my abilities. That's all we can do. Even if you go to Med-Surg, OR, ER, Tele or ICU -- chances are, you may have to carry with you this form of anxiety. No one can guarantee you that on that day -- a patient is not gonna code on you whichever unit you may be.
Good luck to you and give yourself some more time...That's what I tell myself, because it is true. We need more training and exposure and that's how we will become confident with what we do....
4 months is a short amount of time being a nurse. As the others said, things WILL get better in the sense that as you encounter more situations, more patients, you will find out more tips and tricks, and have an overall increased comfort level as you realize that you know what to do in situation A, B, C and D.
However, as nursemike said, hospital nursing is hard.
Take a look at your coworkers to gauge what kind of environment your floor is. The experienced staff, or the staff that has been on the floor a while, do you see them crying? Do you hear them talk about their chest pain/palpitations/anxiety meds since starting the floor? Do they talk about not being able to sleep at night the night before work? Do they say phrases such as that they can not give good care on the floor due to the working conditions, or that they feel trapped because of the economy? Do experienced nurses make serious repeated comments that your floor is not safe, or that they are concerned for their licenses? If you see multiple experienced nurses having difficulty with the floor, then you likely have a problematic floor and things will not get much better. If the staff seem content, keep in mind that you can turn into one of those content people too!
Please don't get the impression that you are failing. You are also in a tough area. Feel free to ask any questions, and don't hesitate to call on your coworkers and your charge nurse for support. They should be more than happy to help because they should remember what it is like!
Life is too short to be miserable. If you see no hope of this job getting better (such as mentioned above, if experienced coworkers are breaking down too), then move on to something else that you will love and that won't be detrimental to your health or to your life outside of work.
I know I'm guy. But it has been a hell of a ride for me since I became an RN.
rn/writer, RN
9 Articles; 4,168 Posts
What keeps cropping up is the acuity of your patients. My guess is that you are carrying the weight of the world on your shoulders because you're afraid that you could make a mistake and kill someone.
While that's technically true, walking around with that thought just below the surface is NOT a good way to work or to live. Too much pressure. And it could become a self-fulfilling prophecy by keeping you so preoccupied with worry that you miss what's right in front of you.
How do you escape this horrible place you are stuck in? And by place, I don't mean your unit. I mean the mental quagmire that is slowly sucking you under.
You escape by determining what is true and choosing to believe it. This starts with assembling facts and realities. You are well-trained and well-prepared for the job at hand. You have all kinds of resources at your disposal--other nurses, monitors, docs, labs, even Google, for pete's sake--to help you ascertain what is happening with your patient. You are a go-getter kind of person who will not sit around waiting for answers to present themselves. The patients will tell you plenty--by mouth, by actions, by history, through family--if you are wise enough to listen. I'm sure you can think of many more.
When a little kid learns to ride a bike, he starts out wobbly and scared to pieces. He has all kinds of head knowledge about what to do, but for those first couple of attempts, the only thing he can remember is to panic early and often. Eventually, through anger, fatigue or sheer stubbornness, he steps down on the pedal and this time he doesn't fall. Pretty soon, he has developed the level of trust he needed all along to be able to ride down the street.
You don't have that trust level just yet, but it's coming.
So you round up the truth and then, with an act of your will, you choose to believe the facts. Little by little you let go of the death grip on yourself and your job and replace fear with trust. At some point, you will realize that you forgot to be scared for a few minutes. Then an hour. Then a couple of hours.
You'll still freak over things that deserve that kind of reaction--a patient crashing, for instance--but you won't have that free-floating kind of terror that can leave you paralyzed.
Even if this isn't the right unit for you, as others have said, this newbie neurosis is a part of transitioning from student to practicing nurse, and you'll go through it to some degree no matter where you end up.
DO take good care of yourself across the board so the main part of your energy can be used on this process.
You will come out of this with strength and confidence. And the ability to encourage those behind you on the path.
I wish you the best.