Impostor Syndrome in Nurses and Teachers: Why These Two Jobs

A nurse with seven years behind her checks a dose she knows by heart, three times. A secondary school teacher her students genuinely like is convinced she will one day be found out. A junior doctor rereads at night a protocol he has applied correctly for eight months. None of the three is incompetent. All three are living something the literature has described since 1978.

The feeling is very widespread in these two professions, and the usual explanations — low confidence, perfectionism, misplaced humility — explain almost nothing. What does explain it are features of the work itself: the nature of error, the way results are assessed, the scarcity of feedback, and the reference point people compare themselves to.

Let us be clear straight away, because this is regularly misunderstood: impostor syndrome appears in no medical classification. It is neither an illness nor a diagnosis. It is a subjective experience, described by Pauline Clance and Suzanne Imes in 1978, in objectively high-performing people who attributed their achievements to anything other than themselves.

In the article that follows, I explore self-doubt about legitimacy in caring and teaching roles. If you recognise yourself in this theme, the tests on the platform help you take stock.

A mistake that doesn't stay at the desk

In most jobs, a mistake costs time, money or credibility. In healthcare and teaching, it lands on a person: a patient, a pupil. That asymmetry changes the entire relationship to doubt.

Elsewhere, doubting yourself is uncomfortable. Here, doubting yourself reads as a moral precaution. "I'm not sure I'm up to it" is not experienced as a weakness to correct but as proof that you take the work seriously. Doubt is therefore rewarded by the professional culture itself, which makes it far harder to question.

The problem isn't vigilance — that is necessary. The problem is that vigilance eventually merges into a stable conviction: if I doubt this much, maybe I really don't belong here. The reasoning has been turned around.

An outcome that is diffuse, delayed and never attributable

A developer sees the code run. A salesperson sees the signature. A nurse and a teacher work on long trajectories, where the outcome depends on dozens of factors they control only in part.

A pupil improves: is that the lessons, maturation, the family, another teacher? A patient stabilises: is that the treatment, the follow-up, time, the night team? This impossibility of attribution is not an organisational flaw; it is the nature of these jobs.

It has one direct consequence: there is almost no individual evidence of competence. Bandura, working on self-efficacy, showed that the sturdiest source of believing you can do something is mastery experience — having done it and seen that it worked. When the link between action and result is structurally unreadable, that source is largely cut off.

Positive feedback is rare, negative feedback is instant

Nobody flags what goes right. A family doesn't send thanks for an uneventful shift. A lesson that goes well produces no message at all. Feedback arrives when there is a problem: a complaint, an incident report, an unhappy parent, a handover that went badly.

The imbalance is therefore structural. Across a year, a professional accumulates dozens of isolated negative signals and almost no explicit positive ones. Memory does not even things out: it keeps whatever frightened you.

What is described here says nothing about the quality of the work. It is a feature of the information flow, not an assessment. But experienced from the inside, with no other reference point, it looks exactly like a verdict.

Comparing yourself to a role, not to colleagues

This may be the mechanism most specific to these two jobs.

In most professions you compare yourself to real colleagues, whose limits are visible. In healthcare and teaching, the reference is not a person: it is the good nurse, the good teacher. An ideal figure, never precisely described, who never tires, never gets irritated, never loses patience, keeps the right distance and always finds the right words.

Nobody matches that figure. But because it is never stated out loud, it is never contested — you simply notice you fall short. Hewitt and Flett described this well under socially prescribed perfectionism: the sense that others expect something unreachable of you, without that expectation ever having been voiced by anyone.

The gap, then, isn't between you and your colleagues. It is between you and an image whose origin has never been checked.

The continuing-training paradox

We assume that training raises your sense of competence. In these professions the effect is often the reverse, at least at first.

Every course opens a field you didn't know existed. You leave with a sharp awareness of everything you weren't handling, and that awareness is immediate, while the new skill will take months to show. You measure your ignorance before you measure your gain.

The effect is well known, and it is the exact counterpart of what Dunning and Kruger describe at the other end: the more competent you are, the better you perceive complexity, and the wider the gap with the ideal appears. The distinction between those two readings deserves to be set out clearly.

What attribution does to your successes

Attribution theory, developed by Bernard Weiner, describes how we explain what happens to us: by an internal or external cause, stable or temporary, controllable or not.

The typical pattern of legitimacy doubt is remarkably regular:

Success is explained by the external and the temporary; failure by the internal and the permanent. None of these lines of reasoning is absurd on its own. It is their systematic quality that is the problem: nothing that goes well can ever be credited to your account.

What an outside, dated source can do

This is why thinking harder doesn't work. When attribution is biased, introspection recycles the same materials: the person doing the assessing and the person being assessed are the same, with the same filters.

What actually shifts a conviction of illegitimacy is an outside, dated trace you did not produce yourself. That is the second purpose of ScanMyJob: the record highlights what contradicts the person's reading as much as what confirms it. In real professional correspondence, that takes very concrete forms — the difficult situations get handed to you, you get called in as backup, a senior colleague reuses your wording in a handover, someone redirects a complicated family your way.

Those elements exist, they are dated, and they are never counted. The gallery of examples shows what four real records of facts look like, including when they contradict the person who asked for them.

If the feeling has less to do with your reading than with a ward or a school where criteria shift and feedback is always negative, that is a different question, and it is dealt with separately.

What this article does not do

It makes no diagnosis — there is none to make, impostor syndrome is not one and appears in no classification. Nor does it tell you whether you are competent: nobody can do that from a text.

It gives no clinical or teaching advice. What is described here concerns the experience of the work, not the practice itself.

And it does not replace professional advice. If this doubt comes with disrupted sleep, dread before every shift or settled exhaustion, that is an occupational health matter, and where such services exist they can usually be contacted directly, without going through your line manager.