Confronting the Imposter Phenomenon as a Minority Nurse

Confronting the Imposter Phenomenon as a Minority Nurse

As an academic nurse researcher from an underrepresented minority background, for years, I was plagued by a certain phenomenon: specifically, the imposter phenomenon. In 1978, psychologists Pauline Rose Clance and Suzanne Imes coined this term to describe the internal experience of “intellectual phoniness” that is prevalent in high-achieving women who, despite their academic and professional triumph, feel that they aren’t smart enough, that they have somehow deceived others to view them as successful, and that they will soon be exposed as frauds.

Of course, this phenomenon isn’t limited to women: a 2011 review article published by Jaruwan Sakulku and James Alexander suggests that 70% of all individuals experience imposter phenomenon at some points in their lives. However, in my article, I focus on how I myself experienced the imposter phenomenon as a woman with African roots within Western academia. More importantly, I share my experience to express how detrimental the imposter phenomenon is to educators in academia. Today, I feel obligated to share my story with my students through my teaching and mentoring.

What are the attributes of the imposter phenomenon? From the definition of the term, I identified at least three destructive factors that contributed to my personal experience of it: namely, self-doubt, negative self-statements, and socialization as an African female.

An individual who sports self-doubt lacks confidence in her own capabilities and thus relies upon others to assess her accomplishments, failures, and reality. Naturally, self-doubt fuels negative self-statements that this individual utters about herself and eventually comes to believe about herself. And her negative self-statements will ultimately reinforce what her society and culture demands of women. If this individual is African like me, she will be haunted by her society’s belief that women are a weaker sex, that they should not be heard but only seen, that they are given things and will never truly earn them, and that they are meant to be taken care of by men and other authority figures in their lives.

So, how did this series of negative reasoning come to plague me? It was several weeks after starting my new position as a Sickle Cell Scholar through a grant funded by the National Institutes of Health. A staff colleague was trying to get my attention as I walked through a hallway to my office and she whispered, “Dr. Ezenwa.” I cringed and quickly turned my head around to figure out who she was addressing. Of course, it was me. We were the only two people in that space. I thought, “Wow. Dr. Ezenwa, my foot!”

As soon as this astonishment faded, I went into my office and was arrested by a severe panic at the thought of my “lies” being discovered. My body felt hot, my heart clapped with a chaotic chorus of groans, and my stomach fluttered like a butterfly rain forest. Pearls of cold sweat dripped from my palms. I felt like a deceiver, a trickster. An imposter.

Slowly, my self-doubt magnified and my anxiety about achieving success intensified. I began to question myself: Did I learn enough in my PhD program to be an independent researcher? Do I know enough to teach at the undergraduate, graduate, and PhD levels? What was I going to tell my students? What if I ruin their lives and academic careers because I teach them the wrong things and extinguish their drive for continuous learning and growth? Will they even understand a word I say to them through my African accent?

These self-doubts naturally morphed into destructive self-statements: I am not good enough. I am not smart enough. I am not worthy. Then, perhaps most devastatingly, these destructive self-statements made me feel boxed in and limited by multiple historical and social orientations forced upon women, even though I had escaped them long ago.

As an African immigrant in Western academia, I worked hard to break through multiple levels of convention. I broke through many societies’ beliefs that the proper place for a woman is at home and her role is to bear children, cook meals, and clean up messes. I broke through the pressure of growing up poor and earning the opportunity to reach greater heights without any real road map or directions. I broke through to success as a black woman who American society believes is lesser than her white counterparts thus deserves less in life. I, as an immigrant, broke through the culture shock of living and working in America and always sought peaceful resolutions to clashes in culture.

But under the spell of self-doubt and negative self-talk, I began to think that even the actuality that I’d broken out of these social constructions was all a big lie. These feelings only magnified and manifested as psychological and cognitive obstacles that cornered me into mental blocks. I soon lacked the confidence I needed to effectively teach and conduct research, as well as to see myself as successful and accomplished.

