There is a particular kind of silence that happens in your brain when someone asks you a clinical question and you are absolutely certain that whatever comes out of your mouth next will reveal you as a fraud. It isn’t the silence of not knowing the answer. It’s the silence of knowing the answer but not trusting yourself to say it, because surely someone with your background – a small-town nurse from regional Victoria who learned half her skills on the job in a hospital with fewer beds than a London Travelodge – has no business being confident about anything in a place like this.

I experienced that silence roughly four times a day during my first three months at Great Ormond Street Hospital. In handovers. In multidisciplinary team meetings. In conversations with consultants whose research I’d read during my degree. In the corridor, walking past framed photographs of medical achievements that changed paediatric medicine globally. Everywhere I turned, there was evidence that I was surrounded by people who were smarter, more experienced, and more qualified than me – and the conclusion my brain kept drawing was not “I have a lot to learn” but “I do not belong here.”

That feeling has a name, of course. Imposter syndrome. I’d heard the term before I moved to London, in the vague way you hear about things that happen to other people. I did not expect it to move into my head like an uninvited flatmate and refuse to pay rent for the better part of a year.

The Gap Between My CV and My Confidence

On paper, I was perfectly qualified for my role. I had seven years of nursing experience. I’d worked in regional general nursing, emergency departments, and had completed additional certifications along the way. I’d passed every competency assessment the NHS required of me. I had references. I had registration. I had, by any objective measure, earned my place at GOSH.

But imposter syndrome doesn’t care about your CV. It cares about the distance between where you came from and where you are, and it fills that distance with doubt. The gap between Daylesford and Great Ormond Street felt enormous to me – not just geographically but professionally. I’d gone from a hospital where I knew every corridor, every colleague, every quirk of every piece of equipment, to a sprawling specialist centre where I had to ask for directions to the staff room. The competence I’d built over seven years didn’t feel transferable. It felt small.

I remember standing outside the hospital on my third day, looking up at the building, and thinking: they’re going to figure out I’m not good enough. It’s only a matter of time. This thought wasn’t rational. I knew it wasn’t rational. But imposter syndrome is not a rational experience. It’s an emotional one, and emotions don’t respond well to logic.

The Things That Made It Worse

Certain aspects of my situation fed the imposter syndrome in ways I didn’t anticipate. The language barrier – not English itself, obviously, but the professional dialect of NHS nursing – made me feel stupid in moments where I was simply uninformed. When I didn’t recognise an acronym or misunderstood a process, my brain didn’t file it under “new information to learn.” It filed it under “proof you don’t belong.”

The sheer expertise of my colleagues was another trigger. GOSH attracts nurses from all over the world, many of whom have subspecialty experience I couldn’t have gained in a regional Australian hospital if I’d stayed for thirty years. I worked alongside nurses who’d spent a decade exclusively in paediatric cardiac care, in oncology, in neonatal intensive care. Their knowledge was extraordinary, and rather than seeing their expertise as something I could learn from, I saw it as evidence of my own inadequacy.

And then there was the peculiarly British habit of understatement, which I misread constantly. When a senior nurse said, “That was fine,” I heard it as lukewarm at best – a polite way of saying it wasn’t good enough. It took me months to understand that “fine” in British clinical culture often means “genuinely well done,” and that effusive praise simply isn’t the communication style here. In Australia, a colleague might say, “Mate, you smashed it.” In London, “fine” carries the same weight. I just didn’t have the cultural decoder ring yet.

The Moment It Started to Shift

I’d love to tell you there was a single breakthrough – a triumphant clinical save, a speech from a wise mentor, a cinematic turning point. But imposter syndrome doesn’t break. It erodes. And the erosion, for me, happened through a series of small, undramatic moments that gradually accumulated into something that felt like belonging.

