#855: Overcoming Imposter Syndrome And Accessing Mental Health Support

Dear Cap,

I recently graduated as a Physical Therapist Assistant (PTA). The entire time I was in school I always felt that I didn’t deserve the grades I got, that I wasn’t trying hard enough, and didn’t know enough. But I kept passing with some As but mostly Bs (a failing grade in this program is anything less than a 75). I had 3 clinicals in 3 different settings for a total of 17 weeks and got high marks in all of them.

I got my first job in a nursing home, which was my favorite setting out of all my clinics. I apparently made such a good impression on the rehab director that she cancelled her other interviews and offered me the position 45 minutes after my interview. On my first day I trained with a seasoned PTA. This PTA’s caseload had some of the most difficult patients I’d ever seen; people that couldn’t follow directions and resisted me during the treatment. By lunchtime I was in tears because I felt like I didn’t know what I was doing and that I was doing a bad job. I tried to quit but the rehab director encouraged me to go home and think about it. I came back the next day and asked to not go around with that PTA, to be given a small caseload of simple patients and to go out on my own. I had a good day and was told I did well. That was a Friday. By Sunday night I was having a panic attack (I have a long history of anxiety/depression which had been well controlled with medication for many years). I woke up Monday, had a panic attack and quit.
Now I have zero confidence in myself and I don’t know how I can take another job if this is how I handled my first one. The entire time I felt like I didn’t know what I was doing and I was bad at the job. Choosing another career is not an option. I don’t know how to become more confident or at least fake it until I make it. The only advice I’ve gotten is “go see a therapist”, but I have no job or income. How can I be successful in this career when I don’t believe in myself?

(Pronouns: she/her)

Dear Zero,

On your No Good Very Bad Day, you showed up. You may not have been the world’s greatest & most experienced Physical Therapist Assistant (PTA) because it was your first day on a difficult job, but you were the PTA those patients had and you did the job as best you could. And then, the next day, you asked for what you needed to learn and you got it, and you did better than fine because you were working at a pace that you could handle. Your employer and their patients were happy and lucky to have you and they recognized that you needed an adjusted case load to help with the learning curve. You absolutely deserved that consideration and those adjustments. You are a beginner, not a failure.

You are a beginner, not a failure. Could you be kind and gentle to yourself? Could you give yourself a break for needing an adjustment period between a school setting and a clinical setting? Could you give yourself a break for being a person with some anxiety and depression who had those things exacerbated when you took on something difficult and new? Could you give yourself a break for having a panic attack and for doing the best you could to protect yourself in the aftermath of it?

The people who are recommending that you talk to a therapist are doing so because your antagonist here is You/Your Brain. Not grades (you’re fine), not the profession itself (you’re fine), not the patients or coworkers (you did fine, especially when you asked for what you needed), not the Platonic ideal of what a perfect person or PTA would do (once again, you’re just fine). Where you are not fine is in the uncomfortable and scary feelings you are having, and in the black and white thinking you’re falling prey to (“I must be perfect or else I HAVE FAILED.”) So the logic of a therapy recommendation is, can you treat the anxiety and have a safe place to siphon off some of the panicky feelings you’re having so that you can function in your day-to-day work? And can you revisit some of the strategies that worked for you when you treated your issues in the past (maybe medication adjustment, maybe some strategies of recognizing cognitive distortions and calming your thoughts when you get overwhelmed)? Maybe there is a larger question to be talked over, like what attracts you to this career, what to expect in the beginning, and what specific kind of employment situation would be best for you. A therapist (aka a fellow traveler in the Helping Professions) might be a really good person to talk that all over with.

It can be very hard to access mental health care when you’re stretched thin, but there are some resources out there. See these posts on locating low-cost and no-cost mental health care, and on green flags for a good therapist. Since we published those posts, a whole bunch of online therapy resources have sprung up, like, 7 Cups of Tea. The National Alliance on Mental Illness (NAMI) has a free helpline and a ton of programming. They are experimenting with an app that offers instant peer-to-peer support. Here’s a massive list of online support groups. Maybe one is right for you.

One of the awesome Twitter people I follow made this useful worksheet for organizing yourself to find a therapist. I thought that BuzzFeed had some excellent writing about mental health last year – see this piece on how to get some of the benefits of therapy even when you don’t have a therapist, ways to make yourself feel better when you feel alone,  and this piece on mental health care and race. Ijeoma Oluo is writing some beautiful stuff at The Establishment. I think this NYT op ed about how therapists need to acknowledge political realities is right on. The mental health system has many holes in it and it is not the safety net that it should be for everyone, but you absolutely deserve care, so I hope you won’t talk yourself out of receiving it.

If finding mental health services is totally out of the question right now, could you re-connect with a mentor or teacher from school, the career office there, and some of your classmates? Maybe that network can help you find the right job fit for you, and help you readjust what you can expect at the beginning. Maybe your story of panicking can help someone else know what to expect on their first day.

Whatever you decide to do, you are not alone.

You are not the only one to have a surprising and terrible adjustment period to a new job.

You are not the only one to say “Wait a minute, this doesn’t match what I know from school! How can I tell what is normal?”

You are not the only one to quit something that didn’t feel right for them!

You are not the only one who second-guesses themselves or feel like they are faking it in front of others.

You are not the only one to have a false start (or several!) who has to bounce back.

You may have burned your bridge with that employer, but if you called them and said “I am so sorry, I overreacted. Can I come back with (this adjusted schedule/workload)?” they might take you on. If they don’t (or you don’t want to) that’s okay – don’t even put that job on your resume. The interview skills and resume that made them want to hire you immediately will make you attractive to other employers, maybe ones that are better staffed and have better training/on-boarding procedures for new hires.

In the end, it’s going to be you and the patients in front of you and the work you were trained to do, one patient at a time, one appointment at a time, one day at a time. I hope you can find a way to give yourself permission to be there for them and for that work. Let yourself be a beginner. Give yourself permission to learn as you go. Give yourself permission to have bad days and to not know what you’re doing. Give yourself permission to lean on mental health care when you need to. Give yourself every kindness that you would give to a patient or a friend. Remind yourself that you are a beginner, not a failure, and it’s okay not to know everything yet.






161 thoughts on “#855: Overcoming Imposter Syndrome And Accessing Mental Health Support

  1. Absolutely. I think this happens to new grads in pretty much every field. Because what they teach you in school (where you excelled and got great grades) is often very different from what goes on in a real life job situation. It is so normal to have that “wait, I thought I was great but now I’m not so sure” feeling. I’m 11 years out of graduating with my accounting degree and I STILL question myself and double check things with my superiors. It is totally normal.

    But, yes, if your feelings are seeming extreme, please look for therapy. In the beginning of your letter you sounded so upbeat and enthusiastic about entering your field. Don’t give up on that!

  2. I sooooooo feel for you LW. I don’t know if you’ll find this helpful, but I’ve never had a first day of work where I didn’t end up in tears at some point. Starting a new job is just very, very stressful on top of everything else you’re dealing with. I usually end up finding somewhere quiet (bathroom, outside) to cry for a moment, then pull myself back together and continue on. My current job, which is my first permanent position where I’m not a temp, I cried every day of my first week. It sucks, but it happens even when you’re not told you have to be the PTA for someone with a particularly difficult caseload (talk about sink or swim… I’m side eyeing the nursing home big time for putting that on you on your first day).

    I’ve since learned that you really have to give it at least 2 weeks – 1 one month before you know whether you can handle a position* – and even longer before you know whether or not you like the position. I am notorious for being really hard on myself and thinking that I should know everything immediately, when in reality every single person walks into a new job not knowing at least something about that job. CA was exactly right when she said you are a beginner. I know you want to be perfect, because I want to be perfect, but that’s not how it works… I have to tell myself all the time that mistakes happen and that I am just learning… and try to make myself believe it if I’m told I’m doing a good job.

    *Exceptions exist, of course; I knew within half a shift that working at McDonalds was Not For Me no matter how much my parents pressured me to go try to go back. I’ve never regretted quitting after 3 days there and I never will.

    1. Right! It takes time to adjust. Like, your first day, you don’t even know where the safe/good bathroom is. You don’t know who is cool to talk to. You don’t know the etiquette about where/how to eat lunch. Of course your system is exhausted from all the new stimuli!

      LW, is there any way you could give yourself a “I will stay for at least 1 month even if things seem to suck the first week” rule going forward? After a month, if you want to leave, at least it’s an educated decision.

      1. I made up my mind years ago that I was just going to expect that the first month at any new job was going to suck. Nothing to do with the jobs, nothing to do with people I might be working with, nothing to do with how well I could deal with the job in the long run. But the first month was going to suck, and only then was I allowed to make decisions about whether I liked the job and wanted to stay. I am not necessarily recommending this! A month can be a long time. But it helped me to have a set period of time where ‘this sucks and I hate it’ was separate from ‘do I come back tomorrow’. Sometimes, the end of the month meant that finally I could quit! And sometimes it meant that I had learned enough that I wanted to stay.

        Also, therapy is a really good idea in learning coping mechanisms. I’m sorry it’s hard for you to get access to that right now, and I hope you figure something out. Jedi hugs if you want them.

        1. A month actually sounds about right to me. (Barring a situation of abuse or something, where there’s no need to hang around that long.) Even if you are 100% fully experienced and on top of your game, chances are good you’ll feel kind of lost that first month. You don’t know the people you’re working with yet, they don’t know you, you don’t know the office norms/culture/dynamics, you probably need to ask for help with things like “okay, which network printer do I use?” a lot, you don’t know the specific workflows and tools at play, etc. The first month is generally not at all representative of how you’ll feel about the job in the long term. At my workplace, we expect new employees to be a bit wobbly for the first month, to need help for the first three months, and to take at least six months to be fully settled in and at full capacity, simply because the amount of technical knowledge you have to absorb is pretty high.

          1. “Even if you are 100% fully experienced and on top of your game, chances are good you’ll feel kind of lost that first month.”

            Didn’t think my experiences would help here, but huh: I’ve done v. low-level mentoring / talks for children transitioning from Primary to Secondary school, ie going up to ‘big’ school at age 11/12. One of the first things I tell them is: prepare to feel small. For a year they’ve been the oldest in the school, the top class, the ones who know more than anyone else and probably the physically biggest, and then all at once they’re dropped in a new place where none of that is true. They have to start all over again from point 0 as the youngest, the smallest, the least-taught. For some kids the change is earth-shattering.

            Any time anyone starts a job in a new field, or enters work as a new grad, no matter how brilliant they were at school or how awesome they were in their last field, now they are suddenly – purely by definition of being the last person in – the noob.

            I absolutely concur with the ‘give it a month’ idea; the only way you’re not going to be the new-starter who feels like they know nothing is by sticking around long enough to become the old starter who’s learnt stuff.

          2. A month is a good barometer. We moved offices last year to a much nicer place within a mile of the old place and no job losses or other negative consequences AT ALL, and we were all still super stressed out and upset for a couple of weeks. I cried on that first day even though I’ve been with the company for a couple of years and loved everything about the new building, and I know I’m not the only one. Being new is hard, and the stressors involved in that aren’t permanent or reflective of the difficulties of the job.

