The way it feels to become a nurse is that you absolutely cannot become a nurse.
Awhile back, I read a quote by Cheryl Strayed (of ‘Wild’ fame) which said: “The way it feels to write a book is that you absolutely cannot write a book.”
“YES!” I silently screamed to myself. As a writer who has written several book drafts, I can absolutely confirm that it’s impossible.
It also got me thinking about the other places Imposter Syndrome—the tendency for that sneaky voice in your head to convince you that you’re not fit for XYZ, despite any and all evidence to the contrary—pops up.
Like becoming a nurse, for example.
I can admit this: I’m a Grade A, card-carrying Teacher’s Pet, so my moment of reckoning in nursing school didn’t come until the first day of Clinicals. Like all book-learnt students, I was smug. But there is a big difference in knowing how to insert a Foley catheter on paper, or answering exam questions about it, and approaching an actual, live, human being to do so. In my case, I didn't make it past the first hurdle—donning the sterile gloves required at the beginning of the procedure—that I was meant to perform under my Instructor’s watchful eye.
Realizing my mistake of touching no less than 5 things outside the sterile field, (my face now turning hot and red, a lump forming in my throat), each second of that clinical skill demonstration stretched to excruciating lengths before me. Mercifully, for us all, the dogs were called off before that rubber hose went near anybody's urethra.
Of course, being the stellar student that I was, I passed nursing school with flying colors and easily landed a job at the first hospital I applied to. Like all wet-behind-the-ears Graduate Nurses, I bounded off the elevator onto the unit on my first day with pockets full of pens, a notebook, and a shiny new stethoscope, eager to spread my compassion far and wide.
Instead, what awaited me was the typical shit storm of a shift change in progress. The unit secretary looked like one of those haggard Netflix memes that ask “are you still watching?” as she stared down several alarming monitors. Her attempts to answer what looked like every call bell lighting up were more akin to a game of whack-a-mole than assured, patient-satisfaction-scored service. The charge nurse appeared to be in the midst of receiving a call-out, and several nurses were desperately running into patient rooms after the food service workers. As they retrieved each of the just-delivered breakfasts, they loudly complained that their patients’ fasting blood sugars had not yet been done by the patient care techs. I imagined that those same techs might be down at the end of the unit, attending to the patient who was methodically chanting, “Jesus. JESUS. JEEEESUUUUS!”
I was the first to arrive for the dayshift nurses (early, of course), and when the nightshift realized I would not be relieving them in any sense, their hopeful faces fell at the sight of me.
“Shit. I can’t do this,” I thought.
Before long my preceptor arrived, and bless my heart she was one of the kindest and most patient women I have ever known. She must have recognized my deer-in-headlights expression because the first thing she said to me was, “first shift change, honey?”
Wait. This was…normal?
As the weeks crept by in my three-month preceptorship, I stayed by her side like a loyal Golden Retriever. Smiling at anyone who made eye contact, indiscriminately friendly, and always willing to offer a soft, floppy head to pat (on this particular unit—dubbed “the Nursing Home Dump,” many of the delightfully confused patients did indeed pat various parts of me, in the Universal Way that even demented people feel pity for the inept yet sweetest among us).
In no way did I see myself qualified to work autonomously—soon, or, ever.
Of course, like in any new job, your skills progress and you learn. My progression on the first ever hospital job I worked followed a typical trajectory: I slowly graduated from Newbie to Flying Under the Radar to Solid Team Member who Saved Other Newbies to Charge Nurse to…getting the hell out of there. Eventually I landed in the ED, where I started this whole progression over again.
Every nurse that I have ever talked to, feels the impossibility are becoming proficient when she first starts out. The funny thing is, Impostor Syndrome never really leaves you. Even as I went on to being the appointed charge nurse for our very busy ED, a small part of me would always feel like someone was making a giant mistake putting me in charge.
And if I felt that way, chances are many other nurses were feeling this way, too. Never was it put so succinctly as Ms. Strayed put it, though. What a gift those words were to read, and why I feel this topic deserves attention.
Because no good blog post leaves their dear readers without some “added value” these days, here is my Nursing Care Plan for treating Imposter Syndrome. I humbly leave it here, for the ones carrying on the torch—for those nurses that are currently becoming:
PROBLEM: Negative Self-Talk and Comparison
We would all be walking around with bars of soap in our mouths if the thoughts we had about ourselves were broadcast.
Comparison is the thief of joy—something everyone does, and nearly impossible to cease 100% of the time.
INTERVENTIONS:
Be kind to all, but most especially, yourself. You’re doing better than you think.
Remember that for every superhero nurse you encounter, they got that way through hard work, dedication, and probably a lot of impostor syndrome handling, too.
Be a team player. You know what's better than someone who does everything perfectly? Someone who reliably helps out, asks questions, and smiles more than frowns.
Realize that everyone makes mistakes. Yep, even the world’s most trusted professionals— nurses—make some pretty terrible ones. The first time you make a mistake as a nurse it feels like the world is going to end. Despite all the safety protocols and check lists and computer programs that are there to prevent them, medical errors actually happen quite often.. And when it does happen to you, it's best to frame it as a learning experience. (After all, it's how you move on from these experiences that define you, not the mistake themselves.)
EVALUATION of OUTCOMES:
Have you discovered that everybody’s winging it? Here's a fun, evidence-based fact for you: the more you feel like you don't know what you are doing, the more likely it is that you are doing a great job. It's called the Dunning– Kruger effect, and it explains the tendency for people who are bad at stuff—or absolutely certain in their knowledge of something—to believe they are actually really good at, or an expert, on these things. From this vantage point, it means that your self-actualization—and specifically, the fear of your perceived shortcomings—likely means you’ve become a damn good nurse.