If you feel anxiety when clocking in for your nursing shift, you aren’t alone. The long hours, high-pressure environment, and emotional demands of patient care can take a toll on even the most experienced nurses. Nearly 65% of nurses report feeling “a great deal of stress” because of their job, and the number is even higher for those in settings like the ER and ICU.
No matter how you experience it, anxiety can be a barrier to a fulfilling career and your ability to deliver the best care for your patients. Here’s some good news: you can reclaim control. In this guide, you’ll find 10 practical strategies to help you manage nursing-related anxiety and protect your mental health.
What is Nurse Anxiety?
Anxiety is an emotional reaction to a real or perceived threat to a person’s quality of life. It can manifest itself in many ways, both mentally and physically. For instance, you might feel exhausted, unsure of yourself, or have difficulty focusing at the bedside while waiting for the thing you’re anxious about to happen. You may also find your heart racing or your hands trembling before a difficult procedure.
Nurses who experience anxiety often trace their feelings back to bad staff-to-patient ratios, emotionally taxing situations, and worrying about errors. New nurses, in particular, often struggle with anxiety as they adjust to the fast-paced environment and newfound autonomy. Of course, experienced nurses aren’t immune.
Left unchecked, anxiety can lead nurses to burnout, exhaustion, and mental health challenges (including anxiety disorders). It even drives many excellent nurses away from the profession. Learning to manage your anxiety and identify and overcome the source is crucial to your health and career.
Before diving in too deeply, remember that we’re talking about “normal” anxiety – not anxiety disorders. While the feelings may be very similar, anxiety and anxiety disorders are not the same thing. In broadest terms, anxiety is an emotion that affects everyone on occasion. An anxiety disorder is when you feel anxious in a manner that impacts your daily functioning for several months in a row. While some of the tips below could be helpful for someone with an anxiety disorder, they aren’t a substitute for expert assistance. If you feel you may have an anxiety disorder, consider reaching out to a mental health professional immediately.
1. Establish a Calming Pre-Shift Routine
The way you start your day sets the stage for your entire shift. If you rush into work feeling scattered, anxiety will probably follow. A simple pre-shift routine can help center your body and mind before you step onto the floor. Though you can’t always control what happens during your shift, you have the power to decide how your day begins. Starting on a positive note makes it less likely that you’ll be overwhelmed by anxiety.
How to Get Started
Identify one or two calming activities you can do before each shift. Try taking ten deep breaths in your car before walking in or using a mindfulness app on your commute. The latter is my favorite way to start a shift because it puts my mind in a relaxed, focused state, giving me a strong foundation to build on.
2. Learn to Reframe Negative Thoughts
Those “what if?” or pessimistic thoughts can sap your mental energy and fill you with doubt. Instead of letting them take over, practice reframing them. If you’re thinking, “I’m afraid of messing this up,” replace it with, “I’m prepared to do this right and will ask for help if I need it.” This simple shift in perspective can boost your confidence and stop you from spiraling into negative thought patterns.
How to Get Started
Pay attention to your inner dialogue. When a negative thought arises, identifying it is the most important step. Pause and ask yourself, “Is this thought helpful? Is it true?” Acknowledge the negative feeling and its cause, then balance it out with something more useful.
3. Take Your Breaks
Skipping breaks might seem like the only way to keep up with your workload. In reality, doing so only fuels anxiety and burnout. One of my early-career mentors constantly stressed the importance of taking breaks. Twelve-hour days are physically, mentally, and emotionally exhausting.
Even a five-minute pause can reset your mind and decrease your stress.
Making your meal break a priority is also essential. Your body needs fuel to operate at its best. Neglecting to eat lunch or take a snack break can hurt your focus and worsen anxiety.
How to Get Started
Even on the busiest days, commit to taking at least one break during your shift. Get off the floor, take some deep breaths, stretch, and eat something nutritious. Your tasks will be there when you get back. Try to schedule your break around your to-do list, but if that isn’t possible, don’t be afraid to ask a co-worker to cover your assignment for a few minutes so you can reset.
4. Recognize Early Signs of Anxiety
Catching anxious thoughts early makes it easier to manage them before they escalate. Anxiety manifests differently for everyone, so knowing your early warning signs helps. You might have physical symptoms like a racing heart or tension in your muscles. Or you might notice that one or two anxious thoughts in a row trigger a downward spiral. Recognizing these signs early may allow you to intervene with calming techniques and reset before anxiety takes over.