        2. Thanks, this way of thinking is so helpful to me! Adjusting to a new job is really hard for me, and I usually go through a majorly destructive bad patch where I a) completely freak out at the new environment and b) blame myself for freaking out and for taking the job. I never thought to attribute my emotional response to the transition, rather than to the job or to myself. I’m currently looking to switch jobs, so I hope I can take on your mindset and use it to get through the next rough patch 🙂

      2. And set up some support in advance for that month, if you can. Make an appointment with a mental health care person towards the end of the first week – when things get tough, you can say “Okay, I’m going to keep at it until my appointment and then I’ll have someone to help me with my brain stuff!”

        Have a sympathetic friend or family member on standby – ideally, one who will say “That sounds really tough!” and “Wow, that sounds tricky but I think you handled it well”, rather than “Um, well, maybe this isn’t for you if you don’t love it 100% straight away”.

        Sometimes I plan things early-evening for Friday nights, that I can attend on autopilot and then actually enjoy. This gives me distance from the STRESS and DOUBT of the week that was, and chills me out so I don’t spend all weekend stewing. So set up some things to help you unwind, or distract you for a while.

        Lastly, if you have a lecturer or prof at your university that you liked, consider contacting them. I don’t know if you’ve noticed this yet, but you were a great student. And universities want success for as many students as possible (even shitty students, like me). Some programs have mentoring projects where they’ll put you in touch with a professional in the field to help you navigate stuff.

    2. I can’t agree with this hard enough. Every new job I’ve started* there’s been a several week-to-a-month-and-a-half period where I just feel like I am the worst. Like, there will never be a person that is less competent, less useful, more of a fake–we’re talking sobbing, panic attacks, throwing up before work, the works. (I have an anxiety disorder and depression also, which doesn’t help and amplifies it somewhat, but it’s still pretty universal with everyone I’ve ever met.) Clinic has some important differences from the job, as it turns out, and there’s a fairly serious adjustment curve–same goes for going from one job to another, because they all do stuff differently (why?!) and it throws you off your game. It’s going to feel like it’s too high to climb over–it’s not. It just feels that way until one day it doesn’t. Everybody** else there felt the same way, I guarantee you.

      I guess the point is that you’re going to be okay. Find a job, get in there, cry a LOT and panic some (maybe lots), and pretty soon you won’t 100% remember what you were worried about because now you know what you’re doing in that environment and it’s all semiautomatic. Rinse and repeat for every job thereafter.

      *except the one I quit after less than a week when it became apparent that it was Ombudsman time
      **there’s always that one person who has some special advantage, but we ignore them because they’re the edge case and most people working there aren’t them

      1. Yeah. I’ve found that it’s usually taken me 3-6 weeks to feel like I know what I’m doing (and even then, I still have to ask a lot of questions. That’s normal).

        The exception has been my current job, which is in the same broad field as LW’s but very different. After 9 months, I still felt new, lost and frankly stupid. So I talked to my manager and he told me it was totally normal in this job and it took him over a year to settle in himself.

        The important thing I learned was that you might not be able to set a time limit on yourself to settle in, but you can give yourself a set period in which you can decide whether you like the job, and you absolutely should be discussing with your boss as you go how you are finding things. Because they hired you for a reason, and even if you are kind of slow settling in then that usually reflects more on your boss/colleagues who are supposed to be training you, and it is in their interests to help you.

        1. Seconding AmberXbi – how long it takes really depends on the job. In mine (largely handling finances for big research projects) I’ve never felt like I know properly what I’m doing until a year in, when our sept restructured and our roles widened out it was the same again : a year of feeling a bit thick and needy and then all of a sudden it Clicks into Knowledge and autonomy.

          That’s not to say that you need a full year to know if it’s right for you of course- after a few weeks you should feel relatively settled with your team and feel comfortable talking to your manager if it’s a decent fit I think. And if you feel like ha are tricky but you feel like you know at least where to look for support with the answers that’s great too. But imposter syndrome is so common LW, I think your jerkbrain just ran away with itself when you were put in a situation your manager shouldn’t have really allowed to put you in when you’re new and inexperienced, don’t blame yourself for that – you sound very capable and professionally likeable, you’ll be able to pick yourself up and stand tall from this. Best of luck!

          1. Yeah – I think it takes a full ‘cycle’ of that work to start to feel completely like you’re on top of things. My first year in my professonal job just felt like a continuous stream of ‘oh shit’ moments as I encountered things that I didn’t know how to do or simply didn’t realise I was going to have to do. Once that year was over I had more of a sense of what to expect when and it was all much more manageable. Since then when I’ve spoken to other new colleagues I’ve always shared that experience (I sometimes refer to it as being repeatedly slapped in the face…) and several people have said to me how helpful they found it to know that was normal.

            Now I’m in the situation of moving into new roles within the same job, and every time I spend the first year getting tripped up by things, but I don’t find it as stressful because I know that’s normal and not a sign that I just can’t do it.

          2. @Zooey Glass since we’re out of nesting.

            Absolutely! Where I work, there’s a rule in place that if you can’t figure it out – whatever “it” is, you get 15 minutes to puzzle on it, and then you need to go ask for help. I thought I wouldn’t need that after I finished my first project and wasn’t a “beginner” anymore. Nope! Every new project has its own quirks and weirdnesses that need someone who’s been in the thick of it to explain it to you, or at least offer a new perspective. I still hate feeling adrift, but at least now I know it’s pretty normal.

      2. Ehh…
        Something can be common and normal without being universal. No, not *everybody* feels this way, and pretending that they do isn’t going to help anyone.
        The advice in this thread still applies even if, at a given workplace, it looks like you’re the only one having the experience under discussion. It doesn’t mean your peers are hiding something and it definitely doesn’t mean you need to conceal your experiences or act like something isn’t happening. It may just mean your peers aren’t experiencing newbieness the same way.

        If LW or anyone else reading this is thinking “Well I’VE had this happen but my peers hired at the same time don’t experience it”, it’s OK.
        Some people handle adjustments differently for whatever reasons and that doesn’t make ANYONE not normal or not OK.

        1. Yes! Something just clicked for me reading this comment! For me, being new somewhere is a difficult SOCIAL transition, though given the choices I’ve made (so far) it has rarely been a jarring academic or work performance transition. (Navigating the path AFTER getting started is really rough for me, maybe because I’ve lagged on the social parts and don’t develop sounding boards/mentors.)

          Anyway, being new certainly is a different experience for everyone, and it’s comforting to hear about some of these common responses the Awkward Army is bringing up. Knowing is half the battle!

    3. LW here: I’m an easy crier so it’s helpful to know there are other people out there that have cried at work!

      1. You are definitely not the only one! I’m *not* an easy crier and I’ve totally cried at work. Work is so stressful. It’s how we secure our livelihood, financial security, and in many parts of the world, it’s strongly tied to identity (even in names! “Baker” “Sawyer” “Cooper”, etc.). There’s a lot of pressure on at work. I feel like it’s totally normal to have cried at work.

        1. Every co-worker friend I’ve ever had, and myself have cried at work at some point. I’m in health care too, it’s rough!

          I worry more about the new staff that never doubt themselves than those who do. The best workers are those who always feel they have more to learn. I’m considered an expert in my field and honestly there are still times I feel overwhelmed and doubt my abilities. That’s what inspires me to improve.

          Maybe that wasn’t the exact patient population you were expecting and there may be a better fit for you. Health care is like that. I’m really confident that you’ll find a job that works great for you, if it’s not this one.

          1. “The best workers are those who always feel they have more to learn.”

            YES THIS. I have been out in the workforce for a while, and I have held many different jobs, and something that I consistently get ranked well is that I am willing to ask for and take feedback and criticism. Being willing to ask questions, and learning how to hear constructive critiques of your performance with grace (seeing it as an opportunity to be EVEN MORE KICKASS rather than A TERRIBLE EMPLOYEE) is something that healthy office cultures prize highly in their employees.

            And I say this as someone with loads of anxiety who faces criticism quaking in her boots internally. It is okay to feel scared of the criticism, as long as you also know that it is happening from a place where they love you and want you to grow.

        2. Thiiiiis! I’m not an easy crier either, and I’ve cried at work and because of work (I even have a code for my personal time tracking that means “crying or otherwise not able to work because I’m freaking out”). Work can be so so so stressful, and it doesn’t seem to matter that much for me what it is. I’ve hid in the bathroom and cried during jobs ranging from TA at a summer school to full-time technical writer.

          Huge Jedi hugs for work crying and adjusting to new jobs, for anybody that wants them. I’m currently jobhunting and am going to bookmark this for when I do get a gig so I can come read it again.

      2. Oh, me too!

        The great Barbara Ehrenreich, in her book Nickel and Dimed, put it best: there is no such thing as unskilled labor. It takes time and training to master ANY job, no matter how “easy” or “boring” or “lame” it looks. Just learning how to parcel your energy through the day so you don’t snap midafternoon is a matter of experience.

        I take pizza orders for a living, and train the new CSRs. We take a week to train people and not one of them hasn’t panicked when their first “live” call comes up. It’s inherent in learning a new skill, not a character flaw.

        1. I get the most phenomenal stage fright every time going on any kind of live, customer-facing thing. No matter what that thing is.

          The thing that has helped me a lot is recognizing it as stage fright: it doesn’t make my body chemistry much less panicked, but it helps me contextualize the feeling and know that it goes away after I establish to myself that I do know what I’m doing, and encounter some of the real things that I can screw up and surviving them.

      3. When I started my current job, which is extremely complex, mentally demanding and involves a very high level of responsibility and a lot of very hard decisions, I cried nearly every day. We work from home and there was literally nobody to show me the ropes. My team were all very nice and kept saying “just give one of us a call if you want help” but I have a phobia of making phone calls and never knew which one to call and they always sounded harassed and rushed when I did call. It’s been three years and I still feel lost sometimes (although it’s sort of only two years because I have been on maternity leave for almost a year).

      4. I cry so often at work that sometimes I don’t even bother going to the washroom or dry storage or wherever to do it and just keep working while quietly crying. I’m also a veteran of the public transport cry. Some people cry in their cars but like, I don’t have one of those and I have things to do. Try and hold it in when you can ofc, but if you can’t, well, you’re not alone.

      5. You are not the only one who has cried at work.

        Fist bump of solidarity from another easy crier.

        1. High fives to both of you! I’ve cried in every office I’ve worked, some of them almost once a month. Like clockwork. And every one of my appraisals until the last two. Even when I’m told I’ve done a good job, or being given an award. Office crier- that’s my identity. For a long time I felt awful about it for days after each episode, but then I was lucky enough to get a manager who confessed that she cried too. She’s my best manager ever, and if she could cry, nothing wrong in me doing it too!! So now I let myself cry, wipe my tears, and get on with my work. It’s nice to know I’m not alone. :))

  3. Oh, LW, I’m so sorry.

    One of the things that I learned when I started professional work was that often your mentors will be doing things that make you go, “I can’t imagine handling all that myself.” When I started work as a technical writer, I was doing relatively small/straightforward projects with a lot of assistance, but I was being mentored by someone who did huge complex projects requiring a lot of technical know-how, and doing them more or less independently (she got them reviewed at the end, but she flew solo for the drafting process). It would have been very easy for me to go, “oh my god, I cannot imagine writing that whole manual all by myself, I must suck at this.”

