"Are you qualified?"

This post has been a couple of months in the making. It took me a few weeks to be able to whittle down my feelings into something identifiable. Did it help once I had managed to do this? Sort of. I had managed to work out what I was feeling, now I just have to manage the feelings...easier said than done I think?

Here's a breakdown.

My anxiety starts when I enter the hospital building. I feel the knot in my stomach tighten, my jaw clenches and the tension spreads across my shoulders. I take a deep breath as I cross the threshold into the ward to steady myself.

I've got used to these initial anxieties, and make sure I do some deep breathing exercised when I am in the locker room. This usually helps me to focus on taking handover. Personally I am a fan of square breathing, but there are lots of other techniques out there for breathing and grounding.

Personally, when I start a shift, I like to say hello to each of patients and introduce myself. It means they know who I am, and I can check on their well-being. On a recent shift, whilst I was saying hello, a patient asked me "are you qualified?" For a moment I paused, and I wasn't sure what to say. In the end, I told him that I was a Registered Nursing Associate, and explained a bit about my role when he asked.

But I walked away feeling very unconvinced by what I had just said, and almost felt like looking over my shoulder; sure that at any moment senior staff would be along to escort me off of the premises all the while asking me "what do you think you are doing? You shouldn't be here".

Of course that didn't happen. In fact, I have had patients and colleagues alike tell me that I was born to nurse. That I have found my calling and that I have a great way of working. It is one thing to hear what people are telling you, but it is another thing to really HEAR what people are tell you.

I tend to feel that I am going through the motions of nursing. That I don't know what I am doing; am completely out of my depth and that I shouldn't be in the role that I am. In other words, I feel like an imposter.

I spoke to one of my colleagues about my feelings, and she was the one that first used that word. Initially I laughed and said "that's not a real thing". Turns out it is. There are so many articles and online resources about imposter syndrome - not just relating to nursing. The Kings Fund says that:

"‘Imposter syndrome’ spans sectors and roles [...] The term describes a high-achieving individual who struggles to internalise success; who feels fraudulent; and who attributes success to factors such as hard work, charm or luck. Those with ‘imposter syndrome’ experience a chronic sense of inadequacy. It is an experience shared by women and men" www.kingsfund.org.uk/blog/2019/09/tackling-imposter-syndrome

I find myself, throughout the shift, having moments of rising panic. My breathing gets faster, my chest feels tight, I start sweating and shaking, feeling nauseated and get palpitations. My thoughts get more and more scattered, which in turn means that I get less efficient, therefore feeding into the cyclical thoughts of being inadequate.

This then leads me to feel like I am playing catch up throughout the shift. I generally don't leave work on time. Recently I have left as late as an hour after the end of my shift. On one hand, I don't mind because I would rather make sure that I have documented everything and that all of my care has been safe. But on the other hand, staying up to an hour late on every shift soon becomes tiring - with a burnout inevitable if something doesn't change.

I know that I am slow. But I also know that I am a safe practitioner. With my Irlens Syndrome (please see previous posts) I struggle in regards to doing tasks quickly - particularly if they involve reading or working things out (think medication round). In my mind, as long as I remain a safe practitioner, then everything else will come in time.

The key thing that I have learnt from this experience is to identify my feelings and recognised the triggers and what my experience is, so that I can have tools prepared (such as deep breathing and grounding) for when I feel I am becoming overwhelmed.

Talking is one of the best things I have done to try and recognise and rectify my recent experiences. I have spoken to my colleagues - including peers and senior staff. I have spoken with learning leads and the ward manager. I have spoken to my parents, and to my fiance. I have spoken to my friends - nursing and non-nursing. I have sought advice from my GP.

From what I have read and understood, Imposter Syndrome is a very common experience, across varying sectors but particularly in nursing. So the main reason I have written this blog post, is to reassure anyone that reads it that these feelings are normal, especially when newly qualified, and that talking to people is one of the best ways to start moving forward from it.

For me, I am taking things one shift at a time.