Imposter Syndrome/ Phenomenon

Trauma Columnist · Dec 18, 2007

I have been an APN for 18 months now and I still feel that way - lol.

I think it is normal to feel the new-role and inferiority complex going on for awhile after you graduate. Do you remember being a new-grad RN? That was certainly intimidating too. So...I guess what I'm saying is that it is important to know what you don't know. That is okay.

Like anything new, it will take awhile. What is the orientation period like? How long? How is the preceptorship worked out? Is this a clinic where you have nursing experience? For myself, I went into nephrology and had never even seen dialysis performed before so my learning curve was (and still is) pretty steep. However, if I had gone to the ER, I would have had a higher comfort level because of my nursing experience.

joyrochelle · Dec 18, 2007

Thanks! I am trying to do just that--recognize my deficits and try my best to correct them! The clinic is a women's health clinic--very much my area of expertise, however I haven't been very lucky at getting good school clinical experiences that provide me with ample experiences. my school didnt have a micro lab for us to use, so i feel my skills with the microscope are pretty lame, but i am doing my best to just remember my readings, and utilize my texts.

The clinic is looking to have anew APRN come in to relieve this NP who will retire soon--- so my feeling inadequate is even more impressive, cuz she is clearly masterful and I am the novice!

Trauma Columnist · Dec 18, 2007

But look at the progress you have made! I think you will do fine - take a chance. In my area, it seems like the APNs do change jobs too - there is nothing wrong with that if this turns out not to be the best fit. Good luck - keep us posted.

yellow finch, BSN, RN · Dec 18, 2007

OMG! I felt the exact same way through my first two clinical rotations!!! I'm starting up again in the Spring and am absolutely terrified of looking like an idiot... again! Luckily, I've already expressed this fear to my preceptor and her response was exactly what I was looking for... she remembers what it was like as a student, not to worry because she's been doing this for years, all that good stuff.

If you have a reasonable preceptor, they will be understanding of your lack of knowledge. You're just learning! You can't possibly know everything! I drove home crying every single day during my first 90 hours of clinicals... that was all of them the first semester. I felt so inadequate. But my preceptor still talks to me like a professional and even wrote a letter of recommendation for my scholarship.

Take a deep breath, study as much as you need to in order to be the best provider you can, and hang in there. It gets easier! At least that's what I keep telling myself.

joyrochelle · Dec 18, 2007

Thanks for the replies! I guess with graduation so close on the horizon it makes me a little restless, buggy! Not going to be a student for much longer! ( even though i know i will hopefully never stop learning!)

christvs, DNP, RN, NP · Dec 18, 2007

Thanks for the replies! I guess with graduation so close on the horizon it makes me a little restless, buggy! Not going to be a student for much longer! ( even though i know i will hopefully never stop learning!)

That is so funny-I graduate from my ACNP program in 6 months too and I also feel like that! I feel weird when I go to do my focused H & Ps on patients-I feel I know what to do, but feel absolutely weird, like I'm pretending to be someone or something. :) It's a bit uncomfortable, since it's so new. So don't worry-we know what you are feeling!

VivaRN · Dec 19, 2007

That is so funny-I graduate from my ACNP program in 6 months too and I also feel like that! I feel weird when I go to do my focused H & Ps on patients-I feel I know what to do, but feel absolutely weird, like I'm pretending to be someone or something. :) It's a bit uncomfortable, since it's so new. So don't worry-we know what you are feeling!

Yep, I feel like that too. Must be pretty universal. I have this recurring nightmare that I'll be out there as a new practitioner, tell a patient the plan of care and he/she won't like it. They will storm out of the room and demand to speak with someone more experienced. Oh gosh I hope that never happens!

Because of this feeling that everyone can see right through the facade... it surprises me tremendously when a patient actually listens to what I say and accepts it. Or when I follow up with a patient and they are ok seeing me again.

I remember feeling that way as a new nurse too - like what trauma said. My badge said "RN" and that alone weirded me out for at least a month. How history will repeat itself... .

DaisyRN, ACNP · Dec 21, 2007

you know joy... what you are feeling is very common. in fact, it's normal. :) and you haven't even finished yet... i just finished... so believe me, i understand.

i wanted to share a couple articles with you that you might find helpful. to be honest, i do not normally read a lot of the "suggested" readings in school, but i read these articles...

epigenesis of the nurse practitioner role by eva mae anderson, barbara leonard, and judith yates. the american journal of nursing. vol 74, no. 10, oct. 1974, pp. 1812-1816.

the most pertinent info in that article, to me, is that the authors identify three "epigenetic components" to successfully transition into the np role: competence, independence, and intimacy. here's what the last paragraph says, "furthermore, she must master them in that sequence. the practitioner responsible for primary screening must first develop the clinical competence to make a valid physical and psychosocial assessment. beyond that, she must develop the confidence to make an authoritative disposition of those findings. and finally, she must integrated these extended skills into an expanded role in which she functions interdependently with the physician in the delivery of primary care (keep in mind this is old). knowing who she is and what she has to offer - and liking it - is the crux of the nurse practitioner's new identity."

pretty cool, huh? the article just expands on this concept.

also benner's novice to expert theory is very real and applicable as well. i have part of an article that says, as nurses we are experts... and expected to act as a "novice" again when we become nps. this, then leads to a new stage of development that allows for recognition of limitations of existing knowledge, and assuming responsibility for your own judgement and decisions.

one last article that you might enjoy is "reflections on healing: a central nursing construct" by phyllis kriteck.

just remember... the feelings you are experiencing now are normal... and will only make you a more conscientious and respectable np.

good luck!

core0 · Dec 21, 2007

I was sent this article by a friend that is an ACNP:

http://www.medscape.com/viewarticle/533648

There are also several good articles on the impostor phenomenon in the CNS world that are a little harder to get hold of. It does get better though.

David Carpenter, PA-C

BarbaraNP · Dec 28, 2007

Feeling like an imposter is not just something for the new grad! My first NP degree was in 1988 and there are still some days I feel like that. The only difference is that it happens less often these days.

Just remember...every day is new and every day is a learning opportunity.

BarbaraNP

rnsrgr8t · Jan 3, 2008

This is totally normal and I actually think a good thing! It shows you are aware of what you don't know yet. I have been a PNP for 3 years end felt the exact same way (still do at times). I work in Urology which was a new specialty for me and my fellow PCP and mentor has been doing it for 15 years. She was a fabulous person to learn from and made me feel very comfortable as I learned a new specialty and never made me feel bad when I did not know something. I still have times where I go to her and the MD's I am with b/c I have something I have not seen/don't know what to do with etc. My background is in primary care and my beloved coworker asks for my advice on general peds things all the time. Most of us have a lot of nursing experience prior to going to grad school and are comfortable in our respective specialities and it is unnerving to be back in an enviroment when we have to restart a learning curve. Good Luck!