    But the thing is, she didn’t start out writing an entire API reference all by herself. She started out doing what I was doing–small projects that I could attack in one ‘bite.’ And she worked up to more complex projects, and more technical topics, and so on, over the course of years. And now I’m doing the same thing myself–after a process of getting comfortable with it.

    Part of the thing, I think, is that in school, the things we have modeled for us are generally things we’re expected to do right now. The teacher shows us a problem and how to do it, and then we’re expected to be able to do that problem. We’re taught how to write such-and-such a type of essay, and then we’re expected to do it. And our fellow students are, at least in theory, at the same ‘level’ as us.

    But when you’re working, the people who are mentoring you may be several ‘steps’ ahead of you, doing things that you can’t do yet. That’s fine. You shouldn’t think of your mentors as being like teachers, where they’re showing things that you are expected to do right now, on your own. They’re modeling where you might be in your career two or five or ten or twenty years down the line. Maybe right now you start on ‘easy’ cases and work up. Maybe you do mostly ‘easy’ cases but have one ‘challenging’ case as a stretch goal, and gradually increase it. That’s totally normal! In a healthy workplace, that’s how it’s supposed to be. It doesn’t mean you’re doing badly. It means that your role models are seasoned experts–which is wonderful for you, but nobody expects you to be a seasoned expert yet.

    So go a little easier on yourself. Being new at your career is just… being new at your career. You aren’t expected to somehow magically know as much as someone with a decade or more of experience. You’re just expected to start learning.

    1. This is such a good perspective. You start small when you start anything, and you work up to bigger things. It’s like learning a musical instrument–you begin on simple scales and maybe Hot Cross Buns or something. Single notes at a time. Slow, predictable. And as you get better, you increase the difficulty.

      LW, if I may, I think it would be good for you to seek out employers that offer mentorship opportunities. Or, even if your office/place of work doesn’t have a program for it, to ask for one. It’s okay to need your hand held for a while in a new field–pretty much everyone does! (and often people who insist they DON’T need help from more experience colleagues… are the people who need it the most.)

    2. Yes this! 100% i work in an analytical field as a manager, and all I expect from my new employees for like, the first 3 months, is to learn. That’s it. In fact, that is what I prefer they focus their energies on doing, all the time. I want them to be constantly focused on learning and improving and finding new information and better ways to be better at their jobs so we can make the whole department better.

      And that’s true of people who’ve been here for 5 years, and people who have only been working for 5 months. I expect them to be learning to get better at the things they aren’t good at. That’s all. As long as I can see that they are trying, and that they are building on the skills and knowledge they came in with, I am happy. (Also, you know, following instructions)

      1. Yes, exactly! Even now, when I’ve been working in the field for ten years, I have my ‘stretch goals,’ things that I want to learn to do. New technical topics I’m not yet comfortable with, new ways of presenting information, etc. Having topics where you go, “Wow, I don’t know how to do that yet” doesn’t mean you’ve failed, it just means you have more room to grow in your career.

      2. shinobi42: LW here! Thank you for posting from a manager’s perspective. Hearing that really helps. I’m going to keep this in mind whenever I start a new job!

    3. Oh my word, yes.
      Listening to my boss talking about the projects we are running, and how confident she is and all that is INCREDIBLY confronting for me as the newbie who has never done work like this before. I have to keep reminding myself that she has done this for years, and there is a reason she is paid 3x what I’m on.
      Some days, I sit there and think I will be stuck doing what I’m doing now forever – I cant see my way to being that person.
      Some days, thats ok with me. Some days, its terrifying – what was the point spending all that time going back to uni and studying to get a job I might have got anyway?
      And then other days I make relevant points in technical conversations, and I feel like maybe there is hope for me yet.

  4. Solidarity, LW! I just went through a panic-attack-filled new job start, too. Jedi hugs for all of us who Hate Hate Hate being beginners.

    1. LW here. Jedi hugs to you too. How long did it take for you to feel better with your new job?

  5. This question hit me so hard. I could just cry. I’m trying to hold it together at the office right now.

    1. LW here. So sorry to hear you had a bad day. Everyone has posted some really great advice and I hope things get better for you!

  6. I think sometimes we create the inner script for other people based off our feeligs instead of listening to what they’re actually saying, and that’s where things break down.
    You, your 1st day: “omg this is too hard. I can’t so this.”
    Your boss: “please don’t quit. Think about it.”
    And your voice was so loud, you didn’t catch your boss’s internal voice going “please come back tomorrow. I hired you for a reason and still believe in you.”

    Then the 2nd day you asked for a different workload, and your boss said you were doing great. Your inner voice disagreed – but that doesn’t mean their inner voice was! Their inner voice was thinking “she’s doing great! It’s a good thing we tried this adjusted workload.”

    I was lucky when I first started work out of college that my parents were managers and shared their experience with me, so I could imagine a different inner voice for my managers than my own.

    They told me there’s always an adjustment period – their new hires are almost useless for a month, but they invest in them, trusting in the things they looked for during the hiring process. They like when new employees ask questions, and struggle is okay when it looks like they’re learning, even if it’s slow at first.

    Give yourself time to learn – a good manager will do the same. And listen to what they say on the outside, and trust that they’re thinking the same on the inside. It’s hard when your doubt is so loud, but hopefully a therapist or other support system can help with that more than platitudes from a random Internet commenter.

    1. BTW, side note to SM’s post: Regardless of how many years you have into your career, when you switch jobs, you are always useless for that first month. I’m 20+ years into my career and switched jobs last year. It took several weeks before my workload normalized and I felt “normal” in my new job. Like CA said, it takes awhile to know where the safe bathrooms are, where the good lunch places are, where to find pens, how to run the copier……let alone figuring out how to handle your new clients, and what the CEO’s dog’s name is, and who really knows their sh*t and who doesn’t. A new job is hard for ALL of us! No matter how many years you are doing it.

      Jedi hugs. Remember to breathe. And take it all one day at a time, one bite at a time. Ask for help. We all know what it’s like to be new and good managers and good co-workers will remember what their first day(s) felt like and they will help you!

      1. Just wanted to add, with most new employees it’s more like useless for the first month, kinda helpful for the second month, pretty good for the third month, finally I can stop checking all their work during the fourth month…

        And I’ve observed that with new employees at every level. In fact, the higher level the job, the longer the learning curve can be at times because the skills required tend to be specialized to the organization.

    2. LW here. Thanks for your input SM and JulieB. I’ve read a couple responses from managers on this thread and you’re all on the same page with regards to what I call “ramp up time” (the amount of time it takes for an employee to become efficient). I felt like my ramp up time should be immediate and it’s unrealistic. I will keep your posts in mind when I start a new job!

  7. LW: all the things everyone else said. And, as a P.T. for many decades, I’d like to welcome you to the profession. We need people like you who care about doing a good job and care about people. Please take good care of yourself and come back if you can.

  8. I have nothing useful to add to this wonderful advice, LW, but I need to say that you’re so much more than zero. So much more. To your patients, to your friends and family, to everyone that shares a bit of this planet with you, you are not zero. You add to their lives, same as they do for you. I know that’s sometimes difficult to believe, but it’s true. A person is so much more than the sum of her weak points or bad days.
    Please give yourself time and care, you’re absolutely worth it.

  9. All of this – and also, as someone who has been a manager and has also worked in her field for a long time, sometimes experienced employees don’t realize how much they know just because they *know* it, from doing it every day for years and years. It’s okay to say “I haven’t done X before, can you point me in the right direction?” or “This is the first time I’m doing X in the real world, can we walk through it step by step together?”

    1. Right, being good at something doesn’t necessarily make you a teacher of that thing – that’s a skill in itself, and you might not think of it until there is a new person there shadowing you.

    2. This is absolutely true! I was assigned to help train a new employee, and I don’t have any training experience, so when I was walking her through how I write documentation, I’d say things like, “Okay, so when you’re documenting a feature, first you should play around and get comfortable with how it works.” The person I was training stopped me and said, great, how do I do that?

      Which is an entirely reasonable question! I’m not a training expert, and I’ve been doing this long enough that it’s second nature to me, so the question pulled me up short and made me think, okay, how DO I do this? And then I could walk her through how to find a feature, how to experiment with different configurations, where to find internal documentation to help with that, etc. But it took being asked to realize that, because I am so familiar with the job, I had conflated about a dozen steps into one in my own head–and I’m grateful that the new employee was confident enough to stop me and ask for clarification.

    3. Thirding this! And any reasonable manager will know that this is your first job out of school and that you’re going to be extra-new at things, and will not hold it against you.

      Training a new person can be a great excuse to finally write down those procedures that only exist in Bob’s head, or to realize hey, why *do* we do this thing this particular way? Is there maybe an easier way to do the thing?

    4. I work a lot of other technical and scientific authors, and a point I make sure to get across is that ‘I learnt this ages ago’ doesn’t equal easy! Sometimes, the most experienced employees aren’t the best to learn from because they’ve forgotten how much they don’t know.

  10. I just started as a nurse a few months ago, as a second career, and I think entry panic is really, really common and normal in healthcare. You are responsible for people’s wellbeing–that you take it so seriously is not a failing, it is to your credit! But yeah, none of us get to be perfect when we start. Or, you know, ever.

    For nurses, many hospitals have actual new grad programs that provide a structured transition from clinicals to your first job. You are assigned a mentor and get trained/signed off on the necessary skills over a period of at least six weeks. Because learn all you want from the books, a big chunk of health care is actual physical skill that must be learned in your body as well as your mind. Perhaps there is something similar for PTAs too, that your former teachers may know more about? You might end up starting off in not-a-nursing-home in order to do that, but it might be worth it so you could then go forth with confidence in yourself.

    1. Yes! This is all so normal for new healthcare workers that it’s something we try to tell new grads about- that the first year *is* going to be a steep learning curve, no matter how good a student you were (and sometimes having been a very good student can be something of a disadvantage, as you are not accustomed to the role of being the total novice and asking for help). It’s a big role transition.

      I’ve been a nurse for many years, but I still remember the hollow feeling in the pit of my stomach at the prospect of going in to work that first year, and waking up in a panic sweat with suddenly remembering something I forgot to do or chart or check. The new grads who *don’t* recognize their areas of incompetence and have a touch of panic from time to time are the ones who worry me as a preceptor. The ones who feel total confidence right out of the gate are usually not very self-aware!

      Being responsible for other people’s health and well-being is a big responsibility, and working in an inpatient setting brings with it an institutional culture and confrontation with illness and death that can be overwhelming at first. That is *normal* and I hope the LW will give seeking some therapy and giving the job another chance serious consideration. I have an anxiety disorder as well, and short-term counseling when I was a new grad went a LONG way towards helping me manage the stress of that role transition.

      It’s normal to feel overwhelmed and lost at the beginning of a new job, especially a new job in an entirely new field. The first days, weeks, and sometimes even months in a new role are not representative of what that job will be like once you’ve mastered the components.

  11. LW, I don’t know if this will help or not, but my SO is a big fan of the self help books when he can’t get to therapy, or is in between sessions. He has a couple he bought a few weeks after his first traumatic flashback on coping with PTSD. He is in traditional therapy, but he found the exercises helpful when he was in the daunting process of finding a therapist.

    Professionally speaking, do you have an organization that can help you get experience in real world settings? Volunteer work or free clinics that might be easier to build your confidence in your skill set?