How to Get Started
Pay attention to how your anxiety shows up. When you notice you’re feeling anxious, make a note of what else is happening. How does your body feel? What are you thinking? What’s going on in your environment? You can do this on paper or use an emotion-logging app on your phone. The more you tune into your body’s signals, the better you can become at spotting the signs and stopping anxiety in its tracks.
5. Use the 4-7-8 Breathing Technique
When anxiety spikes, your heart rate increases and your breathing becomes shallow as the fight-or-flight response is activated. Resetting this pattern can trick your nervous system into relaxing. The 4-7-8 breathing technique is often a quick and effective way to regain a sense of calm. It’s also something you can do anywhere, and the more you practice, the more natural it becomes.
How to Get Started
The next time you feel anxious, pause and try this technique. Inhale deeply for four seconds, hold the breath for seven seconds, and slowly exhale for eight seconds. Repeat this pattern four times for maximum effect.
6. Lean On Your Support System
You aren’t the only nurse experiencing anxiety. Connecting with co-workers or mentors who understand what you’re going with can go a long way toward improving your mental health. Talking about your anxiety helps you process your emotions and gain a fresh perspective. Lean on your support system on and off the floor, and you could soon feel a lot less lonely.
How to Get Started
Identify at least one person you can turn to when you’re feeling overwhelmed. It could be another nurse you trust, a mentor, or even another member of the healthcare team on your unit. If you don’t have a go-to person yet, consider joining a support group online or offered by your hospital to start building your support system.
7. Set Healthy Boundaries
As a nurse, you naturally want to help. It’s probably a big part of what drew you to the profession. Yet, saying yes to every extra shift or doing constant favors leads to unneeded stress and anxiety. Setting boundaries is crucial to your well-being. Protecting your time and energy doesn’t make you a bad nurse; it makes you a better one. If someone questions your choices, be respectful but firm while standing your ground.
How to Get Started
Setting limits can be uncomfortable at first. It may be helpful to start by setting boundaries one at a time. For instance, if you feel pressured to take on extra shifts, try reducing the number you work to one or two a month. Or if you find that helping others while at work impedes your ability to succeed and adds extra stress, don’t be afraid to say that you don’t have the time. The more you practice saying “no” to protect your boundaries, the easier it becomes.
8. Prioritize Good Sleep
Anxiety and sleep go hand in hand. When you’re feeling stressed, it’s hard to rest and get enough sleep, which starts the vicious cycle of even more anxiety. Getting enough high-quality sleep helps you think clearly and handle tough nursing shifts with more resilience. If you’re on a night or swing shift, prioritizing sleep is even more critical since it rarely comes naturally when working those odd hours.
How to Get Started
Aim for at least six to seven hours of sleep a night, with a regular bedtime. Whether you work nights or days, if you’re working a back-to-back shift, avoid falling into the trap of neglecting sleep for more “me time” in between. Sleep is the best gift you can give yourself.
9. Use a Post-Shift Decompression Ritual
Your shift might be over, but your mind can keep racing for hours afterward. It’s easy to replay stressful moments in your head or worry about things you might have missed and what may happen as a result. Although reflection can help you learn, dwelling on your shift fuels anxiety. A simple post-shift ritual lets you transition from “nurse mode” to relaxation so you don’t bring stress home with you.
How to Get Started
Decompressing after work is all about finding an activity that puts your mind at ease. My favorite ritual is writing down three things that went well during my shift and one thing I can improve on. Getting these thoughts out of your head distances you from the stress of work so you can focus on the rest of your day.
10. Get Professional Help If You Need It
Sometimes, despite your best efforts, anxiety becomes overwhelming. Although 56% of nurses say they sacrifice their mental health at work, the mindset of “I help others, I don’t need help” persists throughout our profession.
Unfortunately, this is a recipe for disaster. If anxiety interferes with your life, reaching out to a mental health professional can be the lifeline you need. Therapy, counseling, or short-term coaching equips you with coping tools tailored to your specific needs so you can learn to manage anxiety more effectively.
How to Get Started
If you’re struggling with nursing-related anxiety, the best time to seek support is right now. Over three-quarters of hospitals offer mental health support or free counseling for their employees. You can also look for a therapist that specializes in treating healthcare professionals or students. Remember, there’s no shame in asking for help, and you don’t have to battle anxiety alone.