One of the earliest was a conversation with a nurse called Priya, who’d been at GOSH for eight years and who I regarded with the kind of quiet awe usually reserved for people who’ve climbed Everest. We were in the staff kitchen during a night shift, and I admitted – cautiously, testing the waters – that I sometimes felt out of my depth. She laughed. Not unkindly, but with genuine recognition. “Donna,” she said, “I felt like that for my entire first year. Everyone does. The ones who don’t worry me more.”

That comment didn’t fix anything immediately. But it planted a seed: maybe the feeling wasn’t a diagnosis of my inadequacy. Maybe it was a normal response to being new in a demanding environment. Maybe everyone standing in this kitchen at two in the morning had stood exactly where I was standing and felt exactly what I was feeling.

Learning to Separate Newness from Incompetence

The most important thing I learned – and it took far too long to learn it – was the difference between being new and being incompetent. These are not the same thing, but imposter syndrome conflates them ruthlessly. Every question I asked, every protocol I had to look up, every moment of hesitation felt like incompetence to me. It wasn’t. It was newness. And newness is temporary in a way that incompetence is not.

I started paying attention to what I actually did well, rather than cataloguing what I didn’t know. I noticed that I was good with frightened parents – that my years of community nursing in Daylesford had given me a warmth and directness that put families at ease. I noticed that my emergency background meant my triage instincts were sharp, even in a paediatric context. I noticed that my willingness to ask questions – the very thing I’d been ashamed of – was something my colleagues actually respected, because it showed I prioritised patient safety over my own ego.

Slowly, painfully slowly, the internal narrative began to shift. Not from “I don’t belong” to “I’m the best nurse here” – that would have been its own kind of delusion – but from “I don’t belong” to “I’m learning, and that’s allowed.”

What I Wish Someone Had Told Me on Day One

If I could go back and sit with the version of myself who stood outside GOSH on day three, convinced she was about to be found out, I’d tell her a few things.

First: everyone feels this way. Not just international nurses, not just people from small towns, not just Australians. Everyone who walks into a high-stakes environment for the first time feels the gap between what they know and what they think they should know. The difference between people who thrive and people who don’t isn’t the absence of that feeling. It’s the willingness to keep showing up despite it.

Second: your background is not a deficit. It is a perspective. The things I learned in Daylesford – the patient-centred communication, the resourcefulness that comes from working with limited resources, the ability to build trust quickly in a small community – these were not inferior skills. They were different skills, and they complemented the clinical rigour of GOSH in ways I couldn’t see until I stopped comparing and started contributing.

Third: ask for help, and do it loudly. The nurses who helped me most during my adjustment were the ones I was honest with. The moment I stopped pretending I was fine and started saying, “I’m struggling with this, can you help me?” was the moment things began to get easier. Vulnerability in a clinical environment isn’t weakness. It’s safety. And every colleague I opened up to responded with generosity I hadn’t expected and probably didn’t deserve.

Belonging Is Not a Destination

A year and a half into my time at GOSH, I can tell you that imposter syndrome hasn’t vanished entirely. It still visits. It showed up last month when I was asked to help precept a new graduate nurse, and my first thought was, “Surely there’s someone more qualified.” There wasn’t, apparently. Or if there was, they picked me anyway, and the graduate nurse did brilliantly, and nobody’s career was ruined by the girl from Daylesford being in charge of orientation.

But the feeling is quieter now. It doesn’t run the show anymore. It sits in the corner of my mind like background noise – present, but no longer in control of the volume.

What replaced it isn’t confidence, exactly. It’s something more like trust. Trust that I can learn what I need to learn. Trust that my colleagues see something in me that my imposter syndrome refuses to acknowledge. Trust that belonging isn’t a credential you earn once and carry forever, but something you build, shift by shift, patient by patient, conversation by conversation.

I’m a nurse from a town of two and a half thousand people, working in one of the most famous children’s hospitals in the world. Some days that still feels surreal. But it no longer feels like a mistake.

It feels like exactly where I’m supposed to be.

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