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Hidden Nurse Anxiety

Anxiety can significantly impact many nurses’ work environments. Personally speaking, nothing has shaped my career as a nurse more than anxiety derived from negative nursing experiences.
Nursing anxiety and burnout

Nursing is a difficult career. That statement won’t come as a surprise to many; however, nurses can sometimes make things more difficult on each other than they need to be, leading to a large amount of turnover, burnout, and anxiety.

Anxiety can significantly impact many nurses’ work environments. Personally speaking, nothing has shaped my career as a nurse more than anxiety derived from negative nursing experiences. To be clear, I’m not an anxious person, and if I do happen to be anxious, I usually do a decent job of hiding it. Managing personal anxiety as a nurse is an extremely important trait; otherwise, you’ll end up drowning in indecision as it fills you and affects your productivity.

Over the course of my seven-year career as a nurse, I’ve come to realize that I’m not the only one affected by anxiety and that everyone (nurses and non-nurses) has experienced it in the workplace at some point. Looking back, there are a handful of pivotal situations I can point to that led to my feelings of anxiety as a nurse, and my conversations with many other nurses lead me to believe these are pretty common. A better understanding of how these moments affect us is only the first step. Learning from these moments and understanding that we are all shaped by them can help us become better nurses and even better colleagues. Allow me to share a few from my career:

Nursing School Clinicals: There is perhaps no other time in a nurse’s career in which we’re as malleable as during nursing school. Clinicals offer a rare chance to practice what you’re learning in real time, which can be both exciting and terrifying given the field we’re in. For me, the grouchy nurses who couldn’t make time for me because they were (rightfully) busy had a lasting impact. It wasn’t their dismissiveness as much as it was their lack of patience with me that made me feel like I couldn’t ask questions. We all know how dangerous that is, so making sure our students feel well supported is important for their success as nurses and for our patients.

Physical Nursing Skills: Nurses often have a set of skills they become proficient in based on their department type. IV starts are the most obvious example. If you work at a hospital that has an IV team that starts all of your IVs you can lose that skill, and no matter how smart or great at nursing you are, you may feel like you’re less talented than other nurses. NG-tubes, foleys, lab draws, and other basic nursing skills come with time and experience, and when your department doesn’t provide those opportunities early in your career you may feel inadequate and let that turn into a career anxiety. If anyone who’s reading this feels that way, please read all the way to the bottom.

Two Nurses in Supply Room

Poor Preceptorship: Full disclosure, I was once fired. After three months of orienting with six different preceptors, I found myself at the whims of a preceptor who just really made things difficult for me.

Preceptor: “Ok, let’s do some practice quizzes. What are the side effects to Vancomycin?”

Me: “Um, Red Man’s Syndrome… that’s all I can think of right now.”

Preceptor: “Nausea, vomiting, diarrhea.”

A week later, I found out that she had reported me to our manager for “not knowing the side effects to basic medications.” She did this sort of extrapolation with a number of things that are neither here nor there, but the whole process was traumatizing. I never made any medication errors, had any patient complaints, or had any safety reports filed against me. My orientation was going well up until this last preceptor, who assumed the worst of me and made me feel new (which I was) and inadequate.  

The anxiety caused by this experience shaped me more than any other in terms of my overall confidence as a nurse. I was unemployed for five months and felt so inadequate that I seriously considered another career. The next person who hired me considered it a “risk,” but a few months into the job said that it was one of the greatest choices he’d made as a supervisor. When he hired me he told me, “I don’t believe that a person can be judged by any single experience.” Having someone believe in me went miles for my confidence, and helped quell a large amount of anxiety I had developed from my previous experience. No amount of time can entirely erase the anxiety that getting fired instilled in me, but now it’s a part of me and I can use my experience to prevent others from going through what I did.

Report Sticklers: “Did you prepare their paperwork? What were you doing all night?” We’ve all worked with nurses we hate giving report to. Their consistently negative mood, hyper-criticism, and lack of empathy filled me with anxiety the moment I’d find out I would be giving report to them. No one is advocating you be ill-prepared for report, but there are professional ways to conduct yourself that help foster a good patient handoff. Searching for opportunities to make people feel bad about the work they did during their shift is not productive, even if such intentions are subconscious. I’ve received my fair share of terrible reports, but I always looked to understand why things were left undone or incomplete because I know just how crazy things can get. No one should go into a report feeling anxious about the person they’re giving it to, and no one should go home fuming over how terrible they were made to feel.

This list could be longer, and it’s different for every person. But the common theme is that we all go through experiences that cause us anxiety as nurses, and this anxiety becomes a part of who we are; all we can do is try our best to use it to better ourselves and prevent the same types of experiences from producing unnecessary anxiety in our colleagues. For me, these negative experiences almost made me leave the field; instead, I acknowledged and grew from them. You face unavoidable anxieties too, but don’t let them define the nurse or person you’ll be to your next new colleague, preceptee, patient, whoever. That part is totally up to you.

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