    Could you reach out to the place that hired you, apologize, and ask if there is room for a part time or per diem assistant to let you get (paid) experience without being overwhelmed by case after case?

    I’m sorry your transition to Actual Practice was so jarring. I hope you can get the support you need to bolster you while you find your clinical legs.

  12. From a manager/owner perspective, I’d like to say that being a beginner is okay and nobody expect you to know it all right away. We always say that a new hire will take 3 months to know what they’re doing, 6 months to start doing things automatically, and a year before you’re valuable. This holds for all sorts of work. Being invested in the work, asking questions, being diligent, being reliable — these things count for more than knowing everything at once. It’s the same way you learned to walk and talk after your birth. You add and add and add and learn and learn and learn. Everybody in the world learns this way. So relax. You’ll get there when you get there. And you’ll be finer than you were when you started.

    1. LW here: Thank you for this perspective. It really helps to hear what managers are thinking!

  13. My first job straight out of college was in a different field than the one I had studied. I had worked in the new field, and adjacent ones, on and off part time in high school and college but nothing prepared me for that first day, which was still only a half day. I made a lot of mistakes, had the people above me and even many on the same level as me tell me a lot of things I was doing wrong or should do instead, etc. And not just on that first day, but for the first several weeks/months. Sometimes it really got to me. I knew I was good at the job but there were days I felt like I was doing everything wrong. I had to keep reminding myself that they weren’t mad or angry or going to fire me, but that everyone there wanted me to succeed and were just doing their best to help me get there. After a few months I was asked to take on some new duties I felt 100% unprepared for. I was terrified of what my boss was asking me to do, but I agreed to it anyway. (I admit, mostly because I needed more hours.) What I kept reminding myself of in this case was that she would not have asked me to take on these duties if she did not believe I could do them. I was not a last resort or a desperate request; she had full confidence that I could perform in this situation, and perform well enough to maintain the level of quality expected from our organization. It wasn’t a complete comfort, and again, I still made a lot of mistakes and had to have some higher up people fix some things, but once I was able to complete that huge thing that scared me I felt a million times more confident in my abilities.

    Ok, that got kind of long and wordy, but my point is, I think everyone has been thrust into situations in which they feel unprepared and totally wrong. It’s important to remember that for the most part, everyone else wants you to succeed and is going to help you do so, and that (again, for the most part, and if they are a good manager) bosses ask employees to do things if they feel they are capable and a good worker. It’s terrifying sometimes, but generally I’ve found that the person with the least confidence in me is me.

    Also, one big, huge, but very very basic skill I had a ton of trouble learning was how to ask questions. I went into this same job feeling like I should just know everything already, despite not having worked in that field in a few years, and never having worked in that specific environment. No one is expecting you to know everything right away. Asking questions is good, necessary, and better than doing something wrong and having to fix it later when you could have gotten it right once if you’d asked. I spent months at this job doing things in a really ridiculous and inefficient way because I was just too afraid to ask up front how things were supposed to happen. Learning to not just ask questions, but be comfortable doing so, made me a better, happier, more productive worker.

  14. LW, as someone who is currently suffering from imposter syndrome, I sympathize. For my part, hearing feedback from mentors about how smart I am is actually horrible to hear, because my brainweasels immediately think “oh gods, not only am I horrible and stupid, I’m lying to them and tricking them into thinking I’m smart.”

    I don’t know if you have a similar reaction, but if you do, it may help to sit back and think about what you know about the person (e.g. a teacher or mentor) giving you positive feedback. Are they, in general, intelligent people? Do you think that in any other respect, they are easily fooled? If you trust their judgement on other things, trust their judgement about you, too.

    1. LW here. YES! The part about not wanting to hear how smart you are is how I am, too. While I hate that we both think that way, I’m glad to know I’m not the only one. When people praise general things about me, especially intelligence, I feel a pressure to maintain that image. If someone says I’m smart, I might be less inclined to ask questions for fear of looking stupid. I’m trying to get over that, because as everyone here has pointed out, you’re SUPPOSED to ask questions when you’re new.

      1. One of the most valuable things to me as an office manager is the questions I get from new hires. When they go “Wait, none of the printer information in this works?” I have the opportunity to review it and go “You’re absolutely right, that’s from the old building, and you’re the first new person we’ve hired since we moved. Thank you. Do you want to ask IT for the current listing or should I?”

      2. Hi LW, kudos for reaching out to the captain, and I agree with everyone else who is telling you it’s ok to be a beginner and learn and ask questions. You are not alone in thinking praising people for their smarts is not the best method. Carol Dweck wrote a book, Mindset, which is all about that and in my opinion should be mandatory reading for all perfectionists!

        Maybe one way of handling people who give you praise in that way could be to ask follow-up questions to ask them to describe your actions, what you doing that they think works well. I’m pretty sure it there’s an old post on this blog about asking for feedback in a professional context that I found quite enlightening at the time. Have a look through the archive I’m sure you will find lots of useful things!

        I hope you will find support and take care of yourself and give yourself permission to make mistakes as you learn. I’m rooting for you!

      3. And if you are working at a place where people make you feel stupid for asking questions, then that’s not a place where you want to work. That’s not a safe or good working environment. You should NEVER EVER EVER be made to feel stupid. If you are, it’s time to go job hunting. (Been there, lived that, and found a new job.)

      4. LW, if you’re open to a book rec, I really recommend you check out Cheryl Dweck’s Mindset based on your comment here. It’s a quick read and was a total lightbulb for me. At various points in my life, I, too, have felt a lot of pressure to keep looking “smart” and avoid making any mistakes, asking any questions, etc., that would harm that image. The entire premise of Mindset is to help people move away from what was for me (and occasionally still is!) a really paralyzing, opossum-in-the-headlights frame of mind, and into one that’s aimed more towards growth and learning.

      5. LW, I mentioned this above, but it bears repeating.

        I’m a woman in a STEM field. The pressure in my own head to be really really good at my job or else “you let women everywhere around the world down and make it harder for every woman following you to get a job and are a failure at everything” can get intense sometimes.

        But my workplace is actually really forgiving of mistakes – we test and test and test our code to make it fail, and we have a guiding workplace principle of “If you haven’t figured it out in fifteen minutes, go ask for help.” And it does help. Because if I stare at my screen for three hours and finally figure out that I forgot to add AND to my query, I’m at the same place I would be if someone pointed it out to me after 15 minutes, except now I’ve got three hours of work to catch up on.

        All this to say, questions and asking for help aren’t a mark of a dummy – they’re a mark of someone who is *smart enough to know when they don’t understand*

      6. A new hire asking questions is actually one of the ways that shows me they’re smart and efficient–because otherwise they waste a LOT of time trying to figure everything out on their own when they’re new. Someone who doesn’t ask questions (even if it’s just a “so I do this, not this” clarification) worries me, because I wonder if they fully understand what’s being asked of them, and I worry that they’re not curious about what they’re doing or don’t care to understand the whys/hows of the job.

        1. seconding the idea that asking a clarifying question is a huge indicator of how good you’ll be at the job.

      7. Maybe you can ask them for some specifics, to coach them into the kind of feedback pattern I mention below.

        “What, specifically, did I do particularly well?” “What, specifically, are you basing your evaluation on?”

        To get them to see that you are wanting evaluation, and not just general affirmation and praise.

        And oh yes yes yes, do smart questions make you look smart. So don’t try to deliberately ask “smart” questions–just focus on learning, and ask the questions the help you fill in the holes. Then they’ll BE smart questions.

    2. I agree 100%! Similar to the comment above about separating out your inner voice from the voices of others. It really helped me when I realized maybe I didn’t have to automatically disbelieve people who thought I was doing a good job. If an experienced person tells you that you’re doing something right, believe them!

    3. Impostor Syndrome. Because sometimes my self-image is running 10 years behind what I can actually do.
      I spent about seven years reminding myself that hey, I’m a college graduate, I’m not a little kid anymore – and I spent seven years not believing myself. Then it finally sank in.
      Then I had to tell myself, “I’ve been working seven years, I’m not a noob anymore”

      Brains. WHY do they so often contain the seed of their own destruction?

      1. Oh lordy yes. I have my ph.d in the hard sciences, two postdocs, several publications and a currently funded proposal under my belt and STILL I get attacks of Impostor Syndrome. I have to actually painstakingly remind myself sometimes that I really did earn and do all those things–I didn’t somehow cheat my way through it all. I really can do it, and the proof is– I’m doing it right now! Jeez, brain, get a grip.

        Brains. @@

      2. “Brains. WHY do they so often contain the seed of their own destruction?”

        Because it makes them less appetizing to zombies?

        I’ve been having this problem with my job hunt– I’m looking for a full-time job, and I’ve had one part-time job that was a complete disaster for reasons that intellectually I know were more on my bosses than on me, and several internships and temp jobs that have gone well, one of which turned into my current Real Employee part-time job… and I’m *still* thinking every time I go into a job interview “Why am I doing this? They’re never going to hire ME!”

    4. The takeaway for some of us that I see here is how important it is to give useful, CREDIBLE positive feedback.

      My mom was so good at this.

      So: “You listen well,” or “you have a good grasp of the physiology” or “your calm manner is very reassuring”–those are very concrete and believable.

      But “you’re doing great” sounds like bullshit.

      So just as I would never, ever, ever, ever say “you’re doing a lousy job” to someone, I try to avoid saying “you’re doing a great job” and instead say, “you’re attentive” or “you did this specific thing correctly” or “you clearly understand how this works, and you ask smart questions.”

      When I give compliments or positive feedback, i try to be as specific as I would be if I were giving negative feedback.
      Focus on the actions and their end result.

    5. ‘hearing feedback from mentors about how smart I am is actually horrible to hear, because my brainweasels immediately think “oh gods, not only am I horrible and stupid, I’m lying to them and tricking them into thinking I’m smart.”’

      Hi how did you get in my brain?

      LW, I’m sorry you are having such a hard time. I’m currently on the receiving end of a lot of physical therapy right now and one of the reasons I like my PT so much is that she doesn’t act like she knows everything. So I hope that once you’re able to get back into the swing of things professionally, you’ll keep in mind that coming to terms with your own imperfections is not just good for you but is also making you a better healthcare provider. I agree with what others have said about having doubts actually being a good sign, that you are open to learning.

  15. I can relate to the all out blinding panic and intolerable waves of ‘failure’ that come with a new job. My mental ill health means that any new environment or responsibility will result in an adjustment period where I need to focus on breathing/looking after myself/not letting my C-PTSD sound the alarms and ducking for cover.

    It gets easier. If you can learn to accept the panic will happen and it is not a sign that you are wrong but a sign that you are out if your comfort zone temporarily, that comfort zone will grow. And it will grow into a safe sphere of career fulfilment where one day someone says ‘I could never do your job, you are such a natural, I bet you always knew you’d be a successful PT’ and you remember that wow, you were once terrified and now you are just happy in your job.

    Secondly, consider that this panic is in fact an asset. Physical therapy is often meeting someone in their time of crappy, pain ridden, lonely, disabled vulnerability and witnessing their own journey. It might mean askin then to consider moving beyond their comfort zone. It will involve watching them fail and try again. Actually, what you have here, from my perspective, is an affinity that cannot be trained or studied because real empathy comes from lived experience.

