I experienced the feeling but didn’t know it had a name. How was I qualified to be titrating life-sustaining medications and managing airways of critically ill patients? What right did I have to be educating family members on end-of-life care? And should my assessment really be used to make decisions that influence care?

What I was experiencing was impostor syndrome.

What is impostor syndrome?

First defined in 1978 by Clance and Imes, the impostor phenomenon is used to “designate an internal experience of intellectual phoniness that appears to be particularly prevalent and intense among a select sample of high achieving women.” Now updated, the definition from Merriam-Webster is “a psychological condition that is characterized by persistent doubt concerning one's abilities or accomplishments accompanied by the fear of being exposed as a fraud despite evidence of one's ongoing success.”

So, what does this mean for nurses?

As a profession where transitions and advancement are often sought after, nursing is not immune to the effects of impostor syndrome. From the start of our careers as new graduates, we are thrust into a role where others rely on us for expert knowledge and skills. It takes time to develop those skills with much “on-the-job” training, so it stands to reason that as new nurses, developing feelings of impostor syndrome is a real threat. As we transition in new specialties and roles, advance our education, or switch paths from a clinical setting to an educational or business setting, for example, we are again faced with new challenges and experiences which take time to grow into.

In nursing, the reality is that time, staffing, and other workforce issues don’t usually allow us the time to develop our skills and confidence at our own paces. We quickly try to get up to speed, even concealing inadequacies at times, but low self-esteem is a breeding ground for impostor syndrome. We must recognize these real feelings and do something to combat them. If we don’t, burnout and job dissatisfaction are likely to ensue, and our own well-being is at risk.

Impact on certain populations

Interestingly, in a systematic review looking at prevalence, predictors and treatment of impostor syndrome, numerous studies found impostor syndrome to be prevalent among ethnic minorities. “A key finding from one of these studies is that impostor syndrome is a stronger predictor of mental health issues than minority status stress. This is particularly significant given that research on ethnic minority populations tends to focus on their minority status and presumed experiences of discrimination, rather than the individual differences within a minority group such as the impostor syndrome” (Bravata et al., 2020).

Overcome self-doubt and recognize your strengths

It is not unusual to doubt ourselves when facing new challenges, but impostor syndrome can generate an all-encompassing fear of being discovered as a fraud. The American Psychological Association offers this advice for overcoming the fear associated with impostor syndrome:

1. Talk to your mentors.
2. Recognize your expertise.
3. Remember what you do well.
4. Realize no one is perfect.
5. Gradually reframe your thinking.
6. Get professional help.

Impostor syndrome is real. In fact, it’s believed that up to 70% of people have feelings of impostor syndrome at some time in their life (Haney et al., 2018). Don’t let these feelings derail your goals and achievements. Believe in yourself, get help when you need it, and spread awareness to help others.

References:

Bravata, D. M., Watts, S. A., Keefer, A. L., Madhusudhan, D. K., Taylor, K. T., Clark, D. M., Nelson, R. S., Cokley, K. O., & Hagg, H. K. (2020). Prevalence, Predictors, and Treatment of Impostor Syndrome: a Systematic Review. Journal of general internal medicine, 35(4), 1252–1275. https://doi.org/10.1007/s11606-019-05364-1

Clance, P. R., & Imes, S. A. (1978). The imposter phenomenon in high achieving women: Dynamics and therapeutic intervention. Psychotherapy: Theory, Research & Practice, 15(3), 241–247. https://doi.org/10.1037/h0086006

Haney, T. S., Birkholz, L., & Rutledge, C. (2018). A Workshop for Addressing the Impact of the Imposter Syndrome on Clinical Nurse Specialists. Clinical nurse specialist CNS, 32(4), 189–194. https://doi.org/10.1097/NUR.0000000000000386

John, S. (2019). Imposter syndrome: why some of us doubt our competence. Nursing Times [online], 115(2), 23-24.

Merriam-Webster. (n.d.). Impostor syndrome. In Merriam-Webster.com dictionary. Retrieved June 24, 2021, from https://www.merriam-webster.com/dictionary/impostor%20syndrome

Weir, K. (2013). Feel like a fraud? American Psychological Association. Retrieved July 12, 2021 from https://www.apa.org/gradpsych/2013/11/fraud