Do Nurses Suffer From Impostor Syndrome Because Of Workplace Pressures?

"We need to be a bit more open and honest about imposter syndrome in nursing…There are a lot of perfectly capable nurses out there who feel like they are faking it" - Nicola Bailey, RCN Nurse of the Year in 2021.

Imposter syndrome is characterised as a persistent feeling of being unworthy of success or status. Feelings of unworthiness can, in turn, lead to self-handicapping behaviours. As a result, nurses sometimes end up sabotaging their own careers, or leaving the profession altogether.

In 1978, two psychologists observed how high-achieving women felt they had deceived people into thinking that they were intelligent. The psychologists labelled this observation ‘imposter phenomenon’.

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, provoking strong feelings of self-doubt, anxiety and worry. It can have detrimental effects on mental health and professional development.

Newly qualified nurses can be especially vulnerable, doubtful of their readiness for qualification or questioning their ability to fulfil the expectations of both colleagues and patients.

Do you think that formal guidance on how to recognise impostor syndrome, both in oneself and others, should be included in nursing degree programmes?

Demands on health services mean that numerous newly qualified nurses find themselves forced to work beyond their professional level and experience, meaning these new and inexperienced nurses may quicky feel out of their depth.

Alex Dray, whilst working at Great Ormond Street Hospital as a newly registered nurse, felt stunned at the intensity of her feelings of being an imposter after she started in her first role. Her nursing colleagues who had also started their first jobs, had similar experiences.

‘I don’t think I have spoken to anyone who hasn’t felt some of these feelings…It is a very tiring experience to live with’ she explained.

Should employers of newly qualified nurses, if they don’t already, aim to mentor them more closely than they might more senior colleagues, in anticipation of such situations arising?

There is a growing body evidence linking between imposter syndrome, which involves feelings of emotional exhaustion, depersonalisation and reduced personal accomplishment with burnout.

Against the backdrop of the ongoing staffing retention crisis in nursing, over a third (37%) of nurses reported to last year’s NHS Staff Survey that they felt burnt out by work, with burnout contributing to a poor quality of care, poor patient safety, and nurses planning to leave their jobs.

A study from 2015 titled ‘The imposter phenomenon among emerging adults transitioning into professional life’ suggested that high job turnover rates, as well as high numbers of nurses leaving the register, could be attributed to imposter feelings.

The study also argued that managers, and other mentor figures offering support could reduce the rate of staff turnover, as well as improving job satisfaction, employee performance and wellbeing. This in turn, would improve patient outcomes.

Would retention rates be improved by recognition that impostor syndrome can affect nurses at any stage of their careers? And if so, what support would be required to keep nurses in post during that time?

According to Foundation of Nursing Studies chief executive Joanne Bosanquet, 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 explained.

Is it the pressure of the workplace that can lead to nursing teams becoming less cohesive? If so, do you agree with Ms Bosanquet that better support would lead to better staff morale and thus to improved patient outcomes?

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