Imposter Syndrome in Nursing: When You Don't Practice What You Preach

Katrin Moskowitz, DNP, FNP, PMHNP - 08/21/19

As nurses, one of the fundamentals of our education is patient education and empowering patients to change their lifestyles and habits in order to improve their overall health. We learn about the importance of primary, secondary and tertiary prevention. Our empathy and compassion allows us to sit down with them and allow them to understand the pathologies that are affecting them and how it may impact their future lives. Although we try not to lecture our patients, nurses often spend a great deal of time having compassionate conversations about these topics.

What if

What happens if you are morbidly obese and are educating a patient regarding weight loss and healthy eating? What if you, a smoker, are trying to inform a patient regarding the harm of their lifestyle choices? What if a patient responds with “Who are you to tell me what I should do, when you are not taking your own advice”? Obviously these situations can lead to awkward silence, patient resistance and possible non compliance.


            Before I went back to Nurse Practitioner school, I was the poster person of fitness. I went to crossfit 5 days a week, ate a strict Paleo diet, ran a marathon three years in a row and felt the best I could have physically. Once I had to balance working nights as an ER nurse while trying to finish clinicals, exercise took a backseat, carbs reentered my life and the pounds began returning. Something happened during this time in primary care clinicals: I began feeling like an imposter, a phony. How could I encourage my patients to exercise daily and eat healthy when I myself considered couch surfing a sport and convenience foods a staple. I grappled with this guilt for quite some time and honestly up until this day.

Changing the script

            In order to continue to be an effective nurse, provider and person, I learned that I needed to change my script. I started to be openly empathetic to my patients struggles in their quest  to implement lifestyle changes. My conversations about exercise and eating healthy now  are followed by “and I know how hard those things can be to try and fit into your life”. I meet the patient where they are at. We often discuss what goals they have for themselves and how they see themselves attaining them. Change starts with small steps. Nurses want to instantly cure those before us, but we have to see our patients as a giant puzzle that needs to be completed over time. Todays goal may be taking a 10 minute walk a few times a week, eating a portion of vegetables a day, or decreasing soda intake by a glass a day. Every little step is a small puzzle piece that goes into the finished product of a patients health. Overall this is a simple concept but in the long run it will allow for patient relationship building and future excitement then they are able to share their successes with you in follow up.