Now, I first learned about the concept of the imposter phenomenon many years ago during my graduate program. Back then, I brushed the idea aside as silly. How could individuals who paid with blood and sweat to accomplish their goals diminish their accomplishments? But after spiraling into such depths upon simply being called by my appropriate doctorate title, I realized that I was not above this sort of destructive thinking. I had to take control of this phenomenon if I was going to effectively and full-heartedly serve my students, my institutions, and, most importantly, myself.

So, how did I cope with the imposter phenomenon? There are three major strategies that I endorse and have taught my students: self-accountability, accountability with a trusted partner, and continuous self-love.

First, self-accountability: I began by recognizing that I am accountable to myself to be the best I can be in all my life’s endeavors. I am accountable for the outcomes of my actions and inactions, as well as my failures and successes. Once I accepted this fact, I engaged in bone-deep self-reflection about the imposter phenomenon that I had allowed to take up residence in me. I asked myself, “Why do you think you’re not bright enough? Why do you think you’ve fooled anyone who believes otherwise? Why do you think you’re not good enough, that you’re unworthy?”

I wrote down my thoughts on a piece of paper and waited a few days to return to it. When I saw all the questions and my initial answers written out, other realizations came to mind. I, for instance, suddenly understood that the imposter phenomenon had been creeping up on me my entire life. Growing up, everyone had told me that I was “so smart” and openly assumed that I would become a medical doctor. I had always been afraid that I might not live up to this idea of intellectual perfection that my family and friends held about me, and, even after I became an academic doctor, I felt that I was not the genius everyone believed that I was.

When I had excavated my mind of these recognitions and purged any negative ideas that imprisoned my capabilities, I reached out to my accountability partner for a meeting. I shared with her the result of my self-reflection honestly and openly and, in turn, she worked with me on enhancing my confidence. My accountability partner assisted me in three important areas: changing my mindset, developing a strategic plan of action to combat the imposter phenomenon, and constantly checking in to see if the plan was on track.

To shift my mindset, my accountability partner coached me to see the opposite side of my negative thoughts. For example, if I doubted that I was not smart enough to have accomplished the current goals in my life, she empowered me to believe that my current achievements were not handed to me for free like Halloween candy. Instead, I had to earn them through a combination of my intelligence, efforts, and wise leveraging of available resources. She assured me that I already had a long record of accomplishments, and there was no reason for that trend to stop so long as I was willing to challenge myself and do the work required.

Once this mindset shift was underway, my accountability partner helped me develop specific, time-bound goals and strategies to succeed in my current endeavors. Finally, we set a timeline with consistent, scheduled follow-up meetings to assess my progress. During these follow-ups, we reevaluated my goals and strategies, as well as adjusted my timeline as necessary.

The third and final strategy I used to combat the imposter phenomenon was practicing continuous self-love. As a woman, both in African and American society, I was socialized to care for everyone else before thinking of myself. Consequently, I was petrified to upend the status quo and focus on myself for once in my entire life; after all, I had equated self-love with selfishness.

So, to successfully exercise self-love, I had to be intentional. I worked tirelessly to reprimand myself every time I felt guilty for focusing on my needs over other obligations. I reminded myself that, when I am overflowing with love for myself, I will have enough energy to achieve my goals and dreams and also healthily give to my family, career, academics, and finances. I made sure I celebrated my successes, both big and small. Every night in front of the mirror, I stood and told myself how deserving I was of all the accomplishments I worked so hard to earn.

So, with all three strategies combined, did I beat the imposter phenomenon? That I am still a professor and a researcher in one of America’s top ten public universities is a testament to how I conquered self-doubt and negative self-statements and how I refused to allow my ancestral background and cultural identity to confine me from living in my highest potential. That I was recently inducted as a Fellow in the American Academy of Nursing is evidence that my research on health disparities in pain management in patients with sickle cell disease or cancer made a difference in peoples’ lives locally, regionally, nationally, and internationally. That I am now an entrepreneur is a manifestation of my mindset that now asserts, “You are good enough. You are smart enough. You are worthy.” So, yes, these strategies worked!

The imposter phenomenon is a monster, and the struggle to overcome it is real. Successful women have systematically been robbed of important opportunities because of our own self-doubts, negative self-statements, and our giving into social orientations that seek to confine us. But there is hope and there is help. The strategies I mentioned here, as well as with professional help from psychotherapists, can move us toward controlling the phenomenon and casting it out of our lives.