    People you treat want to know that you are capable but more than that, they want to know that you get what it is like to move beyond fear and pain. They want to know you have hope and can hold onto hope when they feel defeated. And you have that. You can do that by being who you are right now.

    Don’t give up.

    1. LW here. Thank you resili0. Your paragraph about the panic attacks being an asset in one way is something I hadn’t thought about before.

    2. To add to resili0’s brilliant insight, patients resisting physical therapy is not a sign of failure. When your body is in a bad way it crouches in on itself; trying a new movement seems like the most terrifying and painful thing. It’s only after trying a procedure on several occasions that my body has learned to stop freaking out over it. My best therapists have let me express my distress and have gently encouraged me, with low but gradually increasing expectations.

  16. I know the Captain said this twice, but it cannot be said enough: You are a beginner, not a failure.
    Something equally relevant – everybody was a beginner at some point; you are not alone in this. Environment shock, going from school to work, is normal (though knowing that it’s normal doesn’t make it any easier). Not knowing up from down when starting a new job is normal. Please don’t take this as “It’s normal, so get over it,” but as “It’s normal, so what you’re feeling is understandable – we’ve been there ourselves.”

    I’m also seconding the Captain’s recommendation, that you try calling the company again (but only if you want to, of course). There’s a couple of green flags I see in what you wrote that suggest that she’s a good manager and that you’re a good fit for the company (cancelling the other interviews suggest that the two of you ‘clicked’; listening to your requests for a different set of work). Because what you experienced is normal, a great manager will see this as “I’ve been there” – and probably also “Thank goodness LW still wants to work here!” I like Aurora_Belle’s suggestion – asking for part-time work as a way of easing into the job.

    1. Right, and also, that they clicked so much with you that they gave you what might be too much work for Days 1 And 2. It’s a sign that they believe in you — even though it would probably have been better if htey also realized you are a beginner!

      “By Sunday night…” So you may already know this about yourself, but check to see if your self-critical thoughts increase as it gets later at night. This may sound really dumb, but, I have had to make a rule for myself: I will actually just go to bed early, rather than stay up until my (already fairly early) bedtime, if all I am doing is freaking out about my (perceived lack of) abilities.

      “The entire time I felt like I didn’t know what I was doing and I was bad at the job.” — Actually, if you’ll remember, on Friday you did okay, and you knew you did okay. It was the brain-weasels, or monsters, or whatever you like to call them that works for you, that started getting to you over the weekend. Something to think about.
      Something else interesting: You will definitely not feel like you know what you are doing and are bad at teh job on Day 1 & 2, and lots of days thereafter. That is normal to feel that way. It totally sucks. But it does take some time to figure out how things work at a totally new place. You were in a totally new place. That is a major change.

      “when I don’t believe in myself?”
      One thing that helps me is, I try to just do the work in front of me. Like, the one thing. Not the whole day’s things, or the whole week’s things, or what all I’ll need to do all month. So if I were a PT, then, not thinking about the next person, I would just deal with that person, and do only that task we were doing at that moment, the best I could. When I start to think about the next task & the next person & the next people and all the people & the whole week, I really freak out & I start to shut down. I work best when I get myself to focus on just one thing at a time.

      Also, PLEASE know, if you are a PT, the best one on the whole entire planet, you would still have clients who won’t follow directions and resist you. You’ll learn some skills of how to get around that, over time and years and experience. But it still won’t be zero percent, there will still be some, even then. And it does not mean you don’t know what you are doing and are doing a bad job. It totally does not mean that, at all! For some amount of those situations, it’ll be 100% on the client themselves. And that’s okay.

      1. Also, PLEASE know, if you are a PT, the best one on the whole entire planet, you would still have clients who won’t follow directions and resist you.

        And know as well that this reaction is not about you.

        It’s about them. They’re out of their comfort zone, and scared, and annoyed at being bossed around, etc. etc.

        If you can hold on to that thought, it will not only help YOU, it will help you help them.

      2. Oh, and on the “just go to bed to shut up the voices in your head that are fed by tiredness and boredom”:

        I notice that you went from Friday to Monday. What other PEOPLE did you speak with? Was your weekend full of expectant people saying to you, “How was the first week?” in hopeful tones? In tones that sort of implied that they really expected to hear, “Oh it was great!” and really did NOT WANT to hear, ‘It was hard and exhausting and disorienting, really”?

        One area we can all grow in is to disconnect from them. But boy oh boy is it hard!

        And a takeaway for the rest of us, who AREN’T starting a new job, is to remember that in our attempt to be supportive, we often put pressure on people, who end up feeling that they are only allowed to complete the script, to make US happy, and not to be real.

  17. Oh, LW. You are just fine. Those brainweasels are right nasty little buggers, aren’t they?

    Impostor syndrome is very much a thing, especially in medical work. I’ve a relative who works in respiratory therapy and his wife in physical therapy, they’ve been at this for yonks and yonks and yonks, and both have confessed that even after all that time they *still* have those “I don’t actually belong here! I’ve been faking it this long and I am still faking it! Oh god what is going on!” feelings. My own doctor, who’s been doctoring for at least twenty years, still has moments like that at times. Etcetera etcetera. And yet they are still perfectly talented, competent and certainly not faking it even if they feel as if they are. No matter what the brainweasels say.

    You are fine, and you will be fine.

    Jedi hugs if you would like them.

    1. LW here. Thanks Kai Lowell for that insight into other health care worker’s minds. I talk with other new grads a lot about our feelings, but I never heard any seasoned professionals talk about imposter syndrome!

      1. You are very welcome! I think stuff like that would only come up when you’ve got quite a close, trusting relationship with someone, really, so it isn’t surprising that you’ve only heard it from the newer people. 🙂

  18. LW, I was in an accident that required several surgeries over two years’ time and two, 3-week stints in a Skilled Nursing Facility. I went from driving while thinking about bills and sex to having a permanent disability. It was my first experience with PT. Those professionals had to deal with me registering my new physical state, and all the drugs I was on, as well as my anger, grief and fears. I was still in shock and denial, and your well-written account of what you faced makes me realize how difficult I was to help.They’d smilingly roll the therapy ball to bump my walker, I’d burst into tears. There were crummy conversations with doctors and staff, then those PT sessions- scary starts that ultimately left me optimistic, because the professionalism and knowledge of the PT’s was tempered with genuine kindness. What a wonderful field you’ve entered.

    Having said that, I congratulate you on showing such good self-care at the very steep gradient you faced, and your negotiation skills. Now you know so much more! You won’t have that “first time” again!

    -Do you have to be full-time? Is there another scenario that would be a better fit for you? The PT’s I worked with seem to have been part-time, and either were being dispatched through an agency or maybe they were even self-employed? They rotated between several SNF’s owned by the company.

    1. LW here. Myrtle: I enjoyed reading your response about your positive experience with PT, although I’m sorry to hear about your accident.
      I wrote a more detailed response below, but I have accepted a PRN position at the place I did my last clinic, which is going well and building my confidence.

      1. thank you for your nice reply but— Hurrah to you! Congratulations and best wishes!

  19. Wow. I did not know how much I needed to read this. I’m in a similarish position (just got a really good beginner job in an industry I really want to work in after acing the qualifying course, am really struggling to apply skills learned in the workplace and am panicking about how my nice new boss is disappointed in me and scared I’m going to be fired. I’ve also been thinking about how to get into therapy for semi-related problems, but I’m agnostic about therapy because I’ve had very bad experiences with it in the past) and this was such kind and helpful advice. Anyway, LW, you’re definitely not alone. I hope you can find a job that gives you the chance to show how great you are.

    1. LW here. Thank you, LucySnowe24! I hope things improve at your new job. Several managers responded on here with some great insight about what they expect from new employees. I hope their posts help you feel better, like they helped me!

    2. LucySnowe, I’m so sorry you had bad experiences with therapy, and that you’re struggling with your new job.

      Can I offer you encouragement to try therapy again? The trick is getting the right person who can help you: not only do they need to have the professional tools that fit you, you need to be able to click with them as a person you trust. I’m pretty sure the Captain has a post(s) about finding the right therapist.

      In the meantime, my bit of wisdom acquired when I was flailing badly on my first job and I had a freak out session at my dad: He asked, “what’s the worst they can do to you?” “They can fiiiiiiiiiiiire meeeeeee! Waillllllllllllllllllllllll!”
      “Exactly,” he said. “The worst they can do is fire you. That’s all.”

      We’ve all been indoctrinated to believe that getting fired is THE. WORST. THING. IN. THE. UNIVERSE and Your Life Will Be Over. It sucks and is humiliating to be fired, and it sucks to have to look for another job, and it’s scary and all sorts of uncomfortable or worse, but it won’t tear the fabric of the universe and cause all of creation to implode.

      Getting fired sucks, so you generally want to avoid it, but it’s not doomsday, so you don’t need to *fear* it.
      Also, firing you is the worst *they* can do to you, so you don’t need to be afraid of them either.

      Fear is primal and the amygdala’s fight-flight-freeze strategies were developed for the veldt and the jungle, not an office building. As big an asshole as a boss might be, they’re not going to jump out of an office and literally eat you.
      No matter how unpleasant your situation, you’ll be able to function so much better once you’ve gotten control of fear.

      I’m not discounting emotions, or saying don’t have them, or denying that it sucks. But *fear* is not a helpful emotion in an office because all it offers is fight-flight-freeze, when what you really need is to be calm so you can think clearly and do your job.

  20. LW, along with so many other commenters, I want to say that you are not alone and not a failure and oh my goodness I hope you can take CA’s excellent advice and be kinder to yourself.

    There is a particular kind of self-doubt and anxiety that I’ve noticed in people who work in healthcare (this is anecdotal, of course). My mom has been a nurse off and on for 47 years. She went back to nursing at a large practice after 25 years of other non-healthcare work. She’s been there now for 12 years. And she still has days when she is anxious. My mom is BELOVED at the practice. She’s one of the best nurses I know: compassionate, hard working, organized, and focused. They tell her all the time that they’d be lost without her. And yet.

    This isn’t to say that you’re doomed to never feel secure or capable. This is to let you know that your feelings are so incredibly human. Taking a deep breath and reminding yourself of that might help. And that you are doing the best that you can. Being a beginner isn’t a pathology to overcome but just the first part of your career. My mom may have her moments of worry, but the difference in how she feels in that office now compared to how she felt her first year back is huge. You can absolutely do this. You are imminently capable and worthy. Good luck.

    1. LW here. BHicks: Your comment about a particular kind of self-doubt for health care workers is really insightful. There’s a lot of pressure on healthcare workers, including things patients don’t see, like efficiency (or productivity as it’s called in physical therapy). Thanks for your kind words!

  21. This happens to me with everything. Literally everything. New class. New Job. Business trip. Vacation. Basically any time I make a major change, even if temporary, my brain has a massive freakout meltdown and my thought process is “I HAVE MADE A HUGE MISTAKE AND THIS IS GOING TO BE TERRIBLE BECAUSE I AM TERRIBLE AND I AM GOING TO BE MISERABLE AND EVERYONE WILL HATE ME AND THE ONLY SOLUTION IS TO RUN AWAY.” I liken it to someone moving a cat to a new home. You know how after you move your cat spends the first two weeks behind the couch hissing? Yeah, that’s me. It sounds like it is maybe you also.

