Posted 09 August 2023 - 01:00
Posted 09 August 2023 - 01:00
Career advice
What is imposter syndrome and why is it so common among nurses?
Imposter feelings can erode self-confidence and increase the likelihood of burnout, but there are ways of defusing its negative power
Imposter feelings can erode self-confidence and increase the likelihood of burnout, but there are ways of defusing its negative power
Imposter syndrome, sometimes known as imposter phenomenon, is a persistent feeling of being unworthy of the status or success you have achieved.
People with imposter syndrome struggle with accurately attributing their performance to their competence and may see their success as down to luck or having received help from others. They also see setbacks as evidence of their professional inadequacy.
Are nurses particularly vulnerable to imposter syndrome?
Nurses experiencing persistent self-doubt or fear of being exposed as a fraud could be experiencing imposter syndrome.
Researchers who looked at reasons for
Imposter feelings can erode self-confidence and increase the likelihood of burnout, but there are ways of defusing its negative power
Imposter syndrome, sometimes known as imposter phenomenon, is a persistent feeling of being unworthy of the status or success you have achieved.
People with imposter syndrome struggle with accurately attributing their performance to their competence and may see their success as down to luck or having received help from others. They also see setbacks as evidence of their professional inadequacy.
Are nurses particularly vulnerable to imposter syndrome?
Nurses experiencing persistent self-doubt or fear of being exposed as a fraud could be experiencing imposter syndrome.
Researchers who looked at reasons for imposter feelings in nurses found they arose from role ambiguity, lack of self-compassion, periods of change and minimal clinical experience.
‘There are a lot of perfectly capable nurses out there who feel like they are faking it’
Nicola Bailey, postpartum contraception lead and RCN Nurse of the Year 2021
Imposter syndrome can affect nurses at any stage of their career – from students and newly registered nurses to those in more senior posts, including chief nurses – eliciting strong feelings of self-doubt, anxiety and worry.
Is ‘imposter syndrome’ a recognised disorder?
The term ‘imposter phenomenon’ was coined in 1978 by two psychologists, and was initially observed as affecting high-achieving women and other marginalised groups in particular.
The psychologists observed women in good roles, with evidence of their qualifications and professional recognition who nonetheless felt they had ‘fooled’ people into thinking they were intelligent.
‘Imposter syndrome’ is a relatively new term – it was added to the Oxford English Dictionary in 2018 – but it has become a well-established phrase in the workplace.
It is not a recognised psychiatric disorder and is not in the International Classification of Diseases, Tenth Revision (ICD-10), but research suggests it is incredibly common, with one systematic review finding up to 82% of people have experienced it. The analysis of 62 studies suggests that imposter symptoms are prevalent among men and women and members of multiple ethnic groups and are associated with worsened experiences in academic and professional settings.
Symptoms often associated with imposter syndrome include anxiety, depression, low self-esteem, feelings of inadequacy and super-heroism.
Doubt and worry: a newly registered nurse’s experience
Newly registered nurse Alex Dray, who works on a surgical ward at London’s Great Ormond Street Hospital for Children, says she was taken aback at how powerful her feelings of being an imposter were after she started in her first role.
‘It makes me feel very anxious,’ she says. ‘After speaking to a student or family, I would worry about whether I had said the right thing. Even though I do know the answer to whatever I was asked, I can’t stop worrying that I said something wrong.
‘There is a lot of doubt. I ask a lot of questions and seek reassurance, even when I know what I’m doing.’
Speaking to nursing colleagues who also started their first jobs last autumn, she found her experience was almost universal. ‘I don’t think I have spoken to anyone who hasn’t felt some of these feelings,’ she says. ‘It is a very tiring experience to live with.’
Recognition and denial: imposter syndrome as an experienced nurse
Nicola Bailey was named RCN Nurse of the Year 2021 for her inspiring work setting up an early medical abortion service in Northern Ireland amid the pandemic.
When she found out she had won, she says she struggled to enjoy the award as she felt ‘overwhelmed’ and that she didn’t feel like she deserved it.
‘I didn’t feel good enough to be up there, I was just doing my job,’ says Ms Bailey, now a postpartum contraception lead in Bristol.
She found reading up on imposter syndrome and having a name to put to her powerful feelings of self-doubt, lack of self-belief, negative thinking, perfectionism and people-pleasing was a crucial step.
‘We need to be a bit more open and honest about imposter syndrome in nursing,’ she says. ‘There are a lot of perfectly capable nurses out there who feel like they are faking it.’
How to tackle imposter syndrome – top tips
- Cultivate self-compassion and be as kind to yourself as you would to others, says RCN Nurse of the Year 2021 Nicola Bailey. Having supportive colleagues at work and friends outside of work also makes a big difference. ‘Think about who you surround yourself with. If your friends are not celebrating your success, then leave that circle and find people who will,’ she says
- Seek advice and feedback from people you trust, says Ms Bailey. ‘Seeking out feedback from people who are positive can help silence the negative voice in your head,’ she says. ‘Don’t go to just anybody, go to someone you trust for honest feedback’
- Speak to colleagues, who will often have similar experiences to share, says newly registered nurse Alex Dray. ‘Talking to peers, particularly those who started as new nurses at the same time as me, has really helped,’ she says
- Role-play work events you are worried about – it can boost your confidence and help you feel prepared, says Foundation of Nursing Studies chief executive Joanne Bosanquet. Your inner critic is likely to be particularly powerful when starting something new, such as moving to a different role or moving to a different clinical area, she says. ‘This is when preparation is so important to help you control your inner critic. I have found role-playing aspects of work, such as a meeting, conversation or presentation, with someone you trust is incredibly helpful. This often helps put your concerns back into perspective’
Can imposter syndrome lead to burnout?
Evidence is increasingly showing a link between imposter syndrome and burnout, which involves feelings of emotional exhaustion, depersonalisation and reduced personal accomplishment.
Researchers have found a ‘harmful association’ between imposter feelings and job performance, job satisfaction, and burnout among various professions, including healthcare professionals.
With nursing in the grip of a retention crisis, more than a third (37%) of nurses told the 2022 NHS Staff Survey they feel burnt out by work, with burnout linked to many negative effects, including poor quality of care, poor patient safety and nurses intending to leave their jobs.
Environments in which imposter feelings can flourish
Foundation of Nursing Studies chief executive Joanne Bosanquet says a nursing team that is not cohesive and supportive is an environment in which imposter syndrome can flourish.
‘We need to look out for each other, but this doesn’t always happen in nursing,’ she says. ‘I have seen teams where if the chips are down, it is every nurse for themselves.’ This can leave staff more isolated and at risk of feeling their confidence is slipping, she says.
But Ms Bosanquet feels that it could be better to move away from the term imposter syndrome. ‘It’s very negative and it is not really a syndrome,’ she says. ‘I prefer to think of it is as our inner critic and we all have that – it is part of being human and we need to embrace it.
‘We need to normalise it, as we all have these feelings sometimes. Our inner critic is something that can be useful, it can help us reflect and be self-aware, so we need to learn how to use it.’
Further information
- Bravata DM et al (2020) Prevalence, Predictors, and Treatment of Imposter Syndrome: a Systematic Review. J Gen Intern Med 35,4, 1252–1275
- Clance PR, Imes S (1978) The imposter phenomenon in high achieving women: dynamics and therapeutic intervention. Psychotherapy Theory, Research and Practice. 15,3.