Anxious nurses biting finger nails.

It's the night before her shift and nurse Kayla is starting to get a sinking feeling in her stomach, worrying about what the next day holds. What will my patient assignment be like? Who will I be working with? She has been done with orientation for a couple of months and the anxiety still hasn't faded. She often feels nervous and jittery on the drive to work, her heart racing as she rides the elevator to her unit. First, it's important for Kayla to understand that starting out as a new nurse can be scary and these feelings are completely normal. But there are certain strategies that can help combat anxiety levels. These tips will help nurses become more confident, allowing them to enjoy their career and their time away from it.

Where Does New Nurse Anxiety Stem From?

As a first step, pinpoint what is causing the anxiety. Is it the fear of making a medication error? Is it the worry of not being able to keep up with the assignment, or receiving a new admission? Are co-workers not being helpful and a nurse is feeling left to drown or like asking for help is a bother?

If the anxiety is related to understanding diagnoses or performing a skill, it's beneficial for the nurse to spend more time researching and practicing to feel better prepared. Of course, this also comes with time and experience. Nurses often work in a specific field such as orthopedics or pediatrics, which means that they are frequently exposed to the same surgeries and diseases with the same treatments. Therefore, nurses should take the time to look up a disease process or medication that they are unfamiliar with. Write it down or print it out and keep it in a folder to refer back to. This will boost nurses' knowledge, ultimately improving their confidence and expertise.

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On the other hand, anxiety can also stem from a lack of support. These types of issues need to be communicated with leadership. Some nurses require longer orientation than others, and this does not mean that they aren't capable of success. Everybody learns differently and at various paces. If a nurse feels uncomfortable, it is their responsibility to request a different assignment or patient. They could also communicate the need for additional support or resources.

Find A Mentor

Although orientation may be over, learning and collaboration never end. Seeking out a mentor is advisable for ongoing success as a nurse. It's best if this mentor is another nurse on the unit, but it could also be an experienced nursing friend or teacher. One study on newly graduated nurses found that emotional support from more experienced nurses lifted spirits while providing assurance, security, and a sense of belonging. This helped reduce stress and anxiety, which led to increased self-confidence and stronger bonds with other nurses.

Find The Right Rhythm

Every nurse works a little differently and follows their own unique routine. Take notice of the nurses on the unit and the way they plan their day, or even ask them about it! Some use highly detailed brain sheets and jot down all recent lab values, medications and medical histories. Others may prefer to get started on medication passes right away. Some nurses document their assessment findings immediately, while others document when they have more time later on. It's normal to take approximately six months to a year to become fully comfortable in a role and form a routine. Just like starting an IV or changing a colostomy, time management is also a skill that's learned over time.

Tips For New Nurses From Those Who Have Been There

  • Don't be afraid to speak up. Questions are a necessity and could prevent a future error.
  • Remember that nursing is a 24/7 job. Avoid feeling obligated to get everything done in one shift.
  • Don't pretend to know how to perform a skill if you're unsure. Ask for help or request to shadow a more senior nurse.
  • Keep in mind that tomorrow is a new day with new opportunities.
  • Leave work at work. Nurses should refrain from obsessing over things that they forgot to do or say.
  • The patient is always a priority. As long as they are safe with their needs met, a nurse is doing their job correctly.
  • New nurses should avoid overwhelming themselves by working too many extra shifts or staying late. They need their rest and recovery just like everybody else.
  • Be prepared. Get enough sleep, have your scrubs ready, and arrive on time.
  • Use time off wisely. Get out of the house, exercise, or even go on a getaway. Focus on activities that help you recharge and aren't nurse-related.
  • Self Care Guide For Nurses

It's important for new nurses to remind themselves that they can't and won't know everything. Even nurses with 20 years of experience still need to ask questions and look things up! New nurses need to give themselves time to acclimate, keeping in mind that critical thinking comes with time and experience, and asking for help is never something to be ashamed about. By facing each day with an open mind and willingness to put in their best work, the anxiety will begin to fade. Before they realize it, they will serve the role of the experienced nurse supporting a new nurse in overcoming their own anxieties.

Maegen Wagner, RN, BSN

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