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.
Question: How do I overcome imposter syndrome as a new nurse practitioner (NP)?
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.
What Is Imposter Syndrome?
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:
- Impostor phenomenon
- Fraud syndrome
- Perceived fraudulence
- Impostor experience
Constantly feeling like an imposter is often associated with:
- Low self-esteem
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:
- The belief that others have a false view of your abilities
- The fear of being exposed as a fraud
- The thought that your success is based on external factors
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.
5 Types of Imposter Syndrome
Imposter syndrome comes in different forms. The Imposter Syndrome Institution lists five types of IS.
This type of imposter syndrome rears its ugly head when you focus more on the "how" something gets done and "how" it turns out. If it doesn't turn out the way you'd hoped, you think you failed.
This type of imposter syndrome focuses on "what" and "how much" you know. The expert thinks they have to know everything.
This type of imposter syndrome is the feeling that you are the only one who can achieve the task.
The Natural Genius
This type of imposter syndrome is the feeling that you have to be right on the first try.
This type of imposter syndrome is the feeling that you should be able to handle it all.
These five types of imposter syndrome force you into a state of high expectations with a chronic case of self-doubt.
Causes of Imposter Syndrome
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.
"I had never sutured before, and [the patient] was way too young to be experiencing [cardiac] symptoms," Baker says. "Her EKG was normal, but I was so afraid to be wrong I sent her to the [emergency department]."
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.
5 Ways to Overcome Imposter Syndrome at Work
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:
Revisit Positive Past Experiences
Chung, who says IS is now only triggered in certain situations, advises you to think about positive past experiences. What helped her was to think about how far she's come.
"It may be difficult to see your confidence, but think about how you graduated from nursing school, or think about how you overcame certain situations as a nurse," Chung says.
Seek Out Fellowships
Positions with nursing fellowships or nurse residency programs have a built-in support network for their new NP hires. Fellowships were created so new NPs didn't feel alone and to help with the transition into their new role.
If you already have a job without a fellowship, seek out a nurse mentor. This mentor ideally has more experience and is working in the same specialty as you. There are many benefits to having a nurse mentor, but one of the most important benefits is having someone to talk to if you are feeling overwhelmed.
Focus on Your Mental Health
Chung says one thing that is often neglected, especially during the first few months as a new NP, is your mental health. "The first month is a very traumatic experience; you need to focus on your mental health so you don't burn out."
Don't Be Afraid to Ask for Help
If you are suffering from being a soloist — the type of imposter syndrome that feels like you are the only one who can achieve the task — it may be difficult to ask for help.
Baker emphasizes there is no harm in looking something up or asking for help. Your medical director is a great person to start with. "It is not ok to guess. Just stop and ask for help. The patient will greatly appreciate honesty, and patient safety is most important. This will also be a great opportunity to learn for next time," Baker says.
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.
- 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."
- 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.
- IS is rooted in past experiences and is more prevalent in certain personality traits like high-achievers, those who wrestle with self-efficacy, and/or perfectionists.
- When you recognize the characteristics of IS and its root cause, it may be easier to manage and eventually overcome it.
Meet Our Contributors
Karen Chung, RN, FNP-BC
Karen Chung worked as an emergency room nurse for six years before becoming a nurse practitioner. She has been an NP for the past six years and currently works in the retail health industry.
Taina Baker, FNP-BC
Taina Baker worked 10 years as an oncology nurse and has been an FNP for the past five years. She currently works for a managed care company caring for a gerontology population and in an urgent care facility. She is also certified as a wound care specialist. Baker is aspiring to graduate from a PMHNP postmaster's program at the end of this year.
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