7 Tips to Leave Your Pre-Shift Anxiety at the Door

Nursing is a highly respectable and productive career that is growing every day. However, it’s a fairly stressful job that can often not keep up with the demands of the healthcare industry. The majority of nurses regularly experience emotional burnout, anxiety, stress, and even physical burnout. Nurses experience stress in the lead-up to their shifts, either right before or, sometimes, days before. This is called anticipatory anxiety or, more specifically, for nurses, pre-shift anxiety

What is Pre-Shift Anxiety? 

Anticipatory anxiety or pre-shift anxiety is anxiety or dread leading up to an event. It can vary from normal worrying to severe anxiety and panic attacks. It often stems from fear, such as having a panic attack, making mistakes, or something stressful happening in front of others. 

For nurses, this can include things like:

  • Dealing with a difficult patient
  • A traumatic patient experience
  • Working short-staffed
  • Even dealing with their colleagues

These feelings of dread and anxiety can start as early as the day before a shift. They can interfere with life, including time off with friends and family, sleep, and general health. 

7 Tips for Pre-Shift Anxiety

So, what can you do to prevent this anxiety from occurring? Here are a few tips: 

1. Prepare the day before. 

Ensuring you have everything ready when you get up in the morning can help alleviate anticipatory anxiety and decision fatigue. Things like meal prep and laying out clothing can lessen the likelihood of anxiety-inducing events in the morning. Studies show that preparing meals in advance helps prevent decision fatigue daily and helps people make better choices regarding healthy food. Having a healthy lunch made in the morning before a shift can prevent further worries and anxieties. 

2. Get enough sleep. 

Getting enough sleep can improve mental health as a whole. Anxiety can be much worse in the morning and before a shift after a bad night’s sleep. Dealing with fatigue on top of the anxiety can make a shift unbearable. Sleeping at least seven hours has been shown to decrease rates of panic disorders and depression throughout the lifespan. Making sure to get those seven hours before a shift can help alleviate the pre-shift anxiety. 

3. Repeat positive affirmations. 

Repeating positive affirmations daily has improved mental health, especially around anxiety, depression, and feelings of self-worth. The repetition is the important part of this action. Saying something positive once won’t improve any aspect of mental health. Repeating them daily helps to rewire the brain. For added impact, repeat tour affirmation in your mirror. Looking at your reflection adds increased personal effect and motivation. For pre-shift anxiety, repeat things like: 

  • I am a good nurse 
  • Everything will be okay 
  • I am enough 
  • I am smart 
  • I can handle whatever is thrown at me 
  • I am brave 
  • Today will be a good day

4. Journal about your “Why”. 

Journaling provides benefits to mental health in a variety of ways. Journaling helps people:

  • Achieve more goals
  • Gain confidence
  • Track progress and growth
  • Reduce anxiety or stress
  • Improve communication skills
  • Find inspiration

Journaling about why you became a nurse can be done in the morning before a shift to rewire the brain, to focus on the positive aspects of the job. 

5. Practice relaxation and mindfulness techniques. 

Practices such as meditation, guided imagery, and deep breathing exercises can be used in the morning before a shift as well. These mindfulness practices help keep the mind focused on the present, slow the heart rate, and truly relax the body and mind. 

6. Talk to someone.

The effects of COVID-19 on nurses have caused many nurses to suffer from PTSD and other mental health conditions. A licensed therapist or counselor can help you cope with anxiety and the stressors of your job. Check with your insurance company to see what mental health services are covered. Additionally, reach out to your facility to see what mental health resources are available for staff. 

7. Leave it at the door. 

A combination of these practices the day before a shift and the morning of can truly help lesson pre-shift or any other type of anticipatory anxiety. Regular practice of these is essential, and the more often they are done, the more benefits they’ll show. Practicing these tips helps lessen anxiety daily and decreases the incidence of things like panic attacks. 

Working in healthcare is difficult enough without the added concerns of anxiety or depression. Nurses can try these tips to leave their pre-shift anxiety at the door and be the best they can be for their patients.

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Alison Shely, DNP, FNP-C

Alison Shely, DNP, FNP-C is a nurse practitioner, nurse coach, yoga teacher and nurse writer. She’s been a nurse since 2014, working as an RN and FNP in intensive care, women’s health and primary care. She also serves as a mental health coach to other nurses and healthcare workers, concentrating on healthy lifestyles and mental health.

Comments (4)

I bumped on this article in the morning. I experience this every time before each shift. In the last couple of months, the caseload has been on the increase, against a backdrop of staffing shortages.


My anxiety pre nightshifts is excruciating…waiting all day …I’m exhausted when I get there


Very informative


Such great tips!


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