How To Prevent And Overcome New Nurse Anxiety

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It’s not unusual for any new employee to feel anxious in their first few months of work, and nurses are no exception. Becoming a nurse and starting your first official nursing job is thrilling, but also overwhelming. Starting your nursing career in the middle of a pandemic has made the experience even more complex.

Fortunately, there are things all nursing graduates and career changers can do to reduce the amount of anxiety they feel in those first few months. We spoke with Erica Martinez, DNP, RN, NEA-BC, Dean of Nursing at Arizona College in Ontario, California and per diem staff nurse at Los Alamitos Medical Center, about the anxieties many new nurses face. Her resounding message: It can get better, and it does get better.

But first, let’s dive into why you may be feeling this way.

How Common Is New Nurse Anxiety?
It’s well known that nursing is a stressful career. There is often a mismatch between how realistic nursing school trainings are and what the real practice setting is like. For example, you probably had access to an instructor the entire time you were in nursing school — you always had someone to turn to. And in a practice setting, you probably have a preceptor, but you don’t fully know the dynamic of that relationship until after you get there.

Not to mention, not all organizations have new graduate onboarding programs readily available.

“Sometimes, nursing graduates are actually sheltered from some negative aspects that may occur in a practice setting,” said Dr. Martinez. “Here’s an example: In nursing school, you may have grown used to working on 2 patients at a time. But when you get into a med-surg unit, you may be responsible for 5 patients at a time. That’s an overwhelming change to any new nurse.”

Nursing students also don’t get exposure to some types of practice settings like urgent cares, physician practices, and long-term care. Many long-term care RNs are often responsible for entire floors of patients — a major difference from nursing school.

“When you have certain expectations created in nursing school, and the career you step into doesn’t match those expectations, it can cause anxiety,” said Dr. Martinez. “It’s very common in new nurses.”

The pandemic has also shifted expectations. COVID-19 prevented nursing students from hands-on training and observing in clinical units. Then, when these nurse grads entered the workforce, their “normal” became units at full capacity, wearing masks, and no visitors at the bedside. Moving beyond this normal and navigating patient care with visitors in the room is another major change they’ll have to face.

Preventing an Overwhelming Start
“Nursing is all about resiliency,” said Dr. Martinez. “You have to build healthy coping mechanisms into your life to help relieve stress and get through the tough times.”

To prevent anxiety, Dr. Martinez recommends to:
  • Find the right environment for YOU: Not every environment is a good fit. You may think you’ll enjoy a certain area, like ER or obstetrics, but the reality of it might differ from what you envision. Make sure you’re in alignment with details like the hours worked, days worked per week, tasks, number of patients you’re assigned to, how many breaks you’ll get, etc. What you think the job will entail might not be what it is day-to-day.
  • Set the right expectations: Before day 1 on the new job, try to get a true picture of what life will be like where you’re going to work. One way to do this is to find someone who already works in the specific unit you’re going to. Check online (like in Facebook groups or even on LinkedIn) to find people who work at the organization. Ask them about their day-to-day, the culture of the organization, the work environment, etc. Get an insider’s look at what the role is going to be like before you get there.
  • Find a nurse mentor: A nurse preceptor introduces nursing students, novice nurses, and experienced nurses to new clinical settings, but it doesn’t hurt to also find a mentor. Look for someone outside of your unit who acts as an objective third party — a trusted person you can go to for advice or a listening ear. Learn more about how to find a nurse mentor.

Reducing Anxious Thoughts and Feelings
To lower any anxiety you’re already feeling, Dr. Martinez suggests to:
  • Manage your thoughts: If you find yourself discouraged or overwhelmed before you even clock in, try to reign in your mind. When a worry or negative thought pops up, stop it in its tracks by turning your focus to something positive. Maybe it’s an encouraging mantra or a Bible verse that gives your strength. Maybe it’s pausing to take a few deep breaths. Find what works for you and use it whenever needed.
  • Ask for help:  Seek out a nurse, tech, or aide to assist you if needed, especially if performing a task you’ve never done before. Speak with your manager if you are not comfortable with your patient load. Additionally, if you fear your anxiety is negatively impacting your life, consult your healthcare or mental health professional for possible relief techniques, therapy, or treatment.
  • Tackle one task at a time: Are you already behind from the moment you clock in? No wonder you’re overwhelmed. Instead of allowing your to-do list to weigh you down, break it down into manageable chunks. What fires can you put out immediately? What quick wins can you mark off your list? Narrow down your view of your day.
  • Have self-compassion and give yourself grace: Self-compassion is the ability to become mindful of your own distress and work to alleviate it. If you’re feeling discouraged and anxious as a new nurse, offer yourself the same loving kindness you would offer a friend dealing with the same situation. Follow these steps for improving your self-compassion.
  • Prioritize time for self-care: Numbing out on social media, stress-eating, or turning to unhealthy outlets is not going to relieve your anxiety in the long-run. Instead, find healthy coping mechanisms to turn to when you’re stressed, like being in nature, journaling, or meditating

Anytime something is new, we default back to novice status. As a new nursing graduate, cut yourself some slack. Change is hard, but it gets easier as you adapt. Give yourself grace to be a novice. We all start somewhere.

Are you a newer nurse? Did you deal with anxiety or discouragement in your first few months of work? Feel free to comment below.

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Posted by Holly E Carpenter, RN, BSN on Jul 12, 2021 3:58 PM America/Chicago

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