After being in the field for a while, I’ve noticed a common theme… anxious nurses. We see people die during a normal day at work. Our normal day is someone’s last. At any moment, someone’s heart can stop and we’re responsible for restarting it. Someone can stop breathing and we’ve got to know what to do to get air back into their lungs. It is no wonder we’re anxious.
Many nurses struggle with anxiety, whether it be something that was there before nursing school, developed in school, or after being in the field for a bit. Across various social media outlets, I asked to see if anyone that struggles with it had any words of wisdom. The response was amazing – there is some really good stuff here, guys. Below is advice for nurses from nurses that work at the bedside. This is real and practical advice.. not from a research study in researchy language, from a pamphlet, or from a doctor that doesn’t know what it’s like to be a nurse.
It’s from us.
The deal with nursing anxiety, you must first prepare.
Preparation is important because if you have everything together, you’re minimizing the unknown. You’ve got what you need. You’re ready for what’s ahead. If it’s your first clinical in a new place, make sure you know where to go. Do a test-run the night before.. drive there, check out the hospital, walk in to see where you need to go the next morning.
Another aspect of anxiety-management is doing your best to generally lower your anxiety threshold. Meditation has shown to be incredibly powerful in this. I know, it sounds silly – but I promise it works. If you can take just 10-30 minutes to meditate and focus on breathing, it can help you manage it more successfully and consistently. You can just use free YouTube videos at home; you don’t have to go anywhere.
Breathe and focus
I thought it was interesting… basically, everyone talked about how important it is to remember to breathe and also to focus on your breathing. I personally also agree with this – and meditation can really help make this more natural and fluid.
Make sure your clinical instructor knows
“I tell my clinical instructors that I have anxiety at the beginning of each rotation so they are aware and are a little more understanding if I need an extra second to answer questions (if my heart and mind are racing it is a little harder to concentrate when being quizzed while completing a task/preparing medications…this helps them understand that if I need a second it isn’t because I don’t know the answer, it is because I need a second to breathe and bring my heart rate down). The last thing I want is someone getting frustrated and attacking me with a ton of questions while my heart is racing faster each second, my face is burning red, and I can hardly concentrate on what they are saying, let alone spit out a coherent answer. I have gotten to the point where I can now say, ‘I just need a minute’ and they give it to me… no questions asked. It really helps me be able to calm down.”
Prioritize your sleep
“A tired me is a me with more anxiety,” said one nurse. I am also much more on-edge if I am not prioritizing my sleep. Things that would make me anxious are much more challenging all of a sudden. Seriously guys, prioritize your sleep! Sleep deprivation is not a badge of honor. It will just add to your nursing anxiety.
Identify a support person in your class or on your unit
They can tell by the look on your face when it hits you. When things get rough… they can hold you up when you’re crashing down. Sometimes, all they need is a look from you and they know you need some support. Reach out to someone, let them in, let them hold you up when you can’t do it yourself.
See a professional if necessary
A school psychologist, personal psychologist, counselor, whoever you prefer. They can help you to identify specific coping techniques for in-the-moment stuff, go over certain situations (there’s a lot of trial and error in figuring out what will work for you!), and help you prepare for particularly stressful things (coughNCLEXcough).
Schedule reviews with your instructors to combat test anxiety
I thought this was a great tip from a fellow anxious nurse. I’m going to quote her directly:
“I have really bad test anxiety, and (as suggested by a psychologist once) I review every test and quiz. It really helps because I can see where I made stupid mistakes, and I can see if my errors were knowledge gaps or me just reading the questions too fast/not being able to concentrate properly because of an attack. Knowing this helps me be able to calm down a bit before the test, and even during. If I know my mistakes are not knowledge gaps, I can remind myself that I know the information and if I can breathe I will have the ability to think clearly and get the right answer. If it is a knowledge gap, I just study a ton until I am convinced I am prepared and that also helps because I just tell myself that I have done so much to prepare that I couldn’t have done anything more to get ready for the test. Most professors/universities are pretty strict about test reviews, but I just tell them that I have anxiety and reviews help me and they are eager to help. I swear by reviews. I always do alright on my first test, but once I see what the prof is looking for, and where/why I made my mistakes, I do much better on the next ones. My very first nursing midterm in first year I got 57% (not even close to a nursing pass), went for a review and received an 87% on my next one. It has worked so far throughout my 3 years of nursing (1 more to go!) and I have been able to ace most of my classes.”
