New Grad Anxiety
Having new grad anxiety is a completely normal thing. Every single nurse brand new to the profession has gone through it. Imposter syndrome is such a true feeling that you will experience as a new grad nurse. I’ve been in this profession for 3 years now and I still get nervous from time to time.
It is completely okay to feel imposter syndrome. A little nerves and stress is healthy to have because it keeps you observant and meticulous. You have the knowledge and skills to be a nurse. You got the license to prove it. You’ve accomplished the hardest thing you have ever endured in life and you finally got the RN label behind your name. You’re a licensed professional able to help, care, and save lives. You made it.
As I mentioned before I was an RN supervisor at a skilled nursing facility before I got a position at the hospital. I was a newly graduated licensed nurse being a supervisor for experienced LVNs and patients. If you want to read more about my first RN job, you can read it here! I felt overwhelmed with the responsibility but I didn’t feel as stressed because my patients were long term residents at the facility. The only times I felt anxious were the first two months of being there because there was just a lot to learn and document when it came to paper charting. It was nothing compared to hospital anxiety. Hospital anxiety was a hundred times worse.
Once I started at the hospital, I did anything and everything to not come into work. I called off as much as I could. I prayed for an easier assignment and okay shift. I’ve cried and thrown up the night before work because my stomach was so queasy from anxiety. I’ve even cried when I came in early because I was so scared and I really didn’t want to be at work. I’m already codependent as it is, but it worsened when I first started at the hospital because I relied on my boyfriend so much to help me go through it. If you ask my boyfriend, it was the worst thing he had to help me with because it started to take a toll on his mental health too.
Why did I feel more anxiety in the hospital?
First off, patients are unstable in the hospital. Absolutely anything can happen and it’s terrifying to know that you are responsible for them for 12 hours. It’s nothing like being a student where you’re only looking after 1 or 2 patients, except for ICU, but there’s a reason why you’re 1:2 in ICU. Depending on the unit, you’re the nurse for 1-5 patients. You no longer have that luxury of being able to talk to patients leisurely while passing meds with your instructors, doing little tasks like passing trays, and only being there for a few hours.
Now that you have the RN behind your name, you are responsible for assessing, knowing the medications and calculations, ensuring that you don’t make a mistake, understanding the disease processes they are admitted for, noticing if the condition changes, and it’s all on you. No one else, but you.
Patients can be difficult. The word difficult can be interpreted in many different ways. As a nursing student, you get to pick your patients. Obviously you go for the compliant patient who is understanding of students, making it easier for you to learn. You don’t get to pick your assignment when you’re working. You go into your shift blindly, and accept the assignment if it’s appropriate.
You’ll experience patients that are noncompliant and refuse everything and verbal abuse from patients and family members. Patients change conditions dramatically so that you have to intervene and possibly send them to ICU or call a code blue. And you’ll still have 1-3 patients with that one patient that’s super unstable.
I was constantly terrified of making a mistake that could cost my license or possibly kill a patient. I was thinking to myself every time before my shift, “I hope I don’t lose my license today.”
These are the main things that I experienced and completely dreaded as a new grad. I really hope that I didn’t scare you! This blog is written not to scare you but really to show you that these thoughts can come but you can’t let it stop you from being the best you can be. I still feel this from time to time, but I’ve learned to cope with my anxiety and I’ll show you how I dealt with it.
Go into work early.
For the first year, I went to work at 0630 to look at my assignments and gather information on them before I got report so I had a better understanding of them. This definitely helped me as a new grad because I didn’t feel rushed during report to write down every detail. I felt prepared enough to take care of them.
Tapping.
I was already in therapy and I talked to my therapist about how much anxiety I felt and it was starting to debilitate me. She taught me a tapping technique.
Scientifically called the Emotional Freedom Technique (EFT), it is an alternative treatment for physical and emotional distress. You tap on meridian spots or energy spots while saying a mantra three times. My mantra was, “Even though I’m nervous, it’s okay to be nervous. Everything will be okay.”
