New Clinician Anxiety/Doubt

[NewDPT]

Hi, all! I'd like to preface this with the recognition that I have generalized anxiety disorder, which I managed well except during every clinical.

Now, I'm starting as a new clinician and my anxiety and stress are just unmanageable. I'm always second guessing my treatments, worrying that my patients won't improve, and stressing over improving my documentation speed. I know that some worry is natural, but can anyone speak to their experience in getting through this?

I'm not sleeping or able to eat in the morning due to worry. I am reaching out to my primary care provider about this, but if anyone has gone through this, can you give any advice as to how you dealt with it?

Thanks so much!

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[ya1]

You need to take ONE step a time. You are not a super human and cannot do EVERYTHING perfect at the same time.

I'm always second guessing my treatments.
Choose the treatment you are confident/ most confident about. Always start easy and slowly - in this case you will most likely have time to stop before hurting a patient. Do not expect results for the next 1-2 weeks. (Good if there are results, but many conditions take months to improve.)

worrying that my patients won't improve.
If possible, throw this thought out of your head and berry it forever. No PT can guarantee their patients that they will definitely improve. There are tooooooo many factors far beyond your power that affect patients progress (their medical condition, compliance, their work, family, financial situation, mood, etc, etc). You are offering your patients treatment which you believe may (but not must) improve their condition. You and your patient are trying those treatments and see if they help the patient or not. If they do, great. If they do not, you offer another treatment you believe MAY help. If you have tried treatments that you believed might work and none of them did, you refer the patient to another healthcare provider you believe may be able to help the patient. Feel free to ask an advice from you CI and co-workers. If everyone is completely clueless what to do, refer the patient back to his PCP.

stressing over improving my documentation speed.
Pay attention to this only if you are not passing your clinicals because of slow documentation speed. If it is not an issue for your CI, then you do not need to worry abut it. During clinicals, I had to sacrifice my free time to complete documentation (stayed in the clinic extra 60-90 min sometimes to finish paperwork). When you start working, you will not have to do that (unless you choose to) since it is illegal for your employer to make you work off the clock for free.

I'm not sleeping or able to eat in the morning due to worry.
Try to realize that not sleeping and not eating will not benefit you or your patients in any way. If you sleep better and eat better, your brain will function better, you will be able to make better decisions in the clinic, you will have better communication with your patients, and most importantly you will have your sanity that your patients will need you to have.

I am reaching out to my primary care provider about this
Good idea! S/he may know you better and may be able to give you more specific advice/strategies how to cope with your anxiety.

Good luck and just for now, make your goal to pass your clinicals and nothing beyond that. Right now, your CI is responsible for all your patients, not you, you ARE IN TRAINING. So if you are not able to provide patients with the best care, CI will compensate for that (that's what they are for!). Do put yourself first PLEASE.

 

[RNA582]

You should talk to a psychologist or therapist. They will help you to learn how to manage your anxiety. Its never too late to reach out for support. You cannot stop worrying, because you really care about people. But long term worrying and anxiety can cause damage. Your health should be a priority. Mental health problems can lead to illness.

 

[wiseOldPT]

Yes, definitely speak to your PCP and therapist as well. You may need mediction if not on already, especially as you start out as a new clinician in a crazy time in the world. Not sleeping will not help- it gets you into a rough cycle of poor performance and worsening anxiety.

Beyond managing the mental health, do you have a mentor in your new job? It might help your confidence if you have a go to person for both questions and to plan to discuss a couple patients a week. If you see them agreeing with your plans, that'll show you are on the right track! And if they aren't, that is a great opportunity to grow (please try to see it that way and not that you should be 100% perfect now). All new clinicians are slow at documentation. This will improve with time. And as you get more confident in what you are doing, you'll document faster as well, since I'm guessing you second guess as you document as well.

If there is a specific population you feel more confident with, see if you can build your caseload with more of those- for example, knee replacements or something. As you become more "expert" in one area, your overall confidence will grow.

And remember, while PTs are very important, we aren't cutting people open. Most mistakes we make won't be a big deal. Be a caring, compassionate person and truly listen to your patients. That can get you far!