Volume 38 Number 6 | December 2024

Ali (Nussbaum) Murphy, MHHSA, MLS(ASCP)CM, caPM, ASCLS Director

Ali NussbaumImposter syndrome (IS) is a psychological disorder that impacts an individual’s view of themselves and presents as misplaced lack of self-esteem. Super go-getter perfectionists who struggle with accomplishments or struggle with self-confidence, even though they are highly proficient, are common presentations in healthcare. Observable behavior traits like these, and others, are in the workplace even though these people are fully capable, competent, and able. IS, in the healthcare world, can pose a serious patient safety risk.

Patient safety first is the mantra taught to all healthcare workers. No matter what role, it is every person’s responsibility to speak up about concerns of patient safety. However, IS sufferers doubt their experience, knowledge, and capability, which may result in inaction. That inaction poses a very obvious risk in the healthcare setting.

Laboratories Focus on Patient Safety

In the lab, patient safety is the focus of quality: quality of sample, quality of testing, quality of performers of the test, etc. Dedication to patient safety is in every procedure, with deep care taken with every new test implemented, training given, and with every staff member hired. The amount of oversight for patient safety in the laboratory is on par with any other healthcare division. Even without having direct access to the patients, laboratorians still play an integral role for the care of the patient.

“Imposter syndrome hinders the sufferer’s personal ability to see themselves as an authority for the trained specialty.”

How Healthcare Roles Play into IS

In healthcare it is easy to feel less superior to other professions, because each requires a different level of education. Providers, for example, require many more years of education than the average medical laboratory scientist and far more than phlebotomists. However, there is a key distinction between any profession that is important to remember: each profession has a unique educational path for a reason. To study a profession means to study the intricacies needed to ensure safety for patients during that level of service.

Imposter syndrome hinders the sufferer’s personal ability to see themselves as an authority for the trained specialty. Young laboratorians train in the field, and like any profession, learning is a constant part of the career. The problem is that IS leaves your confidence shaky to the point where you question your own validity, knowledge, and skill set. Scientists have a sixth sense that they trained for—for when something is not quite right. However, misplaced internalized doubt keeps sufferers from speaking up when they sense something isn’t right.

How to Ensure Workplaces Support IS Sufferers

A healthy workplace is beneficial for everyone. You can help build the confidence of IS sufferers by allowing the space for them to get the necessary validation of their skills and allowing mistakes to be a learning opportunity, instead of a shame-filled nightmare. The following four tips can teach everyone how to create a healthy working environment.

  1. Physiological Safety. Establishing high reliable workplace standards with an emphasis on psychological safety is a great place to start. Staff need to feel empowered to ask questions, even if they “should” know the answer. If staff do not feel safe asking questions, they will not ask the important questions that may impact patients. Another common breakdown in physiological safety in the workplace is when someone is unapproachable. When people are uncomfortable speaking up to certain people, especially those in authoritative roles, the risk for patient safety increases. It becomes incredibly important to have open dialog between all staff to ensure effective communication. Promoting healthy, communicative environments will strengthen the confidence of all employees.
  2. Encouragement. Staff who struggle with IS, who do not feel confident in their skills and knowledge, will be at a disadvantage. These individuals will have more questions and will doubt results more than confident staff, which is why a safe environment for all is critical. IS sufferers need reassurance and reminders that they know what they are doing. Having a workplace dedicated to learning and encouraging benefits everyone, not just sufferers. Employees who seem to be struggling more than others deserve support and reassurance in order to develop a high performing team.
  3. Actively Discourage Negative Behavior. Some behaviors can actively discourage and intensify self-esteem problems in staff. All staff members need to uphold the safety work culture. No-tolerance policies for toxic behaviors, like toxic correction, bullying, and gossip, require adoption in all workplaces. Setting a standard of positive teamwork will aid all staff and provide an environment where IS sufferers can rebuild self-confidence. Consider adopting team agreements to discourage and speak up against those portraying negative behaviors in the workplace.
  4. Develop Interdisciplinary Communication across the Healthcare System. Healthcare systems that strive for great interdisciplinary interaction will experience higher attention to patient safety. IS does not vanish when collaborating with other sectors of healthcare, it intensifies. Speaking to other practitioners can be very intimidating and spark doubt in people with shaky confidence. Critical values, courtesy calls, and important calls about topics like blood products or microbiology orders will trigger insecurities in people with IS. By developing strong interdisciplinary communication standards, positive interactions with other healthcare professionals will encourage confidence in all team members.
Patient Safety Is at the Heart of All We Do

IS sufferers often struggle in silence, but their potential impact in healthcare can have serious consequences for patients when self-confidence prevents them from speaking up. This is why building strong healthcare teams is vital for patients. Psychological safety, encouraging staff, actively discouraging behaviors that can destroy self-confidence in others, and developing strong interdisciplinary communication will benefit everyone. It is everyone’s responsibility to ensure patient safety, and by enthusiastically cultivating healthy work environments, patient safety will be improved.

Ali (Nussbaum) Murphy is an LIS Technical Specialist at HealthPartners in Minneapolis, Minnesota.