It sounds dumb, I know, but I was desperate and just wanted to feel better. I downloaded an app, but you can always youtube EFT. It honestly helps me. I would drive to work with my stomach cramping but as soon as I got to work and did the tapping, I literally felt my stomach relax and calm down. I do it every time before I go to work. It may not be for you, but don’t knock until you try it. And really try it and try to feel it.
While this may not work for you, therapy of other kinds still can help you. Therapy is a great way to discover and address the root of your anxiety, and you may find other ways to cope. Simply talking about it can alleviate a lot of the stress you feel on your shoulders. Your feelings are valid. Just remember that going therapy is not weak.
You’re not alone.
I mentioned above that it’s all on you. Yes, it is and you’re responsible for your patients. But you have all the help you need. You may be a new nurse but the nurses around you have felt what you’re feeling and will help you. They are your resources. You should and hopefully have a team leader or breaker that is there to help with breaks but also be an extra hand. If one patient becomes a little unstable, you will have a team of nurses that will step in to help with your other patients. You can also always ask for help from other members of the interdisciplinary team.
Have a question about a medication? Call pharmacy. They are way more knowledgeable on them and can give you a direct answer.
You feel like you need a little help assessing this patient for changes? Bring in another nurse and get another opinion.
Do you think a patient is changing conditions but not quite a code? Call a rapid response team (RRT) for that patient. That’s a guaranteed way for you to get more help and the nurse that helps you is experienced with ICU and implementing interventions with RRT protocols. It’s never wrong to call an RRT. Better to be safe than sorry.
Code blue? Call for help, start compressions, and the next thing you know you have what feels like, the entire hospital helping you. You don’t need to think and do everything yourself. You have help. Just ask for it.
The fact that I know my unit will help me and we have such great teamwork is what helps me get through my shifts. This is why I stress the importance of finding a unit and a culture you love. You need be supported by others because it aids the safety of your patients and protects your license. If you need a refresher on what to look for when job hunting, read this blog here
It is what it is.
I’ve learned to go into work with a different mindset. This part definitely took me some time and it became easier as I got more experience. I don’t go into work at 0630 anymore. Ever since I moved back home, I prioritize sleep because I have about an hour commute.
I get to work at 0545-0600 and sleep in my car until 0650. You will see me walk into the unit 0656, clock in, and grab my report papers ready to take on patients.
Having difficult patients is something you’ll deal with from time to time. Know that not every patient will give you a hard time. 99% of the time, your patient will be pleasant, cooperative, and nice. Then there’s the 1%.
Patients have the right to refuse care. As the nurse, you’re responsible for educating the patient and attempting to provide them the care. If they continue to refuse, let the team know, including the MD, your charge nurse, and manager. Keep them in the loop so that they are aware if anything happens. Document every little detail so that you are protecting yourself. You can only do so much as the nurse. Do as much as you can and if they are not willing, then at least you can say you tried.
This can apply to confused patients as well. Even though they aren’t able to make decisions for themselves and they may not know what’s best for them, notify the team and the family. Do everything you can and use all your resources. And if it still doesn’t work? Again, you tried, you notified the team and family, and they are aware. Document it and go home knowing you did the best you could do.
I didn’t feel as confident as I do now until I was a year and a half into nursing. I felt even more confident after I did travel nursing but that’ll be a different blog for later.
Everything takes time. Building your practice and confidence takes time. I wasn’t always this confident in my skills, as knowledgeable, or able to take things with a grain of salt. I probably experienced anxiety more than others and others may experience worse than me. As I continue to practice as a nurse, I fall in love with the profession and enjoy my career more and more. My student recently said that I was really confident and she hoped to be like me one day. I told her that she will one day but it’ll take time.
This is why I created my blog. To help nursing students and new nurses feel safe in the profession. I want to create a community to emphasize the idea that you are never alone. Everyone’s journey to becoming a nurse is different and it’s scary, but we’ve all been there. There’s a light at the end of the tunnel and you’ll get through it and see it to be true.
<3 Mags
Emilurs. Thanks.