Nurse Anxiety After Work
What if you struggle with nurse anxiety after work? One of the benefits of nursing is that is is shift works that usually doesn’t require you to take your work home or complete work off the clock. While that may be true physically, emotionally nurses often take their work home and that can lead to a lot of nurse anxiety after work.
The best way to combat this type of nurse anxiety is with self-care and confidence-building.
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Consider doing the following:
- Practice meditation and deep breathing techniques
- Read relaxing fiction
- Routinely schedule massages, pedicures, or other tactics to gives back to yourself and refuel
- Take a course in an area you feel like skilled to increase your confidence levels
Ultimately, you want to determine the root of your anxiety and practice simple techniques to overcome and reduce future nursing anxiety.
Powerful Nurse Quotes
These are all from messages I received directly from bedside care providers and thought they would be helpful and encouraging.
“Don’t let people minimize your anxiety. It is real, and it is something we anxious people have to deal with…but you can overcome it, it doesn’t have to define you.”
“Anxiety isn’t going to stop you from being a great nurse. If you love what you do, you will find ways to be the best nurse you can be…and passion overcomes anxiety. Your patients will see you care before they see that you are anxious. Just breathe.”
“Don’t feel ashamed of your anxiety. Yes, there are people who won’t get it who will judge you. They aren’t nice and they aren’t worthy of your time. Try to ignore them and turn to someone you trust that accepts your problems. I find it easier to have someone I trust that knows about my struggles. It makes me feel safer and that will make my anxiety easier to handle.”
“Dealing with the life and death situations we see as nurses can really help us put our own lives in proper perspective. I know it has helped me a lot in realizing that a lot of the things that used to give me anxiety (and still sometimes do) are truly not worth worrying about. When I was a new grad nurse, I really worried for a while that even though I loved my new career the anxiety might “do me in” in the long run but it’s actually turned out to be quite the opposite. I think being a nurse has actually encouraged me to become a less anxious person. Or maybe I’ve just better learned to handle it.” – Rebekah Carter (via Facebook)
A Few Stories
“I’ve had problems on and off with anxiety since high school but totally hit the peak in nursing school. I honestly can’t pin point the biggest cause whether it was bills, family or school itself but there were so many moments sitting in class feeling like I couldn’t breathe or I might pass out for no reason as at all. I think the perfect example for the current student in question [of whether they can be a nurse even though they struggle with anxiety] is when I walked out of my cardiac lecture in school because of a panic attack. For whatever reason, I couldn’t center myself and just felt the anxiety building and ended up leaving in the middle of the lecture. However, now 6 months post grad I am working as a cardiac step down nurse in a prominent teaching hospital. All is possible! I think so many people have anxiety and some don’t even really recognize that “feeling” as anxiety itself. I still get anxiety but being able to recognize it and tell myself “this will pass. You’ve felt this before and it’s not something that will hurt you” helps immensely… that and my dog. Hope this helps someone!”
“The first time I did a clinical rotation in the ER I was terrified. All day I kept wondering if I was doing things wrong. Then late in the afternoon a little girl came in with a dislocated kneecap. As I stood by watching the doctor at her feet, her mother at her head, boyfriend by her side, and the nurse I was following trying to start an IV, I felt useless and afraid because I didn’t know how to help her. After a minute I realized that the nurse was having a hard time starting the IV because the girl was shaking too hard. She was crying and so afraid, and in so much pain. So I reached around the nurse and took the girl’s hand. She squeezed (hard), and after another minute she stopped shaking. The nurse got the IV started and we got her some pain meds, and the situation progressed normally from there. I went around to the other side of the bed and tried to catch her attention so the doctor could reset the kneecap. I told her a joke and she laughed, and then she realized the doctor was done and she didn’t feel any pain, and she wasn’t scared anymore. She turned to me and said “Thank you.” That felt so awesome. That was the first time I had made a decision that was entirely my own, based on what I thought I could do for a patient. That was the first time I knew what it felt like to be a nurse instead of just a student. Now I know we don’t do what we do for the thank yous, but from then on every time I got stressed over a test, angry at one of my instructors, afraid at a new clinical site, or frustrated and ready to give up, I thought of that little girl squeezing my hand and thanking me, and suddenly it was all worth it, and whatever anxiety I was feeling would melt away.
