Ask a Nurse: How Do I Deal With Imposter Syndrome as a New Nurse Practitioner?

In our Ask a Nurse series, experienced nurses provide an insider look at the nursing profession by answering your questions about nursing careers, degrees, and resources.

Congratulations on your new role as a nurse practitioner!

If you’re feeling a little nervous or experiencing a case of imposter syndrome (IS), you’re not alone.

According to a study published in 2019, up to 82% of the participants admitted to experiencing imposter syndrome, regardless of profession, gender, and/or age. Imposter syndrome is also higher among underrepresented groups and is common among nursing students and nurses.

Like many new NPs, I also experienced IS. My IS came in the form of thinking I didn’t know enough, being frightened I would be asked a question I wasn’t sure about, and/or terrified patients would request to see the doctor instead of me.

Luckily, with time, I gained more confidence, and the IS faded. It will for you too.

Discover more about imposter syndrome and how you can manage and overcome it so that you’re feeling confident in your role as a nurse practitioner.

By definition, imposter syndrome is “the persistent inability to believe that one’s success is deserved or has been legitimately achieved as a result of one’s own efforts or skills.” IS is also known as:

Constantly feeling like an imposter is often associated with:

Imposter syndrome can affect job performance and job satisfaction which can lead to burnout.

IS is also a bit misunderstood. You may feel like a fraud, but you overcompensate by being an overachiever or believe you can’t make a mistake.

The book “Why Do I Feel Like An Imposter?” by psychologist Sandi Mann, Ph.D., describes three distinct characteristics of IS. These include:

Karen Chung, RN, FNP-BC, says she experienced IS as a new nurse practitioner. She especially felt its intensity during the first six months of working.

“As a nurse practitioner, the way you think changes. You think more critically, and you have to treat patients and follow them throughout their care,” Chung says. The fear of possibly making a mistake, or being exposed as a fraud, haunted Chung.

Taina Baker, FNP-BC, is no stranger to IS. Five years ago she started her first position as a new NP. For some, IS feels like you are “a fake” until the “real” doctor comes in, says Baker.

“You then realize there is no one coming. You are it,” Baker says.

When you’re in the field by yourself you have to make decisions for your patients; for many suffering from IS, that’s when it sets in.

Imposter syndrome comes in different forms. The Imposter Syndrome Institution lists five types of IS.

These five types of imposter syndrome force you into a state of high expectations with a chronic case of self-doubt.

According to Mann’s book, imposter syndrome may stem from having high-achieving siblings or being raised by a family with high expectations. Those who wrestle with self-efficacy, high-achievers, and perfectionists are typically susceptible to feeling like an imposter.

Imposter syndrome can also be triggered by lifestyle choices like becoming a student or a first-generation professional. So it makes sense that transitioning into a new role as an NP also provokes feelings of IS. You have different responsibilities as a healthcare provider, and although it can be scary, it is certainly normal. But if you’re suffering from IS and believe you aren’t good enough, it may make the transition even harder.

Chung’s first physical exam of a patient with diabetes, hypertension, and hyperlipidemia was a huge contributing factor to her IS.

“Although you learn how to conduct a physical exam in school, until this patient is yours and you become their primary care provider, it is very confronting when it first happens. I wasn’t ready for it,” Chung says.

Baker describes when a patient came in for sutures for a hand laceration and another patient with cardiac symptoms. These examples triggered IS for her.

As a healthcare provider, it is normal to be nervous. Your patient’s life is in your hands. But if you are constantly questioning your decisions, you feel like you have to be right all the time, or feel shame when you aren’t, you are experiencing IS.

Now that you know the causes of IS, it may be easier to manage and eventually overcome it. In Mann’s book, she points out that IS is not a mental illness or a condition. There is no diagnostic code psychologists use to classify it. IS is more of an “experience.”

When you recognize the characteristics of IS and its root cause, it should become easier to work on overcoming it. Here are five ways to conquer IS at your new job:

Imposter syndrome is composed of self-limiting thoughts and the idea that there is no room for mistakes. When you redefine your thoughts, it will help with feeling like an imposter.

It would also be beneficial for nursing classes to incorporate strategies to overcome IS in the nursing curriculum. Lastly, if all else fails, it’s important to remember experienced NPs and doctors may also struggle with self-doubt. Remember we all have to start somewhere.