The question is, are we willing to confront the imposter monster in ourselves? Are we willing to tear down limiting beliefs about academic success, professional success, business success, financial success, and whatever else we desire? Are we willing to free ourselves from the bondage of history, cultural codes, and oppressive gender roles? Are we willing to look in the mirror and say “I am good enough, I am smart enough, I am worthy?” Are we willing to do the hard work to love and respect ourselves?

And, finally, are we willing to do the work now? Not next year, next month, next week, or tomorrow. Now.

Are you willing to take the challenge?

You may write me down in history
With your bitter, twisted lies,
You may trod me in the very dirt
But still, like dust, I’ll rise.

—Maya Angelo, “And Still I Rise”

UW Nurse Camp Offers Support to Underrepresented HS Students

UW Nurse Camp Offers Support to Underrepresented HS Students

When Carolyn A. Chow, MA, currently an HR recruiter and inclusion program lead at Cornell University College of Veterinary Medicine, was the director of admissions and student diversity at the University of Washington (UW), she co-founded their successful UW Nurse Camp, which still continues today.

“For schools and colleges who want to make a longitudinal difference in the future of nursing and health equity, a program like UW Nurse Camp is a win-win for high schoolers, current nursing students who are mentored to be leaders, and nurses who want to make a difference in the lives of the high schoolers who shadow them,” says Chow. “Costs to run the program are completely covered by community donations.”

Chow took time to answer our questions about the camp.

You co-founded the UW Nurse Camp in 2009 while on staff. Why did you start it? Had you been thinking about it for a while?

We had a very dedicated team of student leaders who wanted to create a group that was for building community and mentorship opportunities among students of color in the nursing program. In 2007, we sat down to talk about ways we could do that. So, UW Nurse Camp became a way we could have underrepresented students have professional mentors, be mentors to fellow students and high schoolers, build community through a specific year-long project, and to provide a pipeline of “first in their family to go to college” as well as underrepresented-in-nursing applicants who would get support from UW School of Nursing through the program. It took two years of fundraising in the community and organizing before we launched the camp in summer 2009 with 24 campers. In 2018, the camp expanded to hosting 36 campers.

What is nurse camp, exactly? How long does it last and who attends?

UW Nurse Camp is a five-day, Monday to Friday, 8:30 a.m. to 4 p.m. day camp. This year’s camp is July 15-19, 2019. UW Nurse Camp accepts applications from February 1 to April 15. High school sophomores and juniors who are underrepresented and/or first in their family to go to college are encouraged to apply. While most applicants are from Washington state, the camp has also had campers from California, Oregon, Maryland, and Illinois.

UW Nurse Camp is run completely by staff, nursing students, and community volunteers. Former campers who became UW BSN students are mentored to be UW Nurse Camp Leads, where they run the program so they can “give back” by sharing their success stories and serving as inspiration to future campers.

What do the high school students learn at UW Nurse Camp? 

The curriculum for UW Nurse Camp is designed to introduce high schoolers to the profession of nursing and everything it has to offer as a meaningful career. We focus on what a powerful difference diverse high school students can make in the promoting health equity. The sessions are taught and supervised by current and diverse UW Nursing students, alumni, staff, faculty, and community members. Campers also shadow nurses taking care of real patients and their families at the University of Washington Medical Center (UWMC).

From the UW Nurse Camp website:

  • Shadowing nurses at UWMC in various hospital units
  • Completing CPR certification and HIPAA training
  • Learning:
    • about infection control and proper hand washing techniques
    • how to take blood pressure and vitals
    • how to prepare for college and getting into nursing school
    • in the School of Nursing learning and simulation lab and UW Medicine’s WWAMI Institute for Simulation in Healthcare (WISH) Lab
  • Participating in nursing “speed rounds,” where you will meet and talk with nurses working in all areas of health care, including forensics, public health, emergency and research
  • Touring the UW Seattle campus

Why is it important to have this? What does it bring to the students that they may not get otherwise?

