Overwhelmed to say the least...

[J&B-RN, BSN, MSN, RN, APRN, NP]

Ok my background:

I have 1 year on a med/surg unit.

I just started a new job (across the ENTIRE country) in a trauma 1 hospital in the SICU. This is week 4 on my 20 week orientation.

ICU has been my dream job for YEARS! Since I was in high school pretty much.

I recently developed an anxiety disorder. (recent as in 2 years ago) My anxiety problems are rare, only 3 "episodes" in the last two years. Episodes for me revolve around big changes in my life and typically last a few weeks.

Obviously moving across the country, starting a new job in an ICU, is a BIG change for me. So my anxiety has been through the roof for about 6 weeks now, although the last two weeks things have calmed down a lot, and I am coping well.

I am having some serious second thoughts about continuing to work on the SICU. Although everyone is very supportive at this hospital, and very nice to work with. I lucked out with the very smart, drill Sargent, baptism by fire kind of preceptor. She teaches me A TON but can be very overwhelming and intimidating most of the time.

Obviously just being in the ICU is intense, stressful, terrifying, overwhelming, and just plain hard to handle!

Last week, I cared for a VERY sick neuro trauma patient. My preceptor of course just threw me in and told me to take care of him. She backed my up when sh** hit the fan of course and explained many things to me, but it all got a little to intense for me. Mind you, I had NEVER worked with the charting system, was totally lost on that, never worked with vents, or titrated drips, or dealt with ICP's, or really any of it besides turning Q2hrs! I ended up having to take a 20 minute sobbing in the backroom break three fourths of the way through the shift. After crying, I got it back together and finished the shift out.

This week has been much better for me, I was able to care for two critical but stable patients and do nearly all cares alone, including the charting!

I know that feeling terrified and overwhelmed is normal, but I worry that I can't handle the stress. I have very little confidence in myself. My anxiety problem has really taken a toll on my "can do, go out on a limb, wanna be in the action" personality traits. While in nursing school I went to every code, wanted to see the sickest of the sick, be in the action, learn everything... But now, I panic at the idea of running a code on someone. I get nervous when I'm left alone with my ICU patients. I have a difficult time sleeping/eating the day before my shifts. I get overwhelmed and scared much more easily. I feel like my general anxiety is so much on a day to day basis that I can't handle any new scary things and end up getting so overwhelmed. And In the ICU everything is new and scary.

I have had a total of 6, 12 hour days on the unit. Somedays I think I have it together and I feel really confident that I can do this job, But other days I just feel like giving up and going to work in a doctors office.

My problem is that I have wanted my dream job for so so so long and have worked so hard to get here. I don't want to give up on myself. I want to be here. But feeling this anxiousness and feeling terrified all the time makes me not enjoy my job AT ALL.

Any words of advice? Encouragement?

I'm not giving up just yet, I keep telling myself that things will get better, I will gain confidence and that I can do this!

I feel like my anxiety disorder is ruining my chances of achieving my dreams, I refuse to take medications, but do see an anxiety specialist on a weekly basis.

Please help!

[seanpdent, ADN, BSN, MSN, APRN, NP]

First of all congrats on finding your dream job. Knowing what you want and then finding it takes courage.

I would highly suggest telling this exact story to your preceptor as well as your unit director/manager. You are definitely NOT alone in how you are feeling, but don't ignore it either.

Just because it is a common reaction doesn't make it any less complex.

You're right, the anxiety and fear will decrease the more you learn, the more you grow and the more comfortable you get, but you have to allow the transition to work for you and not against you. Learning should be fun, not intimidating and fearful. A certain level of anxiety is expected, but don't let it paralyze you.

Hang tough and definitely talk it out with those in charge of your orientation, if you truly want to give this the best shot you got, then be sure to share your feelings with those that can help make a difference. If you're unit and co-workers are as good as you think they are, they will greet your fears with open arms and help you navigate your way through this tough time.

Best of luck!