    In the long term, yes, what I needed was therapy. It happens because I have an anxiety disorder that causes my brain to react to new situations by telling me I cannot cope and I AM GOING TO DIE. In the short term, I was able to recognize this pattern about myself and know that if I stuck it out for the first week or two I would settle in and be just fine. The more times I did that, the easier it got. The first few times it took a week or two. Then it took 5-7 days. Then three days. Then one or two days. Then I did a lot of therapy and now for the most part I can just walk in and get down to it without much if any hissing-behind-the-sofa time.

    A therapist is definitely the most efficient and effective way to deal with this particular issue, and long-term I think that would be really, really helpful for you. But if that’s not an option for you right now, you CAN to some extent push through it yourself. For me it really helped to tell myself that this panic was temporary and it wouldn’t last forever and I would be okay if I could just get through one week. And then I’d make myself get through one more week after that. And usually by then I was okay.

    1. >I liken it to someone moving a cat to a new home.

      This really, really helps put my own behavior into perspective. Thank you for this!

    2. LW here. Thanks for your perspective, stellanor. I like the cat analogy! I want to be more like a dog in a new place, which if it’s like my dog means running around, wagging his tail and going up to all the new people with a smile waiting for pets.

      1. I want to be more like a dog in a new place, which if it’s like my dog means running around, wagging his tail and going up to all the new people with a smile waiting for pets.

        Just remember that, while dogs are great (¡THEY ARE SO GREAT!), that kind of behavior on their part can also be overwhelming and annoying and clingy. So to further the metaphor, you don’t need to become the new employee who barges into her new job and brashly thinks that she can do ALL! THE! THINGS! and that she is BEST! FRIENDS! with ALL! THE! NEW CO-WORKERS! In fact, I could very easily see a hypothetical letter to the Captain from a person with a more “dog-like” outlook, wondering why all her co-workers seem frustrated with her and why they keep telling her to slow down and be a little more cautious.

        Instead of wishing you were more like a dog, maybe think instead about how you could work on becoming a braver, friendlier cat. There are so many good things about a cat (caution, needing to go at their own pace, respecting other peoples’ boundaries); it would be a shame to bury those qualities while trying to fashion yourself into the dog you think others want you to be.

        1. I cannot second this enough. New hires who come in like the dogs in this metaphor drive me (and others) up the wall b/c we often don’t have time to give them all the attention/pets they tend to demand. The people who take time to get used to the work and to their coworkers in a more catlike-way tend to end up much happier with everyone, because no one feels like they’re going to have to start enforcing boundaries.
          That’s not true everywhere, and it definitely doesn’t mean that more dog-like behavior is totally unwelcome! It’s just that, take time to take stock and keep professional distance, for your own sake as much as everyone else. Especially in work environments where you spend a lot of time working with people who are in pain/aren’t professionals themselves (as you do with PT), that distance can help you preserve your sanity/feelings.

      2. Just don’t do the nose to crotch thing that my dog does to new people!
        Jedi hugs.

  22. I really have to wonder, LW, if your parents were the sort who expected you to already be good at things right off the bat. Or maybe they told you you were “smart”, or “not smart”, or “talented” or “not talented”, or somehow gave you the idea that if you weren’t immediately expert at something then you weren’t really meant to be doing it.
    See, I understand this because it’s the sort of thinking I was brought up to believe. If I didn’t do well in math, it wasn’t because I’d fallen behind the other kids and perhaps needed a little help to catch up and maybe even had to work a little harder than some of them. No, it was because “Some people just aren’t good at math”. This sort of thinking is why children who are described early in life as “gifted” often fail to live up to their early promise. They’ve been led to believe that innate ability is more important than work and practice.
    You, on the other hand, have done the work. You now get a chance to get in the practice. Nobody, but nobody, starts off expert at their job right from day one.

    1. Yeah, this. I was the “smart one” as a child., which meant that everyone reacted with horror and shock when I didn’t automatically know everything or when I behaved in what was actually an age-appropriate way. Even the smartest and most “mature” child is still a child, with a child’s capability of handling emotions. As a result I became both terrified of failure and deeply needy for approval from authority figures and it really, really screwed up my first few jobs until I was able to start sorting that out. (It also didn’t help that I had Terrible Bosses at three of my last five jobs.)

      For any parents on here, please, stop and think if you find yourself referring to your kids as “the X one” or “the Y one.” Being shoved into those boxes as a child is really dangerous. I never felt like I had permission to try something I wasn’t good at, because I might fail, and that would mean I wasn’t smart, right? In retrospect I would have been way better off if less emphasis had been placed on being “smart” and I had been given the freedom to try things I wasn’t necessarily naturally good at doing and to fail at them.

      1. Oh, God, that “what? you don’t KNOW?” reaction, how I hate it. I remember hating being called on in class because if I didn’t know the answer the whole damn class would ooh and ahhh about how unbelievable it was. Which is utter crap. And I NEVER reacted that way to any of my classmates not knowing every single thing in the whole damn world.

        1. Me too! When I was a little kid, my classmates used to come up and ask me stuff in the middle of class like how to spell words. And if I said I didn’t know, they didn’t believe me. So in the end, if I didn’t know then I’d just make something up. But the worst was the way teachers used to read my work out to the class as an example. One day, we were tasked with writing a poem, something all my teachers had said I was really good at. But that day I kind of had a mental block and what I produced really wasn’t very good. When the time was up, the teacher asked for my book and read my crappy poem out to the class without even reading it to herself first. I was probably 8 or 9 years old and I was sooooo embarrassed.

          I totally identify with this thread. I was always the intelligent kid, always top of my year group in primary school. Everyone told me so. I was selected to represent the school at a regional schools quiz competition when I was only 7 and was the only girl in the school to pass the national exam we used to have at the age of 11. But the higher up in education I went, the harder things got, because the more hard work you have to do and I’d always been told it came naturally to me. This stopped being true pretty early on.

          1. Oh gad amberxebi, are you me?! I coasted the whole of my early childhood happily at least a year or two ahead of everyone else, breezed through the 11+ so easily I don’t even remember taking it, and then started to plateau around the start of GCSEs. I’d never had to work hard my entire academic life, and I didn’t have the discipline to knuckle down and slog through. My exam results on up to A level were fine, in the general scheme of things, but not at all what they could’ve been.

            People say it’s hard having to struggle the entire time, and I don’t doubt that’s true, but it’s just as hard not to know how to struggle until it’s almost too late.

          2. Ugh. As it turns out, I have ADD (on top of an anxiety disorder/depression), and I was classed as “gifted” from, like, kindergarten. I skated through primary and most of my secondary education on my ability to pick up material quickly and without much effort, though my overall grades were rarely good because I didn’t turn in homework, and would overreach on projects and then try to do them last minute when they probably were a stretch even if I had started early. Early college (at a community college, because I didn’t get into any of the schools I applied to, given the aforementioned grades) was also reasonably easy, but then suddenly…I couldn’t coast because the material started to require effort to learn and I had never, ever learned how to do that, for two reasons a) I HAVE ADD and my brain balked at sustained effort and b) I had internalized the idea that if you had to *try*, you were stupid, and that kicked the anxiety up into high gear. (I also spent a lot of high school resenting the students who got decent grades by, you know, working hard and turning in their work, because I *knew* I was smarter than they were, and that was what should have mattered. And I probably am “smarter” than many of them, whatever the hell that means, but “smart” is not more valuable than “hard-working”.)
            And I got the idea that I was better, smarter, than other students because of the special treatment I got from adults, from having my essays used as how-to guides (name expunged, but I still knew, of course), to a math teacher having me grade tests in the 5th grade for my own class, to the fact that I was never removed from the honors track despite my grades (for which I am grateful, because dropping me would not have “taught me a lesson about applying myself” or done anything useful except bore me and possibly cause me to have even more contempt for other students). But it meant that not knowing something, not being good at something, not understanding something right away was something I could never, ever admit to, was an utter failure, and I’m still terrified of doing things wrong. I’m in grad school. I should have had a draft of my prospectus done a month ago so my PI could give me feedback before I sent it out to my full committee. Every time I open that document I a get pit in my stomach, because what if it’s “wrong”, what if I’m really stupid, what if I get kicked out what if my PI hates me because I’m not good enough what if what if

            Not knowing how to be wrong, how to work at something, has an incredible chilling effect. I’m getting better, but it’s a huge struggle.

          3. An ex of mine, also with ADD, went through exactly that except that unfortunately zie has none of the self-awareness that you have demonstrated here and always blames other people when things go wrong. Zie was sent to a school for “gifted” children and used this fact to demonstrate that zie was always right about everything, ever. Not only that but zie also used hir ADD *all the time * as an excuse for bad behaviour of any sort (“Oh but I’m only being judgemental about that person’s choices BECAUSE I HAVE ADD! How could you use my disability against me like that you HORRIBLE PERSON?!”). I blamed this almost 100% on hir being taught that zie was Special and Wonderful and every bad thing in the world ever was someone else’s fault because of it.

            Zie never had to try, and if zie then failed then – zie had learned – hir ADD was a magical get out of jail free card.

    2. LW here. RSVP: I was (and still am) praised for my intelligence, which has always made me feel a lot of pressure to maintain an image. I don’t want to look stupid to someone who things I’m smart. But I would much rather be praised for an accomplishment than a general trait. (“This story you wrote is great” vs “You’re such a great writer.” or “That play you made in the game was impressive!” vs “You’re a natural basketball player.”) I agree with you that “gifted” children often fail to live up to their early promise. It messes with your identity when you tell someone who they are, and then they fail to live up to that idea of themselves.

      1. and, when you are smart, you also can see all the holes in other people’s admiration. You probably are quick to understand things, which means you’ve got plenty of time to understand how much better you could be.
        That’s often an asset, a HUGE asset, because it means you will probably always be learning. As long as you can stop focusing on the shame/fear of having gaps in your perfect-ness and not being as smart as they apparently think you are, and instead focus on the gaps that you can see, and how to fill them. When you can stop caring much about their evaluation of you, and start relying on more objective means (not necessarily your own subjective opinion, but objective stuff).

  23. Oh, the joy of jumping in at the deep end of the pool.

    My first year teaching high school – my first week teaching – I was sure I should never have started that job, it was much too hard, the students were too wild for me to handle, there was no classroom control – I thought this teacher is a failure. There was no way I’d last the first semester, let alone the year.

    Then I heard the other teachers for that same class saying this was the most rowdy class they’d had in years. These were veteran teachers, not newbies like me, and they were having a hard time. I stuck it out and the next year seemed like a walk in the park. If I had that same class now, it would be difficult but not the impossible task it was on my -first day-.

    So, LW, the mix of zero real-world experience and a really hard first day is touch combination for anyone. Add that to anxiety issues and you have a recipe for serious stomach pain. I want to let you know that gearing down does not mean you’re a failure at all! It means you started playing this game on ‘expert’ level instead of ‘beginner’ and it was just that hard.

    You can ask the experienced PTA you worked with on that killer first day if zie could have handled a day like that on the first day on the job. The answer might surprise you.

