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15 Tips for Nurses to Deal with Pre-Shift Anxiety

January 17, 2023

As a nurse, it is not uncommon to have momentary feelings of anxiety, stress, and physical burnout before a shift. The nursing job is highly stressful and can hardly keep up with the demands of the healthcare industry. 

No matter your experience level, many nurses, tend to experience anticipatory stress either before or sometimes days before their shift

Leaving these anxiety experiences unchecked can aggravate more severe psychological conditions like burnout and depression.  

What is Pre-Shift Anxiety?

Pre-shift anxiety is the dread nurses experience leading to a shift. Pre-shift anxiety is generally known as anticipatory anxiety and can graduate from normal worrying to more severe panic attacks and anxiety. 

For nurses, pre-shift anxiety often results from concerns such as fear of making mistakes, dealing with complex patients, Working short-staffed, and witnessing a traumatic patient experience

Feelings associated with pre-shift anxiety can often drag your feet while getting ready for work, increasing your stress levels as a nurse. 

Why Do Nurses Have Pre-shift Anxiety?

Rewarding as the nursing profession might be, it does not come without its stressors. Double shifts and long working hours can lead to mental and physical exhaustion. Frequently working multiple shifts can break the normal sleep cycle. 

Understaffing is another cause of pre-shift anxiety. Understaffed shifts mean an increase in workload and require that you fill the role of 2 or more nurses combined. This is one of the most dreaded experiences of nurses that causes pre-shift anxiety. 

In addition, losing patients is another lead contributor to nurse pre-shift anxiety. For nurses, losing patients is inevitable, but knowing this doesn't make the experience of losing patients easier. 

What makes patient loss worse is when you put yourself under severe pressure and go out of your way to ensure the patients get the maximum possible care, and they don't make it anyway. In another light, nurses tend to feel emotionally stressed if, for one reason or the other, they fail to provide adequate care to patients, which results in loss of life.

A toxic work environment or workplace culture is another factor that can amp up pre-shift anxiety in nurses. Lateral violence, bullying, and harassment occur more frequently in the nursing profession and lead to high anxiety levels. 

What are the Effects of Pre Shift Anxiety on Nurses?

Without proper attention, pre-shift anxiety can rapidly aggravate and have devastating effects on nurses—feelings of physical and mental burnout. Sometimes, you might find out that you wake up earlier than usual on your shift days and experience frequent panic attacks. 

Nurses who experience pre-shift anxiety tend to have occasional mood swings, lack of interest, and job dissatisfaction. Stress can also increase the risk of making mistakes during shifts if it occurs frequently. 

Tips for Dealing With Pre-shift Anxiety

Pre-shift anxiety is a delicate condition that rarely receives attention. Most of the time, it is one of the earliest stages of burnout. Therefore, it is imperative to combat these subtle enemies before it escalates into a more severe condition. 

Here are 15 tips for dealing with pre-shift anxiety; 

1. Prepare The Day Before

When you have everything you need in place when you get up in the morning or hours before your night shift, it can help alleviate anticipatory anxiety. For instance, having a healthy lunch prepared in the morning can reduce the likelihood of further worries and fears. 

2. Get Enough Sleep 

Enough sleep is necessary for maintaining good mental health. After a stormy night's sleep, there is a high possibility of having anticipatory anxiety in the morning before your shift. Ensure you get enough sleep (typically 7 hours) before a shift to help relieve the pre-shift stress. 

3. Incorporate Regular Exercise Into Your Routine 

While it is impossible to eliminate stress, you can learn to manage it. When it comes to managing stress, regular exercise plays an essential role. Regular exercise improves concentration, cognitive function, sleep quality, and muscle development. 

4. Find a Fulfilling Community Outside Of Work 

While building out of work connections can be difficult because of the long hours and commitment demanded by your job, You need to develop other relationships to prevent anxiety. It Is best to find non-stressful and relaxing ways of connecting with people. 

You can connect with people by joining a spiritual group, starting a book club, going on group hikes, or even spending quality time with friends or family members. 

The primary purpose of all these is to relax and have fun. These help you feel less anxious and more connected to your support systems.

5. Create an Uplifting Commute To Work

You can surely make your commute to work a pleasant experience. Simple steps like keeping a list of inspiring podcasts you can play while going to work can elevate your mood throughout the day. Keep in mind that your attitude determines how you respond to stressful situations. 

6. Before Starting Your Shift, Calm Your Mind

It is easier to overcome stressful situations when you have a calm mind, and achieving a relaxed mind doesn't have to be complicated. A practice as simple as taking deep breaths is an effective way to calm your nerves. You can regulate anxiety before your shift by taking three deep, slow breaths whenever you detect it. 

7. Recognize When Anxiety Strikes And Seek Help

A problem detected is a problem half solved. You should be conscious of your emotions enough to know when anxiety sets in. Some of the common signs that stress might be setting in include dizziness, shortness of breath, extreme fatigue, irritability, and restlessness. 

8. Get To Work Early 

Before you clock in, you can decompress by getting to work early. When you go late to work, there is a high tendency you start the shift on an anxious note. But, when you get to work early, you get yourself prepared for business before getting started with the day. 

9. After Your Shift, Exit With a Coworker 

When you can, try to exit the workplace with a coworker. Another nurse is the best person to relate to what you pass through as a nurse. 

Also, labeling your emotions gives you more control over them. And who is better to these apart from a fellow nurse worker?

10. Notify Your Supervisor When You Have Concerns About Staffing Levels

When you have concerns about the staffing level in your department, let your superiors know. Do not internalize these concerns as they may come back to stress you in the future. Therefore, be proactive about addressing staff changes and nursing retention rates with nursing supervisors. 

Some researchers compared patient outcomes in California, where there is mandatory minimum nurse staffing per admitted patient, with Pennsylvania and New Jersey, where such mandates do not exist. 

The research showed that there could have been 486 fewer surgical deaths in New Jersey and Pennsylvania if they had implemented minimum staffing mandates. 

This is no surprise because adequately staffed hospitals have more highly motivated and mentally fit nurses. Which, in turn, improves patient outcomes. 

11. Repeat Positive Affirmation 

Positive affirmations work like magic, especially when done consistently. You can improve your mental health and reduce anxiety and depression by talking positively about yourself every day. When you achieve this state, it becomes difficult for stressful situations to get the better of you. 

12. Write in a Journal 

Journaling helps you keep track of where you are coming from, where you are, and going—remembering your why is the only motivation you need to keep going. And journaling is one of the best ways to achieve this. 

Journaling helps you achieve more goals, track your progress, reduce anxiety or stress, keep track of your emotional triggers, and overall work at becoming a better person. 

13. Talk To Someone

Talking about your feelings can help alleviate stress, especially when talking to a good listener. Talking to a licensed therapist or counselor can also help you stay above the anxiety and strain of the job. Also, you can speak to family and friends. 

14. Focus On What You Can Control

If you always get nervous about every little thing that goes wrong around you while on the job, you will frequently fall prey to pre-shift anxiety. To get ahead of this condition, you must intentionally focus on what you can control. 

If the answer is nothing, ask yourself, "what can I do about this?" then move on to the next thing. 

15. Find Supportive Co-Workers 

Supportive co-workers can make the job easy for you. When you have coworkers you feel comfortable talking to when you need support or answers to questions; you can relax and reduce anxiety before your shift begins. 


No matter the level of experience, no nurse is immune to anxiety. Even the most resilient nurses have pre-shift anxiety or depression. 

Therefore, you should recognize early signs and seek professional help if you discover you can not cope independently.

Manage your shifts easily by downloading floatcare app on Playstore and Applestore.

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