Now I know we don’t do what we do for the thank yous, but from then on every time I got stressed over a test, angry at one of my instructors, afraid at a new clinical site, or frustrated and ready to give up, I thought of that little girl squeezing my hand and thanking me, and suddenly it was all worth it, and whatever anxiety I was feeling would melt away.
Find your moment. That was mine.” – Thomas Floyd (via Facebook)
The ultimate resource for nervous new graduate nurses
My passion is supporting and encouraging new graduate nurses with honest and practical information. I built this course over years… talked to many nursing leaders, physicians, advanced practice providers, preceptors, and new grads to find out the specific and often unspoken needs… read the research… looked closely at different residency programs… tested material and fine-tuned it. I know what new grads feel and need. I’ve been there myself and I’ve continued to see class after class of newbies have the exact same struggles and needs.
This resource isn’t just about surviving orientation – it’s about thriving. I want to maximize your time at work and teach you how to mentally disconnect from the bedside and cultivate healthy boundaries so you can enjoy your life at home. After all, you’ve worked this hard to become a nurse – you should be able to put in your time at work, improve each shift, and come home to enjoy the rest of your life. However, that does not come intuitively, and I want to teach this practice to you.
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- Nurses and Secondary Trauma – FreshRN guest blog post
- Empathy 101 For Nurses: How to Care for Yourself While Emotionally Supporting Others – a 60-minute webinar I did on Nurse.com
- For the Overwhelmed New Grad Nurse – FreshRN blog post
- The FreshRN Podcast
I am so glad you wrote this article! I struggled with anxiety throughout my first 18 months (and still do now) to the point where I would cry before each shift. I finally started seeing a therapist who taught me about re-framing negative thoughts (“I should have done that better” into “I did the best I could with the information I had”). I also come to work early to prepare and plan for my day. I want others to know that it’s okay to get help if you have anxiety. Now I’m glad I have a little anxiety because it means I deeply care about my patients and their outcomes!
Yes, this article is perfect for me too. I graduated last year and have been working in a frantic medical ward for two months. I have had minimal support from my manager and no preceptor, and my educator is always busy with students – I only see her when she pops her head in to make sure I am staying on task. I have been reprimanded because I have not ticked off things before handing over my patients, but I if I ask for help I am often ignored, and often don’t know what I am meant to do next as – or have not yet got a competency for something – I can assure you I would do the things if I got some guidance – I am not lazy . I am sick in my stomach every day since this reprimand. I am not sleeping, feel heart palpitations and have visible shaking at times. Meditation come to me
Kati Kleber says
Ruby, this sounds awful! I made my FreshRN Podcast and my book Anatomy of a Super Nurse to help nurses transitioning to practice. Check those out, they may be helpful in addition to anxiety management techniques. It will get better!!!
Great topic! Would love to see one with recommendations geared more towards nurses who are in the workforce/icu nurses!
I have been labeled as anxious by some of my coworkers in this last couple of years. It is so very frustrating because a little anxiety I find actually makes you a better nurse. You are very engaged…..and I believe have more aspects thought out than other nurses might.
My questions is: Once labeled how do you fight it? My manager is been on my case and not supportive. I do believe it is very mean to label a fellow nurse in any fashion. Its worse to be felt less and not given assignments for wrong assumptions. It is wrong and Extremely Mean! Certainly it speaks most on those who have judged unfairly.