  24. Oh this sucks so much. I completely understand where you’re coming from. I felt completely unqualified at my first job out of school. Only instead of quitting I just came in everyday expecting to be fired.
    One thing that really helped me is knowing that often the best employees feel like you when they first start. They guy/gal who walks in on their first day thinking they know everything won’t try to learn or improve. You will. No one expects you to be perfect at first.

    If finding a therapist isn’t possible, what about just telling yourself that no matter how terribly you feel like you are doing at a job you will a) fake it and b) not quit. I don’t mean fake being perfect. I mean pretend you are a person who is new at the job but also still good at it. And when I say “don’t quit” I mean, if your employer is really unhappy with you, they will let you know. It sounds like you can’t totally trust you judgement of your performance, so take the decision away from yourself. Let your employer decide if you should stay.
    Now- if things get too stressful, that is a different thing. But don’t quit just because you’re worried about what your employer thinks.

  25. LW, from your letter it sounds like you are a compassionate, caring PTA. That is so, so valuable for the people the PT is working with. Yes, you were overwhelmed, of course you were! But your brain weasels are working overtime, and they’re lying liars who lie. Please, be as patient with yourself as you would be for your best friend. You’re doing a lot of new stuff, and possibly had some really high expectations or thought that your employers did. if I was one of the people who saw you and the PT, I know I would definitely understand and appreciate that you were nervous and overwhelmed, and that makes you /human/. I’ve seen PTs and PTAs that I wasn’t sure weren’t robots, so knowing that you’re human would actually help me relax.

    It seems like PTA would be a very demanding job just on the “interacting with people” front. You know all the technical stuff, it sounds like, but trying to figure out the relationship between you and the PT and you and the patients (especially difficult patients!) can be really draining. Cut yourself some slack there. You have a passion for your chosen profession; that doesn’t mean there won’t be a bump or three in the road. I hope in a couple months we get an update where you’re happy and your job is great and even though you may not have a complete handle on everything, enough is going well for you that you’re in a good place. 🙂

  26. Jumping in with Jedi hugs, LW! You can do this!

    Four years ago, I started work in an entirely new profession, doing stuff I had never done before, flying by the seat of my pants and trusting my boss to tell me what I was doing right or wrong, or could do better. For the first month, I existed in a nervous haze of “Oh God, did I do Thing A correctly?–did I call the person about Thing B?–did I use the correct format regarding Thing C?”, and only the fact that the ceiling never caved in and Boss never started shrieking at me clued me in that I was in fact doing my job correctly and adequately. Four years in, I know damn well that I am good at my job and that peers in my circle know me and trust me to do things right–yet when I do make a mistake, the same voice that howled at me in that first frantic month starts up again, insisting that I am a fraud and a loser and should be ashamed to even be trying. But I can look back at four years of compliments and thank-you notes and saved emails saying “Thanks so much for all your hard work!” and know that that voice lies. Work to the best of your ability, and learn to pinpoint the difference between the voice of Experience (“Oops, a mistake was made, let’s correct it and move on!”) and the voice of Anxiety “Oh crap I made a mistake and now everyone will point and laugh and make a Facebook page about it and if I go move to Alaska right now…”

    On a side note, if you’ve ever watched “Inside Out”, it’s honestly helped me to picture my Anxiety as a little purple dude in a checkered shirt, fretting over tiny things and being soothed by Joy. “Yes, we know you’re trying to help, but I don’t think this situation warrants moving to Alaska quite yet. Let’s start with–with asking for help!”

  27. LW, I identify with this so much! I am a new physical therapist. I just started in September and I’m now 7 months into my first job at a big hospital. Like you, I got a mix of A’s and B’s in school and did well on my clinicals. My first week at my job was horrible. I was thrown into a caseload bigger than I could handle, on a mix of different hospital wards (some of which I’d never even seen during my two days of observation that week) and with an experienced PT training me who actually sucked at training new grads (even though she openly bragged about how great of a trainer she was). My first day, I saw only half of the (already small, training-size) caseload and felt like I made a thousand mistakes. The experienced PT training me corrected me rapid-fire all day, giving me no time to notice or fix a single mistake on my own, even if it was something inconsequential. I felt like I couldn’t do anything right. I was visibly shaking with anxiety, couldn’t meet anyone’s eyes and looked like I was on the verge of tears constantly and was radiating a high level of nervous energy. I felt incompetent and bad at everything and like I would never get up to a full caseload. I resented the terrible “training” caseload I had gotten with patients spread through different wards, when I didn’t even know the names or locations of anyone or anything on even one ward. I had become terrified of my trainer who obviously thought I couldn’t do anything right ever. I wanted to quit. I broke down in tears AT WORK both days, once with a random other PT that was in the rehab gym at the end of the day, and once with my terrible trainer herself, who did not exactly respond with kindness or understanding.

    What did I do? I called my friend from PT school and cried. I called my former professor/mentor in the field, and cried. They both encouraged me to go back the next day and talk to my boss and see if I could be reassigned to a new trainer. They reassured me that even if I only saw half the training caseload, I kept my patients safe and did my best. They reassured me that a “training” schedule on 5 different wards was absurd.

    I went back and talked to my boss (I actually talked to my boss’s boss because my direct supervisor was friends with the terrible trainer). He was understanding and empathetic, and he told me how overwhelmed he’d been when he was a new grad, and how his own boss had given him a smaller caseload and more time as a trainee and that he would do the same for me. He did reassign me a new trainer after hearing my concerns. He made sure my direct supervisor gave me a very clear training schedule with clear expectations, that kept me on the same ward until I had learned that ward fully. Things got better on the surface. The new trainer was good and helpful and understanding, and I slowly built up the size of my caseload each week.

    But, the impostor syndrome and anxiety didn’t let up. I was in better control on the outside but I still felt inwardly like I sucked at everything. I felt sure that everyone would realize I was faking it and that I would get fired. I was having trouble eating and my digestive system was overreacting whenever I did manage to eat, which are my usual symptoms whenever I’m having a high level of pretty much any negative emotion. My health insurance hadn’t yet kicked in because I was still in my probationary period. I made the decision to pay out of pocket for one session with a mental health therapist. I picked someone who had experience working with acutely ill people, because I figured she would understand some of the specific anxieties that were related to working with patients like mine (sick and/or injured people in the hospital, some of whom were truly medically fragile). It was a truly excellent decision and worth all 65 of the dollars I spent. I decided I could hold off on another session until I had insurance. Once I made it past my probation period and somehow, shockingly, hadn’t been fired yet, I began seeing a therapist again (a different one who took my insurance). I am still seeing her to this day, 7 months into the job. Although the anxiety and imposter syndrome at work have decreased a lot, it just helps knowing that I have a session with her on the calendar, even if it’s not for a few weeks.

    I still feel like I’m faking it. I still feel anxious, especially when I have really difficult patients. That first therapist, the one I paid out of pocket, told me that it took not one month or two but SIX MONTHS to really start to feel comfortable at a new job. Hearing this made me treat myself a little more gently when it had been two months or three and I still didn’t feel competent or great at my job. I did feel *somewhat* better at two months and three, but at six months I did feel actually comfortable and starting to feel competent for real, at least when I wasn’t going back over and over an interaction with a patient and questioning whether I should have done more or should have done less.

    You can do this! Although I am not 100% anxiety free, I feel so much better than I did at the start of my new job. Seeing a therapist helped a ton. Meeting with my former professor/mentor, and with my former classmates from PT school helped a ton. As a new grad, when I asked for a different trainer and a slower paced training schedule, they gave it to me. It was a normal thing to ask for as a new grad and they didn’t think poorly of me for asking. I built up to a full caseload in about 2-3 months. You can do this too. If not by returning to this job, at the next one. Your needs are normal for a new grad or even just for starting a new job.

    As for the patients who can’t follow directions or refuse… it’s part of the deal. The only thing I can say is to meet the patient where they are that day. If that means an “easier” PT session than they might usually do, that’s just how it is that day. If that means you have to enter into their medical record that they refused PT, that’s what you have to do and it’s okay – everyone in healthcare knows this happens sometimes. I had trouble at first building a rapport with patients, even the cooperative and enthusiastic ones. It helps to ask them some basic questions about their life that *aren’t* about their physical health or reason for being in the hospital or nursing home. I like to ask them if they’ve lived here in [city] their whole life, about their children/grandchildren (if they have any), what kind of job they had before they retired. A lot of times they start to really open up, talking about their past. Even patients with dementia or who are being really difficult or not cooperating can slowly start to open up to you and trust you a little bit more when you’re asking them to do something physically challenging.

    I feel like I wrote you a book. I hope it was helpful. I have been almost exactly where you were (except that I didn’t actually quit – I just really really wanted to). If you want to talk more about being a new PT/PTA, respond here and maybe we can exchange info?

    1. LW here. Thank you Thank you Thank you for your response! It was so helpful to read about someone else in the same field with the same feelings! I’d like to talk to you. Not sure how to discreetly exchange info.

      1. I have no idea how to discreetly exchange info without posting it publicly… hmm. I will think about this.

        1. Set up a new gmail account, post that mail address, use it to exchange real mail addresses and delete it.

        2. if you are both on the Friends of Captain Awkward forum (or join), you can PM each other there.

          1. yes, I am actually on the forum but haven’t logged in for a while. That would work! My username on the forum is jb0t. LW, send me a PM?

  28. You can absolutely do it, LW. Your teachers and co-workers were right and your jerkbrain is wrong.

  29. Another thing you did right, LW — you ASKED FOR HELP. You took that first scary step away from what jerkbrain was telling you, and took the risk of telling other people about your difficulties. The next step will be less hard, promise. In a way it’s kind of like what some of your clients are probably going through, where they can’t see progress at first and it seems hopeless, but in a few weeks they’re getting used to their knee replacement or whatever and can flex way more with less pain. (Going off vague memories of my dad’s knee replacement here — I know nothing about PT myself 🙂 )

  30. Letter Writer here! I want to thank you, Captain Awkward, and each one of you that responded to my letter. It really helped to hear these things from impartial sources. I’m glad I’m not the only person that has felt this way as a new grad. Reading all your responses has really made me feel a lot better and I will return to this post the next time I’m doubting my PTA skills.
    Since I wrote in I was offered a PRN position at the nursing home I did my last clinic. I accepted and have worked there twice. I already knew all the staff, the facility and the computer system. I was able to avoid any ‘new employee’ jitters, just walk in on my first day and get right to work. My second day was on a Saturday and I was the only rehab staff there and handled it. This job has really helped my confidence and I think it’s the best thing that could have happened for me. I’m scheduled to work again this Saturday!
    I won’t be returning to the job I quit. There were some shady happenings I didn’t write about in my letter. Last week I saw a job posting listed for the manager’s position. I intend to continue to build my confidence and skills at my current PRN position. My clinical instructor is still there. She and I socialize outside of work and I feel comfortable going to her with questions and advice. I’m keeping an eye out for other PRN positions to branch out and build my confidence (and supplement my income), but in the meantime I’m much happier with this arrangement.

    1. Hurray! This makes me happy. So glad you’re on your feet and on the right track.

      I’ve been doing what I’m doing for 30 years now (yikes!) and I still sometimes hear a voice in the back of my head “Listen to you, acting like you know what you’re talking about.” But now the little voice is a mixture of amused and bemused, and say “I know, right? Who’d have thunk?” and then we have a good laugh together.

      You’re doing great and some day you’ll realize with surprise that you’re the old pro that the new kid looks on with awe.

