Help! I feel like a fraud

What is imposter syndrome?

It’s that gripping internal feeling of believing you’re not as competent as others perceive you to be. It can affect your sense of self, how you behave and your confidence in your abilities.

One of the driving factors behind these feeling is critical thinking. We often give too much weight to our thoughts, which can be very powerful, and cognitive biases and distortions are sneaky ways in which the mind can convince you of things that are not true.

Back in the late 1970s, psychologists Pauline Rose Clance and Suzanne Imes coined the term in a research paper, noting three critical attributes:

• thinking people have an exaggerated view of your abilities
• the fear of being exposed as a fraud
• the continual tendency to downplay your achievements.

What are the key characteristics?

Symptoms of imposter syndrome include:

• severe self-doubt
• the intense fear of being exposed as incompetent or as a fraud
• feeling anxious about not being able to live up to expectations
• setting unrealistic goals and becoming depressed when they’re not achieved
• overthinking, having a negative mental filter or rumination
• believing that external factors are responsible for success and accomplishments
• self-criticism and downplaying your performance
• self-sabotaging your own performance and success.

Any signs to look out for?

People may experience increased stress, anxiety, shame and depression. They may also develop a lack of self-confidence or low self-esteem and poor sense of self.

Some may even avoid making decisions for fear of making a mistake.

Why is it common in nursing?

Nursing can be a highly stressful job. Imposter syndrome can cause nursing staff to question their skills or feel inadequate in the face of challenges they may encounter when caring for patients.

Some may silently view their colleagues as being more knowledgeable or better than them, leading to feelings of inferiority.

Feelings of self-doubt in anyone can damage performance and overall wellbeing, and these emotions can be particularly common for some newly registered nurses.

If left unchecked, the power of these emotions can follow people right through their nursing career.

Also, when we consider some of the truly difficult experiences some internationally educated nurses and international students may face – such as microaggression, cultural differences, microinvalidation and/or racism – these experiences can be dehumanising, cutting through the heart of identity and dignity and causing deep humiliation, which can increase the impact of imposter syndrome.

How do you overcome it?

Recognise and write down any negative thoughts and beliefs in the moment. Has that thought started small but has now turned into a massive vortex of emotions, or is it a fact?

Now ask yourself: what evidence do I have for this thought or is there another way of looking at this situation?

Use some positive self-talk, which isn’t about ignoring the negative aspects of life. Instead, it’s flipping the narrative to approach issues in a more productive way.

For example, if you make a mistake at work or while on placement, it might trigger a previous experience where you were reprimanded for the same or a similar error. While it’s vital to report any mistakes, it’s also important to learn from them and move on.

You might initially say to yourself: “I can’t believe I did that. Everyone will be judging me for it.” Instead, try telling yourself: “Tomorrow is a chance to try again, with the lessons learned from today.”

I’m just starting in my nursing career. Any advice?

You’ve been recruited into the role because you trained super hard and you’re good at what you do. Absolutely no one can take that away from you.

Don’t be afraid to ask for help. Rather than being a sign of weakness, it shows self-awareness and strength.

And remember, nobody is 100% perfect. Accept that negative things can and do happen, it’s all part of life. See it as an opportunity to gain experience.

I’m moving upwards. Any tips?

A promotion or step-up may feel daunting at first, especially as it means exposure to an enhanced set of responsibilities, but you absolutely can do it. Prepare yourself by learning as much as you can about your new responsibilities.

Being elevated in your nursing career doesn’t mean you’ll be alone in work. You can still ask questions and seek help from other people who have experience in the field.

Reward yourself for landing the promotion in the first place and if you can, book a break before you start to help compose yourself.

Continued self-care is incredibly beneficial. Whether it’s doing some exercise, spending time with loved ones, or doing some mindful meditation. Whatever your self-care looks like, don’t let it drop off.

What if I spot signs in colleagues?

Encourage colleagues to talk about how they’re feeling and during those conversations connect with empathy. Really listen to them. Ask them to consider making a note of their achievements and remind them that sometimes people must take small steps out of their comfort zone to progress and grow – not just in their career, but in life, too.

What else can help? 

Seek professional help if needed, as early intervention is really important.

For some people, cognitive behavioural therapy is beneficial as it encourages us to see ourselves and the world around us in a more positive, realistic and useful way. A good therapist can support you to replace negative core beliefs and critical self-talk with a more constructive, rational mindset.