UW Nurse Camp is so important for students at all levels. Campers have access to a program that supports and teaches them about nursing and college educational opportunities. They get ongoing mentorship throughout camp and then continued support beyond from UW nursing students and alumni who are professional nurses. They meet diverse nurses in all different areas of nursing. In addition, they are continually advised by admissions staff on how to apply successfully to the UW BSN program and ways to prepare themselves to be competitive nursing applicants.

Current UW students are mentored with UW Nurse Camp as a leadership program. As UW Nurse Camp Leads, the students volunteer their time and efforts through the entire academic year to plan the UW Nurse Camp experience, including engaging in professional communication with camp speakers and instructors. They are mentored by School of Nursing staff in advising and youth program risk management. Additionally, the nursing students conduct the UW Nurse Camp admissions process.

Would you like to see this branch out and be something that other nursing schools offer? Why?

Absolutely. This is an incredibly successful program that supports underrepresented and first in their family to go college high schoolers in their journey to become professional nurses. They get to see diverse nursing students and professional nurses in action. The students also have inspiration and validation that they can make it through the nursing admissions process, and they gain networking contacts to support them throughout their process of graduating from high school, getting volunteer opportunities, completing prerequisites, and applying to college and nursing school.

Do most students who attend end up going into nursing? How do you think that UW Nurse Camp influences them?

According to a survey of former UW Nurse Campers, 50% of attendees pursued or are pursuing nursing. Another 30% pursue other health care careers. Finally, 20% opt for non-health-related majors. UW Nurse Camp influences them because as high schoolers they get access to professional nurses and clinical situations at the UWMC as well as support from UW nursing students, staff, and faculty. They gain access to role models in nursing who are committed to helping them to succeed in the profession. UW Nurse Camp demystifies the journey to becoming a nurse.

Interested in learning more about UW Nurse Camp? Visit here.

National Nursing Assistants Week Spotlights an Essential Role

National Nursing Assistants Week Spotlights an Essential Role

The National Network of Career Nursing Assistants marks the 42nd year of celebrating National Nursing Assistant Week from June 13-20. As lifelong caregivers, nursing assistants are a vital cog in the wheel of complete and attentive nursing care. They provide the hands-on, routine care for many patients, particularly those in long-term care facilities.

As part of the nursing team, nursing assistants often rely on their experience and the expertise of their colleagues to help patients in the ways that work best for them. Based on their long-term knowledge and interaction with patients, they are able to discern the slight nuances in providing one-on-one care to each patient.

Nursing assistants learn how different patients can be moved most comfortably and what foods can be digested most easily, for instance. They understand the emotional triggers for patients and the topics or situations that bring calm or comfort. They understand how to encourage patients in the ways they will respond to best. All of this important information is passed on to the entire medical team to help put together the best care plan.

In addition to the hands-on care, nursing assistants often provide essential and cherished companionship for patients. Because they interact with them so frequently, they become an important social aspect in the day-to-day care activities. They listen for vital clues to how a patient is feeling and can provide reassurance for typical issues or raise the alarm when something seems off or unusual. It’s often those smaller changes that can be a tip-off for a larger problem brewing.

With such frequent check-ins, nursing assistants advocate for their patients and have an important voice on the the care team. Nursing assistants who are in the same facility for a long time or who are career nursing assistant are also a source of stability for patients in times when everything else can be changing. A familiar face is welcome and reassuring.

As the national population continues to see the Baby Boomer population age and also live longer, the need for nursing assistants is growing. According to the National Network of Career Nursing Assistants, another 700,000 jobs will need to be filled to meet the demand over the next 25 years. And nursing assistants can work in a variety of settings, from nursing homes to emergency departments to hospice care.

National Nursing Assistants Week is an excellent time to recognize the role nursing assistants play in your care team’s work. From physicians to patients, they fill a critical need.

Frank Baez’s Journey From Hospital Janitor to Nurse

Frank Baez’s Journey From Hospital Janitor to Nurse

Frank Baez

Frank Baez poses with family and friends after his graduation ceremony. (Credit: Kate Lord/New York University)

Twelve years ago, when Frank Baez was spending his weekends cleaning patient rooms, bathrooms, and hallways at NYU Langone’s Hospital, he couldn’t have imagined that one day he would go from taking care of patient rooms to taking care of patients.

