Performance anxiety and worry...need feedback from other RN's

[RN0302]

I've been an RN for almost 4 years working MS and more recently tele. I take care of 5-6 patients and my floor is very busy. I don't feel I have the time to give the care I want to give and my stress and anxiety over this is increasing. I feel like I'm just jumping from one task to another. I feel like I need to do everything very quickly so I can move on to the next task. I don't feel 'present' if that makes sense. I feel like there are holes in my knowledge (esp r/t tele) and I don't have a good organizational system. I've felt my critical thinking has diminished or isn't what it should be. Lately I've even made a few med errors. I go home at night and worry about the care I give. I worry about what I didn't do and what I forgot to chart. I worry on my days off.

Recently a former patient of mine passed away from an MI. I wasn't his nurse the day he passed but I was the day before. He had some cardiac history but I don't remember to what extent. He was admitted for sepsis but was stable when I had him. But ever since he passed I've been worrying that I did something to negatively impact him. Intellectually I don't see how I could have. But because I'm already worried about the care I give this event is causing me a lot of anxiety.

Does anyone else worry like this? Does anyone else stress over things when they go home? Or feel responsible for their former patient when something happens?

Let me add here that despite my worry about the care I provide I don't have bad patient outcomes or incidents. My med errors are very few and have been only recently. I work very hard to give great care.

[not2bblue]

Nursing is stressful, especially if you are learning new areas and have no time to learn it but are responsible for lives while learning! So some anxiety is normal. But if after 4 years of experience and you are still feeling out of control, disorganized, fixated on every littlw detail and obsessing over what you did wrong, why that pt (with a disease!) died and if you did something, having increased anxiety or worries and it is starting to affect your performance negatively then more may be going on. You may have to talk to your doctor. Maybe just to talk, not saying go get on meds (but if you need them, you need them). I hope you are feeling better soon. Also, maybe a change of pace is in order... is MS tele what you have always wanted to do. Even ICU may sound scary, but with 1-2 pts you may have the ability to focus more? What do you think is the biggest reason you are feeling more stressed?