New grad RN would rather do anything else; extreme anxiety
August 25, 2016 5:39 AM   Subscribe

Is it possible to get over anxiety like mine about nursing? I’m not exactly keen to try, but I feel like I’m failing at having a career before I even started. Can I still have a successful career with a nursing degree I never intend to use?

I graduated from nursing school in May and moved back in with my parents while looking for work. Only, I haven’t applied to a single nursing job yet. I’m mostly applying to low level healthcare admin positions, and I’ve gotten a couple calls back. I had one interview, and looking over my resume the interviewer started off with a baffled “why would you apply for this, you know how much more you could make as a nurse, right?” I was prepared for this question and I think I handled it well, but obviously this is going to be an issue with any application I submit.

My mom asked me today, “are you not applying to nursing positions because of fear or anxiety?” I answered yes. She said “considering the rewards, don’t you think you should try to work past that?” I’m not sure what rewards she was referring to. It could be financial—nurses are well compensated in my area and new grads can easily clear 80k in acute care. The jobs I’m applying for would pay me half that, or less. Or she could have been referring to the reward of having a well-respected job. I don’t know. But her question was something that I had been considering myself for a while, and of course because it was something I was already insecure about I got angry and closed the door on her like a petulant teenager.

I’m not sure if I should try to work past my anxiety, or if I even could. I did a 4 semester program to get my bachelor’s in nursing. 1st semester, we couldn’t do very much as students, and my issues with anxiety were minimal. However, as we progressively took on more responsibility with patient care, my anxiety mounted. When I get anxious I cry and hyperventilate. I call these my “episodes.” In clinical, before my final semester, it was not uncommon for me to excuse myself to the bathroom to have an episode, but I was able to get back on the floor pretty quickly, with one exception where I couldn’t stop. I was sobbing during mid-day conference and my instructor didn’t let me finish the day. Mostly I got away with it though, people probably just thought I had IBS or something with my little bathroom excursions. Sometimes I would even say I had an upset stomach.

By 4th semester we were supposed to be taking on the role of primary nurse for a full load of patients with the supervision of a preceptor. This level of responsibility turned me into an absolute mess. More than usual, and much less discreet. I would cry on my way to my night shift, on my break, and on my way home in the morning. I would sometimes start to cry and hyperventilate during report from the day nurse, just hearing about the patients I would have to care for. My preceptor and many other nurses on the floor were witness to this humiliation. A few times I left shortly after report because I could not pull it together. I had started to become preoccupied with thoughts of death. One night, I left the floor for my break, crying as usual. I went up to the top of the parking garage and sat on the edge, scooting forward as far as I dared, letting my legs dangle over the side. I didn’t want to kill myself, I just wanted to feel like I could do it if I needed to. I needed to feel like there was an out, I guess. I was at a pretty low point. I felt humiliated by my own behavior, I felt like worthless slime that couldn’t amount to anything.

Anyway, someone saw me and called the cops. I tried to run away when they came up the stairs but they caught up with me and started to ask me questions. I somehow convinced them through more humiliating tears that I did not intend to hurt myself. I went back up to the floor, but of course after that I was barely functional. I spent the next 2 hours locked in the leadership office having a fairly unhinged episode, probably my worst to date. My preceptor took over my patients for me during this time. They were asleep, but it was still unacceptable, of course. I was put in clinical jeopardy after that. Still, despite all that, I managed to complete all 225 hours of my senior preceptorship and graduate manga cum laude. I am proud of myself for that, and I’m still not sure how I did it because I have never been more miserable. I think the only thing that got me through it was thinking I could just go work at Starbucks or something when it was all over. I wouldn’t have to step foot in a hospital again.

That was long, but I think I needed to get that out. And I wanted to demonstrate why I don’t want to touch nursing with a 10-foot pole. And it’s not just about my comfort, I don’t really think someone like me should be caring for patients. I know there are non-bedside nursing positions out there, but I don’t want to be responsible for anyone’s care in any way. I don't even really want these healthcare admin positions but I feel like I am more likely to get a call back. Also I hate being asked for health advice, though friends and family do it all the time now. My parents know that I had anxiety and doubts about nursing, but they don’t know the extent of it. I’ve never told anyone what I have written above, particularly not the parking garage story. FWIW I used a couple different therapists and tried a couple SSRIs during nursing school, I didn't feel that either helped very much.