But that’s exactly what’s on the horizon for this recent graduate of NYU Rory Meyers College of Nursing.

When Baez was a recent immigrant from the Dominican Republic, he was finishing high school in Brooklyn and learning English, while working part-time in housekeeping to help support his family. So how did he go from working as a janitor to becoming a nurse?

“I worked as a housekeeper for almost 3 years. While cleaning the rooms and hallways, I observed the interactions between health care professionals and patients and felt that a career in health care suits my values and aspirations,” says Baez, now 29.

He began working in health care by being a patient transporter, taking patients for imaging and other testing. During that time, Baez earned a Bachelor’s degree in Spanish literature with a minor in biological sciences at Hunter College.

After graduating from Hunter, Baez got a job as a unit clerk at NYU Langone Orthopedic Hospital’s special care unit. In this position, he developed a system that improved the process of how patients received their prescriptions after their discharge. While Baez was obviously doing well in his job, he wanted to do even more.

Baez wanted to be a nurse. His colleagues encouraged him to apply to nursing school, and the senior director of nursing even suggested writing his letter of recommendation.

“I became inspired to become a nurse by working with other nurses at NYU Langone Health. Seeing their work on a day-to-day basis and learning how they care for their patients and how they advocate for them inspired me to become one of them,” says Baez.

Frank Baez

Frank Baez at NYU Langone Orthopedic Hospital

Because Baez already had a degree, he was accepted into the accelerated program at the NYU Rory Meyers College of Nursing. During an intense 15-months, Baez earned a degree in nursing with a 3.5+ GPA. He was inducted into the Sigma Theta Tau International Honor Society of Nursing as well.

During his final semester, Baez took the Critical Care Nursing elective, which gave him the opportunity to spend time in the Cardiac ICU. Now, he’s working on a Master’s degree to become an acute care nurse practitioner. “When I took care of my first heart transplant patient, I was impressed by the efficiency and skills of the nurse I worked with,” says Baez. “I also saw the power of medicine and nursing to tide over the patient in critical illness. I want to be a part of that.”

Baez has advice for anyone thinking of becoming a nurse: “I would advise any aspiring nurses to not let any barriers stand in your way. Most importantly, find mentors and coaches. Emulate their attributes and add grit and determination to achieve your goals,” says Baez. “Being in the right place at the right time is just the beginning—one must seize the possibilities. I did.”

What to Know About the CNE®cl Exam

What to Know About the CNE®cl Exam

As nursing has evolved into an ever-more complex field where science, humanity, pragmatism, and professionalism intersect, the clinical nurse educator has emerged as an essential presence among nurses. Whether they are teaching in the classroom, educating patients and families, or mentoring nurses and nursing students, the nurse educator plays an important role in guiding nurses on the leading edge of rapid and continuous progress in health care education and practice. Naturally, the process of becoming a certified nurse educator requires rigor and commitment. To many, the pinnacle of this process is the oft-dreaded Certified Academic Clinical Nurse Educator (CNE®cl) Examination. What follows is a brief breakdown of the exam itself and tips for success.

The CNE®cl Exam

The CNE®cl exam consists of 150 multiple-choice questions. One hundred and thirty of those questions count toward the test taker’s score; the remaining twenty are unscored or “free” test questions, usually experimental. The test is broken down into six topics, each of which makes up a certain percentage of the exam as follows:

  • Facilitating learning (22%)
  • Facilitating learner development and socialization (14%)
  • Using assessment and evaluation strategies (19%)
  • Participating in curriculum design and evaluation of program outcomes (17%)
  • Pursuing systematic self-evaluation and improvement in the academic nurse educator role (12%)
  • Engaging in scholarship, service, and leadership (15%)

Tips for Successful Studying

As with any credentialing exam, there is an abundance of resources available to test-takers, including apps, videos, classroom preparation, and online self-training. Many schools include test prep as part of the curriculum. The best place to begin the studying process is to speak with an academic advisor to find out if the school includes formal test prep in the curriculum. From there, speak to former students who have taken the exam and find out if they supplemented the classroom material.

