Nursing with anxiety

Long Term Care Columnist / Guide · Mar 23, 2017

I am a retired nurse who battled bipolar and anxiety disorders during my career. Needless to say, I had to be on meds and go to therapy, and for the most part it worked for a number of years. It sounds like you may need an adjustment in your med regimen, and perhaps some more frequent therapy to get to the bottom of what's bothering you. Of course, it could be that ICU may simply not be the right place for you, so you just need to get through it and move on to your next placement. You can do it!

fezz · Mar 24, 2017

Hugs! You don't have to work in ICU! There are lower stress jobs. Options are endless. I do think ICU type jobs and high levels of anxiety may not be the best fit but if you put your mind to it you can battle anxiety. That situation you described sound super crazy. Most students in your situation would probably react similar as you did.

Penelope_Pitstop, BSN, RN · Mar 24, 2017

I have battled anxiety and depression for as long as I can remember.

It sounds like you are doing well but that the critical care environment is not for you at this time.

That's fine.

I was a MedSurg nurse for seven years and actually loved codes (as much as a person can). I was the expert nurse always consulted by fellow nurses before an RRT was considered, that kind of thing. So..I went to the ICU.

Well.

It was awful. I could handle emergencies just fine - never had a problem with codes or intubations or anything of that nature. However, something about critical care was just too much for my anxiety.

You know what, though...that doesn't make me any less of a nurse than a critical care nurse. A lot of ICU nurses would have their own panic attacks if they had six patients instead of two. That doesn't make MedSurg nurses better, either.

We're all Olympic athletes, just play different sports.

GeminiNurse29 · Mar 24, 2017

Every nurse has anxiety. We just fake it til we make it. People's lives are in our hands.

That said, there are different environments you can work in and there are different stressors in each. During school, I'd just had a baby and came back in time for clinicals 6 weeks later. I was at hospice. My first two patients died. Ever heard that "we went to turn him and he died?" Yup, pretty much it. Though I didn't know these patients and had barely interacted with them (1 died before the shift began, the other in the middle of that day), it still shook me and I had to take 5.

Codes are always difficult. Critical care is stressful. Keep an open mind, keep up with your meds and therapy, debrief with your instructor and classmates, journal or workout or whatever helps you relieve stress. Good luck.

Penelope_Pitstop, BSN, RN · Mar 24, 2017

Every nurse has anxiety. We just fake it til we make it. People's lives are in our hands.

I agree to an extent; however...

- there exists a difference between expected anxiety related to performance and pressure and an anxiety disorder. A person with an anxiety disorder experiences anxiety when there is really no reason for it, so any situation that results in anyone experiencing anxiety worsens this

- faking it can actually be detrimental in this situation. It's one thing to not show your nerves in front of a patient, it's another to act so confident that coworkers will not step in to assist because you appear to be in control

- additionally, when people's lives are in our hands, it is best to have insight into our limits so something does not happen that cannot be fixed

I'm not wishing to argue, but I think anxiety and anxiety disorders are often put in the same category when they are not the same thing

GeminiNurse29 · Mar 25, 2017

By no means am I suggesting pretending to have all the answers or be in control when you obviously need help from coworkers/classmates. Definitely know your limits. But if you're freaking out and super anxious to the point where it's debilitating and affecting your life and career, something has to be done.

Not a shrink and don't have any (diagnosed) anxiety disorder. But I think you do have a point with anxiety and anxiety disorders being put in the same category when they aren't the same thing, Delana.

mmc51264, BSN, MSN, RN · Mar 25, 2017

I have anxiety. Started in 2006 when my mother was murdered. I couldn't sleep. Put on a benzo (couldn't take anything that would knock me out, youngest child was diagnosed with T1 6 weeks before my mom at age 2-needed to be able to wake up if he needed me).

Then, nursing school got really bad. had bad instructors and developed horrible test anxiety. Never had it before (nursing was 4th degree). took same meds for tests

Now I take something to sleep and do all right during the day. I see a therapist too. It really helps.

Takethatfordata · Mar 26, 2017

Love that end quote!

dec2007 · Mar 27, 2017

bsn46, please know you are not alone! I have had (and been treated for) anxiety for over 30 years. Be gentle to yourself. This was your first really ugly code. Everybody has trouble coping with situations this awful, even with a lot of experience. You may find that you are more comfortable as you have more experience, but if not, there are lots of areas of nursing for you to explore. Don't write off critical care yet either. It took me awhile to be able to function well in that setting, but I love it now. I still have anxiety at times, especially when dealing with particularly pompous and self-righteous physicians (and some nurses), but I don't let them drive me away. Continue your treatment. Keep it pretty much to yourself, as nurses can be a judgmental lot at times, and it isn't anyone else's business. Work with your counselor to develop some coping strategies for the stressful moments (there are lots of tricks that help). I wish you well with all my heart.

RNOTODAY, BSN, RN · Mar 27, 2017

Without reading further posts, apologize-- I think your anxiety is increasing due to your progression in your BSN pursuit, and being in the ICU... and if you had NO anxiety at this point in your career, Id not let you touch a patient, if it were my decision... it's normal. And a good thing , indicating that you don't think you know it all....

basketball13 · Mar 28, 2017

I myself have battled depression and generalized anxiety since I was a teenager. I wrote it off during my teenage years as hormones. I went to college and started nursing school. I was a nervous wreck for clinicals. I was so terrified of hurting someone or messing up and killing someone... and I was just in the beginning stages of clinicals doing bed baths and talking to patients and I was terrified of messing up! I did great on the school work side of things, but clinicals were harder on me. I never slept the night before clinical. I did okay, but still had doubts about going into this profession numerous times. I almost quit in my last semester convinced I was too anxious of a person to do this. ICU clinicals terrified me and I did not even witness anything horrific as you are describing. I stuck it out and graduated. (I even worked as a nursing aide to try to help me overcome it and I do think it helped but I was a nervous wreck in that capacity as well though I was told I did well). I immediately got a job in a hospital in a float pool rotating between 2 psych floors, cardiac stepdown, and a medsurg unit. I never slept well before work and had horrible anxiety which led to even worse depression. I was so scared of messing up and not doing a good job. I cried before I had to go to work nearly every day and on my way to work I'd wish I would wreck so that I did not have to go.... things got easier though! After about 6 months I realized I hated med surg which was where I was scheduled to work the most. I then only worked between the cardiac stepdown and the psych floors. After 8-12 months I finally didn't dread coming to work. I also finally saw a dr. and was prescribed lexapro which helped my depression and my generalized anxiety. I was finally comfortable in my job and while there were still some stressful situations, I did not hate my job. I eventually went to psych full time and loved it. In my opinion psych is generally less stressful than medical units, but some would disagree. I did though just recently start working as a school nurse and overall the stress is significantly less on the average day. There are tons of different options out there, and once you become comfortable you are significantly less stressed. Don't let it scare you away. You are not alone. Critical care was not for me and may not be for you. You'll figure it out.