The previous articles in this series have examined the variety of stresses that impinge on us as nurses, threatening our willingness and ability at times to continue in our chosen career. Too many nurses have left the profession because of overwork, continual staff shortages, inability to focus on patient care, poor working relationships and inflexible shift patterns. The majority of the stressors identified so far in this series are external to the individual nurse. There is one additional important factor that can threaten our survival as a nurse; that is the internal stress factor of our own self-doubt and our lack of confidence in our own abilities.
Over the last 10 years I must have taught hundreds of qualified nurses undertaking a part-time masters degree in advanced practice or independent prescribing; some of the most senior and skilled clinical nurses in the health authority. They were all hard working, committed to their clinical speciality, knowledgeable and keen to learn; but only a few were full of self-confidence. This was reflected not just in how they viewed their ability to write academic essays, but more importantly in their inner belief to be leaders in the future development of clinical practice. Take a few minutes to reflect on how you view your own self-belief:
I'm fairly sure that all those reading this will have scored highly on their self-belief in terms of their clinical abilities, we are generally very good at what we do clinically. However, once we begin to explore our leadership, management, assertiveness and confrontational skills our self-belief begins to diminish. This is not true for all nurses; I've worked for and with some nurses at all levels in the management of the organisation who have great self-belief and somehow manage to infect that belief to others who work with them. Sadly, however, they are the exception and many of us feel unable to put ourselves forward for promotion or clinical leadership or professional development, because we do not have that inner belief or strength.
As I write this article we are dealing with the COVID-19 pandemic; and in this national and international emergency we are seeing many staff who would not normally have the motivation or inner belief to venture beyond their normal routines, stepping up in terms of confidence, leadership, new ways of working and inspiring others. Many staff are discovering inner strengths that they have not used before, abilities that they probably suspected they had, but had not the courage to bring to the surface.
Survival as a nurse centres on inner belief; belief in your clinical skills, belief in your clinical relationship skills with patients and other professionals, belief in your ability to initiate change if needed and belief in yourself. Our self-belief may have been damaged in our childhood and adolescence by our schooling, our families or early relationships and we may have entered our nursing careers in this way; but confidence grows through competence. As our competence increases so does our confidence, and as our confidence increases so does our self-belief. As a nurse our confidence grows through feedback from patients and colleagues; when we realise that we have made a difference to a patient's life, or peaceful death, we realise how important our role is. If a colleague complements us on the way we handled a difficult situation it helps build our confidence. When we move out of our comfort zone as in this COVID-19 pandemic, we realise that we have inner abilities and strengths and our confidence grows.
Many people who leave college to enter the nursing profession do not seem to be the people that are naturally full of confidence and self-belief; their abilities are caring, putting others first and servitude, and these are qualities that form the character of caring and empathetic nurses. But as we enter into the nursing profession and develop our various skills abilities and academic understanding of evidence-based practice, we must let that competence feed our confidence and let our confidence build our self-belief and kick out some of those false self-doubts that might have influenced our lives in the past.
Take a final few minutes before you move on to another article to reflect on your skills, your strengths and your abilities. Be honest with yourself, this is not a time for false modesty. Reflect on how you have responded to the COVID-19 pandemic, both personally and as a nurse. Identify your strengths; think clinically, think clinical relationships, think work ethic. Acknowledge your weaknesses, but build on your strengths exploring ways to develop your weaknesses. Most importantly, believe in yourself as a person and as a nurse.