Pre-Shift Anxiety: How Nurses Can Start Calmer

A knot in your stomach on the drive to work, lying awake the night before a shift, checking the rota obsessively. Pre-shift anxiety is common, especially in new nurses and those working in short-staffed units.

Imagine sitting in the hospital car park ten minutes before your shift, heart racing, imagining everything that could go wrong. You start a simple routine: three slow breaths, one thing you’re looking forward to, and walking in with a colleague. Within weeks, the car park dread fades.

Why it happens

Uncertainty about what you’ll face, high responsibility, fear of mistakes, short staffing, difficult colleagues and past bad shifts can all trigger anticipatory anxiety. It’s your brain trying to prepare you for threat.

Before your shift

• Prepare the night before: uniform, food, water bottle, notebook
• Protect sleep and limit caffeine late in the day
• Arrive a few minutes early so you’re not rushing
• Use a short breathing exercise: in for 4, hold for 4, out for 6
• Remind yourself of one thing you’re good at

During your shift

• Use a structured handover sheet so nothing feels forgotten
• Prioritise one task at a time
• Ask for help early; it’s a sign of safety, not weakness
• Take your breaks

But what if it’s getting worse?

If anxiety affects sleep most nights, causes panic attacks, makes you call in sick to avoid work, or lingers on days off, talk to someone. Your occupational health service, employee assistance programme, a doctor or a trusted senior colleague can help. Sometimes the problem is the workplace, not you, and raising concerns about staffing or culture is legitimate.

Sources: World Health Organization (Mental health at work), International Council of Nurses, American Psychological Association, NHS Every Mind Matters.