[missnurse01, MSN, RN]

you are awesome! if you want this you can do it! it will be stressful for a few years...just how it is...there is a ton to learn, just how it is...each day will be better though.

have you tried a naturopath for your anxiety? we have my daughter on a few supplements and thought I would try that out. I assume you already have good coping mechanisms, meditation or whatever.

good luck to you!

[Sun0408, ASN, RN]

I was where you are now except the moving part. Trauma is amazing,scary and every emotion you can think of balled into one shift. It does get better the more you learn. Jumping in and taking care of the "sicker" pts with back up is a great way to get your feet wet. Its hard to learn by watching. I know how scary it is to have vents, gtts, ICP monitoring, neuro checks q1h with the basic care and charting. Any doubts, concerns or questions re your pts should be asked, never be afraid to ask questions. While your preceptor is a different type you may learn the most from him/her.

You have only been working for 6 shifts, this is a normal feeling. If you feel it is getting too much and your anxiety is stopping you, could you ask for "easier" pts to learn the ropes and help others with the more intense trauma's.. Give yourself time, it will take a few months to be OK with the new pt population but much longer to be proficient in trauma..

Hang in there :)

[Sun0408, ASN, RN]

If you haven't already.. check out this site. Its funny and goes through a lot of the basics. index

Its a clicky to icufaqs.org

[AmandaJoy]

The above suggestions are good. As someone who suffers from anxiety, I know I am unable to handle a lot of situations without help from my physician. Family therapy has helped me learn coping skills that actually work and keep me level-headed. This may not be the answer for you, but it helps me tremendously. Good luck!

[dah doh, BSN, RN]

Some anxiety is normal for a new grad to feel and it will eventually subside as you experience more things including codes. Have you talked to your preceptor about your feelings? Part of precepting is teaching the concepts, making sure the orientee is safe, and the emotional well being of the orientee. I usually ease the new grad into it and am glued to them initially. I don't throw new grads into a disaster until they are ready; usually closer to the end of orientation. If talking to your preceptor doesn't change how she interacts with you to be more physically there, then you need to talk to your manager. A good preceptor will adapt teaching style to the learning needs of the orientee. If your anxiety doesn't become more manageable and your orientation experience doesn't improve, maybe you need a new preceptor. Talk to your preceptor first! She may be unaware of your anxiety level.

[J&B-RN, BSN, MSN, RN, APRN, NP]

Thanks for all the advice and motivation. I am going to stick it out and really give it my best shot. I have talked with my preceptor a bit about everything and she was very receptive and is going to work with me. I hope things turn out well and I begin to enjoy my job again! :)

[BSNbeauty, BSN, RN]

I also suffer from generalized anxiety. I used to take meds for it but stopped because of some of the side effects. I have come to the realization that I do not do well in high stress areas of nursing such as ICU, ED, Labor in delivery and etc. Although, I currently work in ICU, I can only do it two days a week... not full time. I'm not saying don't give up on your dream job, however your dreams turns into a nightmare when you just cannot cope.

There is a difference between new job stress and what you described. I would advise doing some soul searching and looking at jobs that are less stressful. Working in ICU is great, however it is not the end of the world if you are not an ICU nurse. If you are an ICU nurse that is great and I truly hope it works out. Give it more time and just stay true to yourself.

[Mully]

So how is it working out? My initial thoughts were that you need to stick with it and all of your anxiety will slowly disseminate as you increase your knowledge about the ICU and all its magic. Am I right?

[J&B-RN, BSN, MSN, RN, APRN, NP]

Just to let everyone know.... It's all going well!! SICU is terrifying, hard, fun, amazing, and I'm so glad I stuck with it. I just finished my first week off orientation and did well. I'm excited to continue learning and growing. Still a lot to learn, still anxiety provoking but I'm happy and I love my job! It helps that I work with some of the most amazing people. ICU is challenging and inspiring, I am so proud to say I'm an ICU nurse!

[Esme12, ASN, BSN, RN]

GOOD FOR YOU!!!!! Congratulations!!!!