I’m a mental health nurse. It’s not the only thing that defines me but it tends to be my default response when people ask ‘So what do you do?’ I’m also a lecturer in mental health nursing. Working in these roles means that I teach what I do but I also don’t always practise it.
I’ve given up trying to explain to my family what exactly it is that I do. It’s not anything like Grey’s Anatomy (For starters, that’s medics and the stuff they get up would in real life get them kicked off the GMC register). What does happen is that occasionally I expect someone to tap me on the shoulder, say there’s been a terrible mistake and that I need to leave immediately.
Imposter syndrome is something I still experience; it’s faced by the students I teach, and has been linked to burnout. I can see that; I can see how coming home after a particularly difficult shift with that uncomfortable feeling you shouldn’t have been there or feeling like you did the wrong things while everyone else knew what they were doing can lead to churning that over and over in your mind all night. That means you don’t sleep well as you’ve brought your work home or you don’t feel like you had your days off as you didn’t really get that break from work as you were thinking about it.
Imposter syndrome doesn’t always have to appear when there’s been a crisis situation. First-year students often tell me their anxieties about going out on placement are linked to worrying they’ll say the wrong things or won’t know what to do if someone asks them to do something they don’t know how to. To that, I always say that some things come with practice, like talking with someone about voice-hearing or thoughts of self-harm and learning to sit with emotions and being comfortable with silences – It’s a skill they’ll develop. I stress if they’re asked to do something they don’t know how, they need to feel comfortable in speaking up and I try to make it clear that saying: ‘I’m not sure but I’d like to learn’ is not the same as ‘I don’t know so clearly I shouldn’t be here’.
Knowledge of one’s own limitations is necessary for safe practice and is very different from imposter syndrome.
As a nurse, I’m expected to use Reflection and evidence this every three years for Revalidation. I use it regularly; I advocate it to the students I teach as a useful tool to help them to explore their practice. Reflection helps us to consider our thinking, our actions and highlights what went well. We can easily fall into a cycle of storytelling of what happened and what we did or didn’t do and fail to see our strengths. Having it presented back to us helps us to evidence and challenge ourselves that we do belong, we do know what we’re doing or that we have areas for development. But nursing is an ever-changing, evolving skill, and learning is lifelong so insight into areas for development is a strength and doesn’t mean we’re an imposter who knows nothing and got here by mistake or luck. Reflection is important for this reason but I do find that reflection can often morph into rumination and that’s not useful.
Mindfulness (or ‘mindlessness’ as someone I work with calls it) is something I fear is overused and in danger of seeming overrated but as a defence against the ‘I can’t do this/I should not be here’ thoughts or the ever-delightful ‘what if’ question, it comes in handy. When I say mindfulness I don’t necessarily mean your perhaps stereotypical idea of holding an orange, describing it and then smelling it. No; I mean Metallica. I mean paying attention to the sound of a decent guitar rift and thinking about how good that sounds rather than thinking ‘what if I’d done that instead’ or ‘what is that had happened and it all so much more wrong?’ and going round and round as the fun thing about that ‘what if’ question is that it never leads to resolution it only leads to more ‘what if’ questions and usually a poor night’s sleep.
I find that practising mindfulness at night (not so much Metallica at that time; it’s usually focusing on breathing) might give my mind a break from the ‘what if’ cycle and that break brings relaxation or maybe sleep. Mindfulness in the daytime can be as simple as sitting in the car listening to a track before going in the house and putting the shift aside so that when I go inside I’m hopefully more likely not bring it in with me.
I joke that I run off coffee and there have been times when I’ve felt like this is true. Poor sleep or feeling tired has meant coffee on shift is a must. As nurses, we are terrible. We talk about sleep hygiene, managing stress levels and eating well to others but we often don’t do it ourselves. This may be a case of ‘do as I say, not as I do’ or maybe we pressurise ourselves into thinking our superhero cape might slip if we take a break from supporting others to take care of ourselves for 10 minutes – or others who also never take one, will judge us.
It’s ever more important in the current COVID-19 working environment to stay hydrated and to assert yourself in saying ‘I am taking a break’ even if that’s going off the ward for five minutes with a brew or going off to your car for few minutes to yourself because modelling and advocating self-care will hopefully mean this change in nursing culture will continue to gain momentum.
If I have any final thoughts or suggestions to make it’s these: You are not an imposter; self-care is not selfish and try not to live off coffee.
Image credit: Freepik
Angela Glaves is a lecturer in mental health nursing who also works in the NHS as a community mental health nurse for the crisis team and is an avid fan of metal music.