How Nurses Can Overcome Imposter Syndrome

TheresaAPRN

"Oh my God, I'm a nurse now!" is what I was thinking when I walked onto my unit for the first year of my nursing career. I wondered if the other nurses and even the patients could smell my fear. As a new nurse, despite my calm demeanor, I was secretly riddled with anxiety and a deep fear of making mistakes that could cause harm.

These persistent feelings of self-doubt and anxiety are sometimes called "Imposter syndrome" because you fear that others will figure out you are a fraud. They exist despite having achievements such as excellent grades and clinical reviews in nursing school, despite successfully passing board exams that conclude you are qualified to be a nurse. I dreaded making even the smallest mistakes, asking "dumb" questions, or seeing my preceptor roll her eyes.

Imposter Syndrome is not uncommon among nurses. Between 36-75% of nursing students and clinical nurse specialists report experiencing Imposter Syndrome at some point in their careers. This can have a negative impact at the onset of your career. Nurses plagued with self-doubt are more vulnerable to burnout, depression, and anxiety. Imposter Syndrome may also play a role in high turnover rates since we see that a majority of new nurses change jobs within the first year.

Trust Your Instincts

Making a mistake is a scary concept in nursing because you are charged with taking care of people who are vulnerable due to illness or injury and doing tasks that have a higher level of risk than other professions. The responsibility can be overwhelming. But first of all, remember that you have been trained to handle these exact situations and tasks. All those nursing classes, clinical experiences supervised by licensed nurses, and orientation by a nurse preceptor helped you learn your role with a safety net. All those experiences were designed by professional nurses to teach you how to think like a nurse. Remember, you got this!

Prioritize Safety

Reduce the number of things on your worry list and recognize what is truly important. Always prioritize safety. Think about when you took your board exams; most of the questions revolve around safety. There are a lot of new things to learn on your first job, so knowing your priorities can make things seem less complicated and overwhelming. Prioritize safety over less critical things like knowing where everything is in the supply room (an impossible task anyway). Minor mistakes like errors in charting can always be corrected later. Trust the safety protocols you learned in nursing school and don't skip steps. Keeping this in mind can help boost your confidence and alleviate some of the stress.

Set Realistic Expectations

One of the root causes of Imposter Syndrome is perfectionism. It is impossible to expect that you won't make some mistakes, so set more reasonable expectations. Instead, adjust your thinking and develop a growth mindset. This means that you recognize that growth and maturity come from experience, and part of that is making mistakes.

Don't Internalize

Don't be so hard on yourself. But also don't take criticism that is meant to be constructive too personally. Let's say the lab tech calls to tell you that you sent the wrong tubes or mislabeled your bloodwork, and now you have to redraw the samples. By telling yourself things like "I am a terrible nurse" or "I am such a failure," you are shaming yourself, which is demoralizing and will not help you learn from the situation. Remove personal attacks from your internal dialogue and genuinely reflect on the situation. Were you distracted by something, or was the order incorrect on the computer? What can you do differently in the future? Then rephrase your internal dialogue by saying, "everyone makes mistakes; next time, I will double-check the labels before I send them, and this won't happen again.”

Keep a Journal

Many young nurses keep a notebook for details specific to their job, such as the phone number for the charge nurse or what to do with faulty equipment, or how to request vacation time. But besides recording important tidbits, you may want to use a journal to reflect on your overall performance and set goals for the future. Set some time at the end of every shift to reflect on what went well or what could have gone better. This can help you think of small goals for yourself to achieve. Maybe you need to become more efficient at medication administration so you're not delivering them late, or maybe a patient had a question you didn't know how to answer. Sit down to think this through at the end of each shift while it's fresh in your mind so the next time it happens, you know exactly what to do.

This activity will increase self-awareness and reinforce learning and growth. Reflection can also help you gain confidence. Write down the lessons you've learned but don't just dwell on the negative. Notice the positive outcomes as well. Celebrate them! Later you can look back through your journal and see the progress you've made. These experiences will showcase your growth as a nurse and demonstrate your ability to learn. These great examples will be very useful at a job interview in the future.

Mentorship Programs

A variety of nurse support programs exist to help nurses transition into their new roles. Mentoring, internship and residency programs have been shown to improve nurses' self-efficacy, motivation, and even job satisfaction. If you are a nurse manager or just a more experienced nurse, consider starting a mentorship program at your organization. Mentees have decreased stress levels and mentors serve as rich resources for new nurses.

If you are a new nurse and your unit does not have a mentorship program, you can still find a mentor. Look for a more experienced nurse with whom you work well and establish a good working relationship. Maybe ask them to have lunch with you so you can "pick their brain.” Show a sincere desire to learn and treat the more experienced colleagues with respect, and they will be more likely to return the respect and help you out when you need it.

Here are a few more tips/ strategies to inoculate yourself against the threat of imposter syndrome:

Give yourself a pep talk - you were trained for this!
Trust your instincts
Know when to ask for help. It is a sign of wisdom, not weakness.
Admit when you've made a mistake, apologize, and move forward. Surprisingly, your coworkers, patients, and their families will gain respect for you and trust you more when you are honest about your mistakes and have humility.

References/Resources

Burnout and impostor phenomenon in nursing and newly licensed registered nurses: A scoping review: National Library of Medicine

The Effect of Nurse Support Programs on Job Satisfaction and Organizational Behaviors among Hospital Nurses: A Meta-Analysis: National Library of Medicine