Working With Anxiety

When I finally finished PA school there was an immense amount of relief and a huge weight lifted off my shoulders. I would no longer have to be constantly preparing for the never ending stream of exams, for new rotations, and feel like everything else in my life came second. While this is partially true, starting my first job was not as smooth as I expected.

I have always struggled with anxiety—in relationships, school, even as a young child. I would consistently develop this fear of disappointing others or worse, myself. While I did experience this in PA school as well, the anxiety continued to diminish as I was able to prove to myself that wow I can actually pass all the tests and understand all this material. I felt fairly confident starting my job and quickly realized during my orientation how much I did not know. This feeling created a surge of uneasiness as I walked into work before my shift.

I have improved the past few months at work. However, I would be lying to myself and you all if I said I am no longer a little anxious as I clock in. The amount of responsibility is something you cannot gauge during school and let me tell you it is huge! I do know my confidence is slowly building as a provider just like it built up as I progressed through PA school. I have learned to start feeling proud of the small accomplishments in my day to day as well as realize I am learning each day of the week.

If you are someone that also struggles with anxiety, especially when it comes to performance, know that you are not alone. It is not unique to be nervous when you start to take care of people for a living. To be perfectly honest, I am glad you are nervous—it means you care. However, there are ways to not let your nerves debilitate you; I am here to be transparent and raw. I want to provide you all with some tools that I have aimed to implement in my life to help me deal with anxiety.

When it comes to your orientation, write everything down…everything! I carry a notebook around with me and try to write down all the details of care from discharges to post operative checks. Later on that night, or usually the weekend, I review the material and add it to “surgical pathways” that have been provided to me from the team. Do your best to connect with others on your team, nurses, techs on the floor, etc. Anyone you would interact with regularly you should get to know. I cannot even begin to tell you how helpful the experienced nurses on my unit have been to me.

Read up on what you do not know. This is something I definitely need to get better at because it is so important. I usually write a list on my phone of all the diagnosis, procedures, medications that I am not familiar with and plan to research them later on. This can be a fairly daunting task especially in the beginning. What I try to do is set aside time each weekend to do this or lunch breaks. Right after your 12 hour shift may not be the best time— It is important to unwind too!

If you are still in school I would do your best to try to learn about the discharge process if you are on an inpatient rotation. There are so many nuances I was not aware of that go into safely sending a patient home. Typically, this responsibility falls on the advanced practice providers (PAs and NPs) as we are the bridges in care. Learn about insurance coverage for home nursing care, cost of medications, and patient education. I could go on and on with this list but take it from someone who did not pay attention to this on rotation—start now. Discharges are a huge responsibility as an inpatient provider and the sooner you learn the actual process with social work and case managers the better prepared you will be.

Regardless of how prepared or attentive I was on orientation I have realized I need to learn to be okay with being uncomfortable—otherwise there is no growth. It is okay to be anxious and scared when you are off orientation and alone. Do your best to learn what you can and take note of who your support is. I anticipate, just like other things in my life, working will become part of my routine and my confidence will build as I continuously learn and become more independent.

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