On the other side of all of this, I am giving up a lot of money and career potential. What should I do?
posted by efsrous to Work & Money (26 answers total) 8 users marked this as a favorite
 
I think you should continue to try to get treated for your anxiety. Try other therapists. Try other meds. Try meditation or something. That should be your number one priority. And yeah, I get the "giving up a lot of money and career potential" but right now I think you need to not saddle yourself with that. Ignore the whole nursing thing and just focus on getting your mental health under control.
posted by PuppetMcSockerson at 5:56 AM on August 25, 2016 [16 favorites]


Have you considered applying to nurse on call phone lines?
posted by phunniemee at 5:57 AM on August 25, 2016 [15 favorites]


I do social science and health behavior research, and my company employs many nurses to work on projects. This work does not involve seeing patients, but rather informing protocols for data collection, sometimes collecting basic vitals for research subjects, supervising data collectors (like phlebotomists or interviewers). My point is -- there are ways for you to use your nursing degree that do not involve actual nursing.
posted by OrangeDisk at 6:02 AM on August 25, 2016 [26 favorites]


I think your first priority right now should be your own health. I know it's not always easy to find appropriate help, but I think that should be your focus.

It may be possible to force yourself through this and work as a nurse, I don't know, but I really don't think you should. I'm amazed that you've made it through the training as it is, I think you should count that as a major feat. But no, you don't have to work in this field, 80K or no. There are other things you can do. It's your life to live - not your mom's, not anyone else's.

You can absolutely work at Starbucks until you figure out another idea.
posted by cotton dress sock at 6:05 AM on August 25, 2016 [7 favorites]


You plainly aren't cut out to be a nurse. It's OK. Plenty of people complete a course of study and then don't use it. It happens. It's amazing that you got through the course with that level of anxiety.

Please don't force yourself to go on with nursing, no matter what anyone says. You're very young, and you've got loads of time to figure out your career. It'll be fine.

I gather your mom doesn't know about your suicidal feelings. You really need to tell her, or else she'll go on trying to persuade you to do something that could obviously be the death of you.
posted by Grunyon at 6:15 AM on August 25, 2016 [9 favorites]


OrangeDisk's idea is great. You could do that for a while and probably get something like an MPH (or another masters) later, if you like research. For that matter, I bet you could do anything you put your mind to - you've proved that you can, under conditions of extreme duress. But you don't have to stick with healthcare at all if you hate it. I think though that once you've taken some time to heal, you should think deeply about your motivations and what success and wellbeing mean to you. (I think at least some of the criteria should involve liking some aspect of your work and feeling ok about yourself.)
posted by cotton dress sock at 6:15 AM on August 25, 2016 [2 favorites]


You say you've tried SSRIs- have you ever tried anti-anxiety meds specifically? This level of anxiety is not normal and will almost certainly not be limited to nursing-related situations. It will cripple you if you don't treat it.
posted by showbiz_liz at 6:16 AM on August 25, 2016 [30 favorites]


I don't care what you do for your career eventually, but right now you have got to address this anxiety. I know it feels inextricably tied to nursing, but if you avoid nursing, there's no reason it won't come back in some other situation later.

If all you do to avoid your anxiety and panic attacks is avoid a career in nursing, you're just treating the symptoms, not curing the disease.

Please, please don't give up on finding effective treatment for this.
posted by ocherdraco at 6:16 AM on August 25, 2016 [20 favorites]


Try for care coordination. It's less actual nursing and more education, scheduling appointments and discussing things like medication adherence. It may be a good fit. You generally are not practicing direct patient care, and is all outpatient based.
posted by AlexiaSky at 6:24 AM on August 25, 2016 [4 favorites]


First off, it sounds like you did a yeoman's job in finishing your training, and I have to say I admire you for sticking through what sounds like a deeply tormenting experience. I hope you are continuing your mental health care even now that school is over, as self care is going to be crucial for success in any field, as everyone else has mentioned. Plus, of course, for survival itself.

I am a nurse/nurse practitioner and have worked in several different settings. It can definitely feel like a lot of responsibility to care for people when they are in a vulnerable state, like hospitalized patients are, and feeling some anxiety about that reality is probably a good thing, to keep one on one's toes and dedicated to learning and performing well. BUT, too much anxiety is, as you experienced, debilitating, and it is not clear that you would actually be able to manage your current level of anxiety in a work role (vs a student role), and even if you could, what would be a worth-while reason to put yourself through that?

You mention money and career prestige as reasons to pursue nursing, but are there any other, more personal reasons? Like, did you enjoy working with patients and their families, learning the biomedical stuff and managing the plan of care, interacting with other clinicians as a team to improve your patients' health, etc etc? If not, then the cost vs benefit ratio seems way off.

The purpose of education and training for a specific profession, I think (as opposed to a general liberal arts program), goes beyond just mastering a body of knowledge and a set of skills. You are also trying the role on for size. It's like the final course in the curriculum. And if you find that the role doesn't fit you, then changing focus is totally acceptable. And in some cases might even be the proper thing to do (as you seem to have considered), if you feel that you can't and are not interested in performing the role. I mean, you can't really know how you are going to respond to something until you try it. Once you try it and assess the fit, you take the appropriate next steps, whether that's applying for nursing jobs or applying for a non-nursing job to pay the bills and give you the mental space to consider something else.