Lastly, as the saying goes, know thyself. In choosing a method of study, it’s best to choose the learning techniques that have worked best for you in the past. For audio learners, seek out an audiobook or lecture series. For visual learners, try an app or video study guide. For collaborative learners, seek out a classroom or save money and recruit classmates for a self-guided group study. Many graduate nursing students are also full-time nurses, therefore, time management is key. The greatest preparation tool one can have is the peace of mind that comes with an early start and consistent practice.

The Best and Worst States for Nurses in 2019

The Best and Worst States for Nurses in 2019

This month, many nursing students will be graduating and, soon after, looking for employment. While some may know exactly where they want to work, others might just be ready for a change and want to move across the country.

As a result, it’s good to have information about what states are the best and worst for nurses.

WalletHub came up with their results by comparing all 50 states as well as the District of Columbia “across 21 key metrics that collectively speak to the nursing-job opportunities in each market.”

The top ten best states for nurses are:

  1. Oregon
  2. Minnesota
  3. Washington
  4. New Mexico
  5. Maine
  6. Montana
  7. Arizona
  8. Nevada
  9. New Hampshire
  10. Iowa

The ten worst states for nurses are:

42. Virginia
43. Vermont
44. Ohio
45. Mississippi
46. Alabama
47. Oklahoma
48. Louisiana
49. Hawaii
50. New York
51. District of Columbia

As for some highlights of best versus worst, WalletHub discovered the following:

  • “Oregon has the highest annual mean wage for registered nurses (adjusted for cost of living), $83,867, which is about 1.4 times higher than in Vermont, the lowest at $58,810.
  • Utah has the lowest current competition (number of nurses per 1,000 residents), 8.46, which is 2.4 times lower than in the District of Columbia, the highest at 20.49.
  • Nevada has the lowest future competition (projected number of nurses per 1,000 residents by 2026), 7.47, which is 4.2 times lower than in the District of Columbia, the highest at 31.49.
  • Minnesota has the highest ratio of nurses to hospital beds, 5.03, which is 2.3 times higher than in District of Columbia, the lowest at 2.22.”

The states expected to have the lowest competition in the field by 2026 are: Nevada, Alaska, Arizona, California, and Washington. Those expected to have the highest amount of competition by 2026 are: West Virginia, Nebraska, South Dakota, North Dakota, and the District of Columbia.

WalletHub also asked some experts about the nursing field. When asked for tips for recent nursing grads about where to live and work, William “Bill” J. Duffy, RN, MJ, CNOR, FAAN, Instructor, Director of Health System Management Program, Loyola University, Marcella Niehoff School of Nursing, said, “All nurses need to find a work life balance. The amount of care needs in our society right now can burn a caring nurse out if he/she doesn’t find that balance. So to answer the ‘where to live’ question I would say go somewhere that will make you happy (as you should be able to find a health employer looking for nurses in that area). If you want to move to the big city, there will be jobs. If you want to travel and do assignments in different parts of the country? There will be opportunities. The key is don’t just work anywhere.

Right now, there are options so you should work and live where you have a desire to be. For work, I would look for a place that is willing to invest in developing you and your career. So many organizations are looking to fill staff vacancies, that they are not looking at why nurses are leaving their organization. Nurses are loyal, caring people, but the organization has to respect and care about them as well. Make sure your prospective employer is interested in helping you and [your] career grow.”

Duffy says that recent grads should ask the following questions of their prospective employers:

  • Do they have a tuition forgiveness program?
  • Do they have a tuition reimbursement program for advanced degrees?
  • Does the organization support flexible work schedules to support school requirements?
  • How many nurses have been promoted from within?
  • Does the organization support the use of advanced practice nurses?

When WalletHub asked Janet Rico, MBA, NP-BC, PhD, Assistant Dean, Nursing Graduate Programs School of Nursing – Bouvé College of Health Sciences, Northeastern University, the same question, she responded with, “Seek adventure and challenge. Wherever you practice, you will be challenged, humbled, and incredibly rewarded. Consider less-traditional practice settings such as home care, day programs, and long-term care. You will be able to practice to the top of your license and will grow in your ability to think and act independently and collaboratively.”

To view the full report, click here.