Stressed and Anxious New Grad

allnurses Guide · May 29, 2015

I know we don't give medical advice but have you have your thyroid checked lately?

nurseprnRN, BSN, RN · May 29, 2015

Do you maintain your day/night routine (stay up at night, sleep in the day) on your days off? If not, you are seriously screwing up your brain. :)

And the rest of it-- well, I don't want to tell you not to worry, because we all learned in nursing school never to say that to a patient. But we have all been there, done that, and you are the same person who loved what you did a few weeks ago, and have the same competence and willingness to grow you had then. Try to remember that and build on it, even if you have to put a rubber band on your wrist and snap it hard when you find yourself forgetting. This will get better, promise.

canigraduate · May 30, 2015

I had a similar problem after switching to nights. It settled down after a month or so.

You are not stupid, you are suffering from night shift transition.

I absolutely loved the work when I did night shift. But I hated who I became. I was needy, codependent, whiny, and decided that I was useless as a nurse.

It took switching to a complete night shift schedule, even on my days off, to make me feel better. I had to do the whole blackout, earplug, eye mask routine. I had to install a doggie door and a fence so I could get quality sleep. I used melatonin, Benadryl, sleepy tea, everything I could think of.

Once I was actually sleeping and not just occupying the bed for a few hours, my whole attitude changed. I no longer felt like I was a failure, my husband was actually glad to see me and not dreading what bizarre outburst of neediness was sure to come, and I performed much better at work.

Basically, this is a long-winded way of saying that your problem could definitely be as simple as the shift change.

Brissygirl · May 31, 2015

This is very similar to my story. I am also a new grad on an acute medical ward. 4 weeks in and I was feeling fine and coping reasonably well for a new RN. I got to the 8-10 week stage and the anxiety kicked in. My preceptor at this stage was trying to get me to 'step up the pace' where as I felt like I was already flying by the seat of my pants, and I was terrified of making a mistake. Well a mistake did happen, albeit only fairly minor, it completely crushed my confidence.

After that I felt constantly in a 'fight or flight' mode, not able to trust myself, even more terrified, checking everything, and re-checking over and over until I was so exhausted I could no longer sleep, eat, or think clearly. I had no focus and my clinical decision making deteriorated. I lost 10% of my body weight in 10 days. I was due to get up for a morning shift and became frozen in bed just clutching my face and sobbing in fear unable to move.

That's when I decided to see my GP and am now taking medication for the anxiety. 5 months down the track and I do feel a lot less stressed and more confident, however I sill wonder if nursing is the right job for me. Everyone tells me it does get easier, but I seriously care about my patients and do not believe that the time allocated supports the quality of care that I like to give. I never go home satisfied that I have cared for my patients adequately and still feel like it is a high stress job that may have an impact on my own health in the long run.

These are a few tips that has helped me get through:

1. Be organized. Turn up a little early and make a detailed and thorough shift plan

2. Never get complacent about time and always try to be a step ahead of your tasks

3. Take your breaks, it's important to have time out to recharge.

4. Praise and thank any assistant nurses/help, they will always try to help YOU first in the future.

5. Focus on the positive things that you have achieved after each shift rather that all the things you MIGHT have missed (this has been hard).

6. Take time out on days off to do nice things for yourself like visit friends or get out into nature.

7. Use mindfulness when worry is keeping you awake at night.

8. Make sure you have/seek support whether it is a psych, friend, family or all 3. It's important to tell people how you are feeling.

Nursing is a tough gig, but there are ways to minimize the stress.

Best of luck everyone!

LadyFree28, BSN, LPN, RN · May 31, 2015

I would like to add that self-study is the best motivator to self-correction; also remember that this is not nursing school; you have your "training wheels off" and you are going to have scrapes and bruises.

When you make a miss, commit the best practice and proper procedure to memory; even if you have to write things down and access it later.

One of things I did as a new grad and what I do now in being new in my specialty is being my pt care sheets home-redacted for HIPAA-and reflect on what I did for that pt, and reflected on the WHY, examine what I could do better if I see a patient with the same assessment and diagnosis later, and go from there, away from a stress-free environment, and resources, especially from nursing practice books.

It does get easier, but having. A plan to bridge the gap in transitioning and building ones practice is key to reduce the anxiety when missteps and misses occur-be proactive and remember what I call the 3 C's:

Consistency: remember to perform best practice consistently;

Competence: always aim for doing effective nursing care;

Confidence: be confident to ask questions, question orders, and realize that you are learning; be confident that every pt doesn't have a one-size fits all plan; always seek out opportunities in bouncing off ideas with more experienced peers, whether it be a tech, nurse, or provider.

Best wishes.

thevez · May 31, 2015

Start a journal. Write all your anxieties down and what you did great in the shift. What you can do in better next shift. WriWrite yWrite your goals for next shift