All that being said, the good news is that nursing is an amazingly broad field and there are many ways to leverage the RN license other than direct patient care - quality improvement, insurance claims analysis, case management. Heck, even doing patient care in an outpatient clinic has a waaay different feel than working bedside in a hospital. It is a fallacy that you need to get "a year of med-surg" under your belt before doing other things in nursing . Or, if you decide to seek a non-nursing job right now, as long as you keep your license active via Continuing Ed, you can consider re-entering the field at a later point. It might be a little harder and you would probably need to refresh your skills and knowledge, but you have earned that license and it is yours now and for as long as you choose to keep it up.
posted by tentacle at 6:25 AM on August 25, 2016 [12 favorites]


And of course get that anxiety treated.
posted by AlexiaSky at 6:25 AM on August 25, 2016


I just wanted to tell you that I had a similar level of anxiety when I was in nursing school. Clinicals were sheer terror. I had panic attacks on the regular.

I applied to nursing jobs anyway, even though I really really really didn't want to. The first few months were very emotional and stressful. But one thing I leaned on right away- being a nurse is NOTHING like being in nursing school. You will find support in nursing, while nursing school is a lonely existence.

It all becomes less emotional and more mundane.

I think you would actually be a great nurse. You sound like a smart person and probably notice a ton, but can't make sense of it all yet and it worries you.

And definitely see a therapist.
posted by pintapicasso at 6:50 AM on August 25, 2016 [3 favorites]


I have first-hand experience working on a team with a nurse who had severe anxiety. Please don't apply for, or accept, any roles that involve direct patient contact if you are experiencing severe anxiety around this. Please. It will absolutely impact on the patient(s) and the rest of the team - and not in a positive way. Patients deserve someone who is focused on their care and who is calm, confident, and has an appropriate level of anxiety (as tentacle described, above). Your co-workers need someone who can pull their own weight and manage their own patients as much as possible - on a team, everyone relies on everyone else to some extent, and that's normal. Right now, you don't seem confident that you can fulfill those two roles - I would strongly discourage you from attempting it just because of a higher salary or the time spent in training.

Absolutely seek help for the anxiety. Be as aggressive as you possibly can in your pursuit of this. Not because of your career path, but because you deserve to live a life free of anxiety. I am assuming that you're in your 20s, with many years of life ahead of you - please please please don't let those years go by filled with anxiety. I know it's easier said than done to find effective help, but do everything you can. Ask others to help you find what you need.

If, when the anxiety is gone, you feel drawn to nursing with direct patient contact - great! But if that never returns, there is no shame in it. We're all entitled to change our minds, choose different paths, do any kind of work we're able to do (even if it isn't high-paying work). Money is lovely, of course, but if you're in your 20s, you're still able to structure your life around a bit less of it if it keeps you healthy to do so. There is no shame in working at Starbucks for the rest of your life (or anywhere else). There's nothing wrong with using your nursing degree to do something without direct patient care.

But please, please, get help for the anxiety. Don't let it make your decisions for you.
posted by VioletU at 7:10 AM on August 25, 2016 [4 favorites]


I don't know what would be a good idea for you. I mean, do you want to be independent and feel you have mastery over a skill and over yourself? That is generally what makes people happy. Is it more important for you to conquer axiety and live without it or in control of it, or do you see yourself more as someone who is a person with anxiety who lives within the parameters of what your anxiety does and doesn't allow you to do?

It's perfectly ok to decide that being a hospital nurse isn't for you. However, you seem to be ignoring the potential rewards of being financially independent, building a professional skill set, and living without anxiety, because you would rather not do the hard work.

Finding the right combination of meds and therapy to live well over the long term took me a while even AFTER I made a commitment to addressing problems I accepted weren't going to go away. The problem is that I started so late that the years that I COULD have spent figuring out how to fix those issues and then enjoying the rewards of that work are gone. Problems are fixable, and limitations can be overcome, but you have to put in time and effort to do it. Better to start NOW rather than later.
posted by bright colored sock puppet at 7:16 AM on August 25, 2016 [1 favorite]


Aside from getting the anxiety treated, you also could try applying at law firms that do sophisticated personal jury work, or with companies that use nurses in their legal departments to assist with medical/science reviews. I do not know what level of experience they want, though
posted by marguerite at 7:25 AM on August 25, 2016 [1 favorite]


I agree with the folks above that this level of anxiety is something that needs care. Having that out of the way, I imagine that it will be easier to see which path forward makes sense for you. Discussing appropriate medication and working with a therapist both would be best.

