Tips to Manage Pre-Shift Anxiety

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Written by Morganne Skinner, BSN, RN Content Writer, IntelyCare
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Reviewed by Ayana Dunn, BSN, RN Content Writer, IntelyCare
Nurse with pre-shift anxiety sitting in a chair and bitting her thumb nail.

Have you ever experienced a feeling of dread, impending doom, persistent worry, or general sense of uneasiness before your shift? Some people who work Monday–Friday jobs call this feeling the “Sunday scaries” because it shows up on Sunday, before their work week begins.

In the nursing world, where the work week can be variable, this emotion is commonly called pre-shift anxiety. Working as a nurse can be stressful and taxing at times, which can contribute to this feeling. We’ll explain exactly what this anxiety is, why nurses experience it, and what you can do about it.

What Is Pre-Shift Anxiety?

No matter what type of work schedule you follow, you may find yourself experiencing this uncomfortable feeling as you prepare to return to work. Experienced nurses, new grad nurses, or even well-seasoned nurses starting a new position may experience pre-shift anxiety. Nursing professionals typically describe it as an intense fear that feels like a pit in their stomach.

This anticipatory anxiety can range in severity. For example, a person may experience anything from general nerves to severe, debilitating panic attacks that consume their entire day. The feeling can arise the day before, night before, or morning of a shift.

Why Do Nurses Have Pre-Shift Anxiety?

Nurses often sacrifice their health to perform their jobs effectively, experiencing negative stress and physical hardships as a result. During one 12-hour shift, a nurse may delay going to the restroom, miss their breaks, skip meals, or even put off getting a sip of water in order to prioritize the care of others.

In addition, nurses encounter complex and traumatic patient situations and work short-staffed, which is hard on their bodies and psyches. These stressful workplace environments can lead to feelings of pre-shift anxiety.

There are a number of potential reasons for this feeling:

  • Fear of making mistakes
  • Witnessing abuse
  • Working in unsafe environments
  • Incivility from patients and/or coworkers
  • Fear of litigation
  • Emotionally volatile situations
  • Difficult decision making (i.e., ethical dilemmas)
  • High expectations and excessive responsibility

While this list is not exhaustive, it gives you an idea of why anxiety can arise before your nursing shift. If you’re feeling this way, know that it’s a valid experience. Now, let’s get into what you can do about it!

How to Deal With Pre-Work Anxiety as a Nurse

No amount of preparation nor mindfulness can transform the state of healthcare or alleviate the real stressors associated with short staffing. There are, however, strategies you can implement to boost the elements that are within your control.

  1. Create a routine.
  2. Get to work early.
  3. Make time for yourself at work.
  4. Reframe your thoughts.
  5. Talk to someone.
  6. Befriend your coworkers.
  7. Find community outside of work.

1. Create a Routine

When many things are changing around you and are outside of your control, having an expected routine can help build consistency into your day. Try creating a nighttime routine before your day shift.

Example: Go to bed at a predetermined time, implement self-care (like that face mask or bubble bath), set your clothes out, and pack your lunch.

2. Get to Work Early

We know what you’re thinking: “If I’m anxious, why would I go in sooner? I’m trying to avoid it!” Hear us out — getting to work early can help you prepare for your shift and start things off smoothly.

You know the feeling of adrenaline pumping through you when you’re running late? Avoid that by getting to work early, purposefully slowing yourself down, taking your time, and establishing order. You may not be able to control the chaos that ensues later, but you can create your own calm at the beginning of your shift.

3. Make Time for Yourself at Work

It’s crucial that you take care of yourself at work. At the end of the day, you need to look out for you. Identify the things in your control and create a plan for your workday.

This means that you should take that break, even if you haven’t come to the perfect stopping point. Accept help when it’s offered. Mentally allot time to get a sip of water and bathroom break. Have a protein bar on hand.

If you need help implementing these important tasks, ask an experienced coworker for tips. Don’t be afraid to voice concerns to your manager, too. They want you to be taken care of, which includes your basic needs, like eating and breaks.

4. Reframe Your Thoughts

You may have heard the phrase, “Thoughts create reality.” Research shows some pretty convincing data about positive thinking: It increases lifespan, lowers distress and pain levels, and even improves cardiovascular health.

If you say to yourself, “I can’t do this,” you are likely to feel more stress and apprehension.

Instead, try saying, “I am not alone. I know what tools I have available to me. I can ask for help when I need it.”

Some things are indeed out of your control. You cannot manifest more nurses to show up to help you through your shift, but there may be other moments to reframe your thoughts. Choosing a positive outlook can help you cope more effectively.

5. Talk to Someone

You don’t have to suffer in silence. One great tool to eradicate pre-shift anxiety is simpler than you think — talking. Find someone you trust and vent to them.

An analysis of 23 studies found that 29% of nurses have anxiety and 22% have depression. Consider talking to a therapist to relieve feelings of anxiety and improve your mental health.

6. Befriend Your Coworkers

Supportive coworkers can make your shift more enjoyable and alleviate anxiety. When you feel comfortable approaching your coworkers for assistance or questions, your shift feels less scary and you can relax.

Try this: Coordinate a lunch break with a coworker, plan a group breakfast after a night shift, or set up a team movie night on a Friday night.

7. Find Community Outside of Work

The notion of failure stings a bit more if being a nurse is your sole identity. That pit feeling in your stomach and thoughts of dread in your head can seem more powerful. You may become hesitant to try new things, do an imperfect job, or ask for help at work.

What can you do? Foster community elsewhere. You are not just a nurse — you are a human being who works as a nurse. Spend time with friends and family. Indulge in your hobbies, educational pursuits, and bucket-list travel locations. When you feel supported in other areas of your life, anxiety in one area may start to feel less overwhelming or all-encompassing.

Find a Job That Supports You

Hard truth: Sometimes, the best thing you can do to alleviate pre-shift anxiety is to remove yourself from a toxic work environment. Need help finding a job that’s a better fit? IntelyCare can help. Learn how we can match you with nursing jobs in areas that interest you and nurture your goals.