Navigating Pre-Shift Anxiety
Pre-shift anxiety - you either have it, or you don’t (and if you saw my Tiktok post, there were a lot of responses mentioning having pre-shift anxiety vs. not having pre-shift anxiety). If you’re not familiar with what pre-shift anxiety is, it’s anxiety that begins before your next shift. It almost feels like the Sunday Scaries, but the feeling can happen on any day of the week. For some nurses, this might develop a day or two ahead of their next shift. It might be worse when they’ve had a few days off in a row vs. having only a day off in between scheduled shifts. For others, it might begin on the drive in or when walking onto the unit (or into the office).
Why do some nurses have pre-shift anxiety and others don’t?
Many of the nurses reporting pre-shift anxiety were either a new grad nurse, on a unit that was not a good fit, or have management that is unsupportive. Those that reported not having pre-shift anxiety were seasoned nurses, those who felt their unit was a good fit, or they weren’t an anxious person to begin with. Several respondents mentioned purposefully getting to work right on time so that they wouldn’t have time to worry.
What does the actual research say?
Well… not a lot. Even searching other keywords like “anticipatory anxiety,” there’s not much research out there on this topic. If you’re a student or a nurse looking to do some research, this might be a good topic to consider as it affects a lot of nurses and there is quite a gap in the research.
How do you manage pre-shift anxiety?
There are several things you can implement to manage pre-shift anxiety:
1) Practice Affirmations: The catch about practicing affirmations is that you have to genuinely believe what you’re telling yourself. You might repeat to yourself, “I’m a good nurse, I care about my patients,” and those thoughts may be true, so they might be easier to believe and therefore reduce your anxiety a little bit. If you tell yourself, “I know what to do if [a situation you might be worried about] happens,” but you genuinely don’t know what to do… that might not help your anxiety. So maybe instead you could reframe that affirmation as, “If [worrisome event] happens, I can ask [nurse coworker who is helpful/approachable] for guidance,” and that approach might be more helpful.
2) Practice Boundary-Setting: Really check in with yourself about this one - are you saying “yes” to things you really could be saying “no” to? It can be way too easy to be consumed by making yourself too accessible or too available because you want to be a team player. It’s okay to say no, it’s okay to delegate tasks and it’s okay (and encouraged) to take care of yourself. Take your breaks, enjoy your time off, don’t feel like you have to pick up shifts if you don’t need to. Not practicing boundary-setting can cause a build-up of anxiety and resentment.
3) Check in With Your “Why”: It might be a good idea to consider if you’ve overstayed your time in your current role if it’s causing you to feel overwhelmingly anxious before each shift. Does the role no longer align with this chapter of your life? Has it changed so much that it’s not recognizable? Have you changed as a person and the role doesn’t feel like a good fit anymore? All good things to consider.
4) Back to the Basics: As always, prioritize good sleep, balanced nutrition, and routine body movement. Ensure that you’re filling up your cup outside of work. On work days, do something small but meaningful for yourself before, during, and/or after your shift that you look forward to, like grabbing your favorite drink on the way home or listening to your favorite podcast. Little intentional moments like that can add more balance to those really tough days.
5) If your pre-shift anxiety is causing significant disruption, please find a therapist to connect with. Psychology Today is a free directory you can use to help find someone to support you in managing this. You can search for a therapist or psychiatric medication provider by location, insurance plan, and appointment type (ex: in-person, telehealth, or hybrid).
If you have pre-shift anxiety, what helps you the most? If you’ve overcome pre-shift anxiety in the past, what did that journey look like for you? What is a bit of advice you would give to a nurse reading this blog who feels overwhelmed and discouraged?