While you're working with the therapist, you may be able to explore what it was that drew you to pursue a nursing degree in the first place. There is something there that was meaningful and appealing to you. While it may not be hands-on care, seeing what does feel right in there might shine a light on different career options that would allow you to use your skill set, your knowledge and that would provide you with whatever it was that was the first appeal in nursing.
posted by goggie at 7:32 AM on August 25, 2016 [1 favorite]


Please see somebody about your level of anxiety. This is not something you should have to live with.

There are nursing jobs like care management, outpatient nursing or visiting nurses where the level of acuity is much lower than it is on a med-surg floor. Once you get your anxiety treated, one of those types of jobs might be appealing, but you should definitely focus on getting your anxiety under better control first.
posted by The Elusive Architeuthis at 8:23 AM on August 25, 2016 [2 favorites]


I need to point out -- you have incredible tenacity and grit. Many people would have quit, experiencing what you did, and further, no one would hold that against them when it's so obviously unhealthy for them. But you hung in there and got it done. That is truly admirable, and that basic trait will carry you far, no matter which direction you take.

So take care of your anxiety, take care of yourself, but be proud of yourself too.
posted by Dashy at 8:24 AM on August 25, 2016 [12 favorites]


Will any of your credits transfer to a degree in a different major?
posted by Serene Empress Dork at 8:28 AM on August 25, 2016 [1 favorite]


There are many ways to use a nursing degree without direct patient contact. Having an RN is a big plus for all sorts of clinical study, administration and biotech positions. I know many RNs who work in those sorts of positions.
posted by canine epigram at 8:37 AM on August 25, 2016 [5 favorites]


I am totally impressed with your ability to finish the program! You should be very proud of yourself!

One of my friends got her nursing degree without any intention of ever being a nurse (and in fact, she was kind of a disaster of a nurse during her nursing courses, but she passed.) She works in administration and loves it. That was her goal all along. So you can definitely do that, if that's what you'd like to do.

Or have you considered getting certified as a medical coder? It requires a lot of medical and anatomy knowledge, but no patient interaction.
posted by ilovewinter at 9:09 AM on August 25, 2016 [2 favorites]


People change career paths constantly. I have a hard science degree, but I wouldn't consider going back to being a bench researcher--I felt socially and mentally deprived, expected to live inside a windowless laboratory for years before gaining any control over my schedule. I wish I'd learned that sooner, but so what? Count me the fuck out! And that's ok, because there's lots of work out there that requires my background and skills. I switched from research to regulatory consulting on research issues. You, too, can find peripherals to actual nursing practice. I'm embarrassed for your therapists that they didn't help you understand this (did they?).

You might want to consider visiting a career counselor or life coach or someone who fits that description. These people like addressing the challenge of helping you find where you fit. There are untold numbers and types of resources for getting a handle on this sort of question, including nursing forums where you can probably connect directly with people who've left nursing because of anxiety issues, and they can be preliminary steps toward doing things like scanning the Department of Labor's Occupational Outlook Handbook.

So don't sweat it. You have a bunch of high level training under your belt now, and you have plenty of time to find a place where you can use it in a way that doesn't cause you distress.
posted by late afternoon dreaming hotel at 9:31 AM on August 25, 2016


compliance / risk management are also great alternatives that are not patient-facing but worthy of "prestige." but first, time to see your doctor or a psychiatrist about anxiety. nothing shameful about that
posted by peach23 at 9:59 AM on August 25, 2016


Wow. That must have really been tough. I'm incredibly impressed that you made it though school so well given the difficulty it sounds like you had.

I think you have no way of knowing, currently, whether nursing is for you. Your anxiety is totally getting in the way. Nothing you've written here makes me think that, once you have your anxiety properly treated, that you couldn't be a nurse.

That you chose to go to nursing school (and you were, apparently, really good at it despite very challenging health issues) makes me think that nursing is, at some level, something that appeals to you.

Basically, right now, nursing is so tied up with your anxiety that I think it's impossible for you to know whether you like nursing or not. Maybe you do. Maybe you don't. If you don't, lots of others here have great alternate options for you. But I think job #1 is getting your anxiety treated. After that, you'll be a better judge of the best career path for you.
posted by Betelgeuse at 10:22 AM on August 25, 2016 [5 favorites]


The nurse informatics people at my hospital make great money and never ever see a patient. They just teach other nurses how to use technology. I am a palliative care nurse now and I do no hands on nursing, mostly teaching with some case management. There are so many options! I thought nursing school was the shittiest experience of my life and I hated every minute; actual nursing is much much better. Of course, try to get the anxiety treated too.
posted by yodelingisfun at 4:35 PM on August 25, 2016 [1 favorite]


Psych nurse here!

You need to address the anxiety first abd foremost. It might not stay isolated to the idea of hospital nursing. I am not a doctor, but benzos might serve you better?

Nursing admin and nursing call lines might be a good fit for you. Keep applying for them!
posted by RainyJay at 10:31 AM on August 26, 2016


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