    2. I didn’t see this before commenting, so allow me to do a happy dance – this was exactly the outcome I had been hoping for!

  31. I just want to say that I spent the first six months of my teaching career crying once a week (on the floor by my desk, after school) because of how hard it was and how overwhelmed I was with everything. I had anxiety every Sunday night and laid awake with a racing heart too. And I had a great grad program that tried to prepare me for everything. My co-teacher was also a first year teacher and was on the verge of quitting every day until sometime in his second year. Starting a new career is like drinking from a fire hose: it feels like drowning.

    BUT It gets better, I promise. It doesn’t get better right away, but by increments. After a week you turn around and realize that something which was hard a week ago isn’t hard anymore. You CAN do this, if this is what you want to do! Build up your Team-LW!

    And a picture of Imposter Syndrome: https://twitter.com/rundavidrun/status/587671657193455616

  32. Hello, LW! I am also in the field of PT, graduated a few years ago. I’ve worked now at four different locations, and I can tell you that in each of them I have felt the “oh god I am faking it everyone else knows it they all think I’m terrible.” Let me tell you!

    My first job was, like yours, at a nursing facility; I had one day of “training” where I shadowed the leaving PT and then the next Monday I was on my own, the only full-time PT, as a new grad. I turned in my resignation after less than a month. The job was terrible for many, many, many reasons; I had a single day of “training” and was the only full-time PT. As a new grad. Leaving that job was absolutely the right decision for me and absolutely the scariest thing I had done to date. I had nothing else lined up afterwards. And you know what? Less than a month and a half later I was working again, in a much better place.

    Fast forward to the interview for my current job, which was hands down the most terrifying, intense interview I have had to date. I drove home in tears, thinking that there was no way they would ever hire me; after I got the phone call with a verbal offer, I spend the next six weeks before I started panicking that I’d show up and they would say Wait, you? No, we wanted the *10am* interview person, not the *2pm* interview person! Sorry, hired the wrong one, go home.

    But you know what? The emphasis was placed not on someone who already had the answers, but someone who could be *taught* to learn the right answers, and my boss told me that up front. As a new grad you’re not expected to know everything, but bosses like someone who is eager to learn and who is willing to listen to feedback. It’s difficult, because the temptation is to compare yourself to those incredible people who have been in the field for 30+ years and whose clinical judgment seems unquestionable, when you’re still trying to remember which one is the talus and which one is the calcaneus. Your mentors know that you’re not perfect! I look back at my first job and think, wow, I could have done such better things with all these people. But you know what? All my patients in the future will benefit from my trial and error; I will learn; I will grow.

    And, dear LW, I expect your boss feels the same. In a new grad — even in someone who’s been in the field 10 years! — a good boss will hire someone they think will *learn* the necessary skills. Especially in a people-oriented field, it’s so crucial to be *not* someone with all the answers, but someone willing to learn and who is empathetic. Someone as eager to do right by your patients as yourself has those skills. Take heed of all the great advice from the commentariat and know that you are not alone.

    (There is, on my fridge, a piece of positive feedback I received from someone whose professional opinion I value highly. I still read it on bad days.)

    1. Fun story, I’ve actually gotten, “No, we wanted the *10am* interview person, not the *2pm* interview person!” in a manner of speaking.

      I went to an interview to do video editing for a music promoter, a position that can mean everything from guy who stands on pedestrian overpasses and hands out flyers and homemade CDs to booking big dance clubs on The Strip (I was in Vegas). He had dedicated the lower floor of his house to his business, and had an assistant, so I figured he was somewhere in the middle with actual clients occasionally making real money. (I mention the apparent legitimacy of the job because contract/part time interviews for video work are as much about figuring out if the person who wants to hire you has any idea what they’re doing and if they have enough of an idea to actually pay you). The first question on the application he hands me is about my astrological sign. After a lecture about our potential compatibility he asks me to do some quick editing and some technical questions. The editing went fine, but I sort of BSed my way through a few of the technical questions.

      Despite that, I got a call the next day to arrange a second interview. In the course of the conversation he disparages the interviewee before me by bringing up one of my particularly egregious items of BS! I was the interview before myself! He totally thought he was talking to someone else. I didn’t say anything, because I really needed a job. When I tried to arrange a time other than the initial time offered (on the same day) for a second interview his assistant just hung up on me.

      I’m probably glad I didn’t end up in a job where my boss uses astrological signs to make hiring decisions anyway. This is my story.

  33. Idea: next time you start a new job, if you have an EAP (employee assistance program), use it! The EAP is a free program that the employer pays for to promote the employees’ well-being. They sometimes have 24-hour call lines and free counselling (phone or in person) that can help with situations like yours. They can deal with acute crises or help address chronic problems. I’ve called them while at my desk during a personal crisis and still remember how helpful it was just to have a sympathetic ear in that moment. You can even call preventatively about anxiety related to your transition to a new job, before a possible crisis occurs.The EAP is confidential and doesn’t release info to your employer. It’s a great and underused resource. Not all jobs provide an EAP but big healthcare settings might.

    The EAP can’t replace all therapy options (they give a set # of free sessions), but it could be a great option if you are low on funds. Most people forget about the EAP pamphlet after their orientation but I’m so glad I kept mine as it came in handy!

  34. When I started at my current job, I was totally overwhelmed. By the end of the first week, I couldn’t imagine ever being able to cope. 15 years later, I’m still there and in management. I still remember that first week, and I’m very understanding towards new people. If someone quit in a panic and then came back to me a few days/weeks later and said can we try again, I’d probably try to make it work. It’s possible your boss would be sympathetic.

  35. I feel like I’m faking it most days here at my current job and I’ve felt like I was faking it in most every other job I’ve ever had. I think most everyone feels like that. I’ve been working at my current position for well over three years and just yesterday I had this moment where I thought “OMG, I finally understand what it is I’m doing!” I had an issue that I was able to fix without searching for someone with more experience. It was one of those moments where I knew all the lingo, the rules, the people involved. Most days I feel like I’m just faking it, but then there are days that I feel like I’ve finally gotten it.

    LW, please, don’t be so hard on yourself. Everyone feels like this at some point in their careers. Is there anyone in your field that you could speak to and ask how they handled those first months of work when they felt that same way???

  36. This is pretty close for me. I started a new job in a field that can suddenly become VERY busy at a moments notice. The first 3 days I was scheming for ways to quit. During my first week I would lay in bed every night panicking about having to go in the following day. I also thought I was doing a terrible job. Part of my job is being responsible for other people’s money which really freaks me out. I was terrified all the time! it got better – it’s been almost a month and I’m no longer scared of everything and my boss has taken the time to tell me I’m doing well. It really does get easier, you just need to give it time

  37. Also important: my sister is a PTA who has been in the field A Very Long Time. And sometimes she still has very difficult days even though she is very confident in her skills because while she’s experienced, sometimes the patient is brand new to being a patient, which can introduce all kinds of complicating factors into the mix. It’s an occupation where you’re working very closely with people who really might not want to be where they are at all. Sometimes the terribleness is unavoidable and also completely unrelated to you, what you’re doing, and how you’re doing it. Just a good thing to keep in mind.

  38. All the hugs, LW. I think most of us have felt lost and overwhelmed and asked ourselves “WTF am I doing?!” You’re your toughest critic, and it can be hard to be #TeamMe. I also get that feeling of “Am I really doing that well? Is this a fluke, or do I deserve this?” Answer is yes. Yes you do. Be kind to yourself. When bullying yourself, ask “would I say this to a friend in the same situation?” Nope. You would be fair and encouraging to another person, so as hard as it can be sometimes, try to do the same for yourself. Good luck! ❤

  39. I think that feeling successful must be even harder to achieve (especially in the granular day-to-day) in a field in which your success relies on the cooperation of other people.

    In the OP’s situation,
    “This PTA’s caseload had some of the most difficult patients I’d ever seen; people that couldn’t follow directions and resisted me during the treatment.”
    I think that ANYone would have had difficulty. So it’s important to think bigger-picture in terms of determining success.

    1. LW here. I have the hardest time with the patients that can’t follow directions or speak, usually the ones with severe dementia. The patient that resisted me didn’t understand what was going on and refused to let go of his walker. The other PTA pried his hand off the walker. I tried but he had a death grip on that thing!

      1. I’m not surprised, if he didn’t know what was going on and didn’t really know who you were. As far as he was concerned, you were trying to take away the one thing he relied upon for physical support, leaving him completely vulnerable.

        It is really, really hard working with people who don’t understand what is happening in the same way that you do. I have been doing it for 13 years and you never, ever get perfectly good at it because every person you work with is different.

        You already know this, but the key is rapport and the difficulty is how to build that with each different person when you have limited time to do so. If someone has dementia, for example, you have to enter their world, where they are currently in their own mind – which could be another continent, the 1970s, whatever – and try to see what they’re seeing and experience it with them.

        One nursing home worker I met recently told me about how a resident with dementia was getting more and more distressed trying to force his way out of the locked front door because he “had to go to work” (it had actually been 20+ years since he’d last worked). Instead of trying to convince him otherwise, or lying, she said, “Oh no, that must be really stressful for you, but I’ll help if I can. What can we do?” She went through several options like “would you like me to call your work and say you have a domestic emergency and can’t come in?” “is it possible for you to work from home today?” and various others, and she could see him getting less panicked. Then she said, “If there’s nothing we can do to get the door open, there’s no point in panicking here, so let’s get a cup of tea and I’ll make that phone call.” She went into the office, came out as if she had made a call (I think she actually did, only it was unrelated) and said, “It’s OK [name]. It’s sorted. You don’t have to go to work today.” She hadn’t even told a lie, and she spent the next 10 minutes chatting happily with him about his work while he relaxed with a cuppa.

        Obviously it would be a different scenario for you, but if your people are accompanied by carers who know them well, you should be able to figure out together what they’re likely to be finding difficult and what might help, and that makes things sooooooo much easier. I’m not going to pretend it’s easy, because you know full well that it isn’t. But you will definitely find that your confidence builds over time.

  40. I had the great luck and pleasure to take a juggling workshop with Avner the Eccentric. The first juggling move he taught us was The Drop. So every time you drop your juggling ball, you’re performing a Move!

    I’ve been of the opinion for a long time that education at all levels needs to put much more emphasis on teaching people how to blow it all over the wall. Failure is a vastly underrated, but deeply necessary skill.

  41. I needed to read this today. 🙂 I started a new job last summer and was told after a few months that they wanted to promote me–a big promotion, more into a realm commensurate with my education but totally outside what I was hired to do originally. Fast forward to two weeks ago and my replacement in my old role was hired, so I’m training them, and my work email is a dog’s breakfast of old role stuff, new role stuff, and surprising and random stuff, which I find very stressful. This morning I kind of freaked out, so I am sitting in my office with the door closed and music playing, just trying to methodically get through all the things that need to happen today.

    I love my office. I love my coworkers. I liked my old job and I think after an adjustment period I will LOVE my new one. But I fully expect to spend 3 months just getting my feet half under me, and a full year hammering down processes before I can start making the kind of changes I want to.

    It is DAUNTING. But it will be okay. Cap’s advice is super awesome. And LW, you will be okay too. Just remember that “okay” doesn’t always look like what you expected it would before it happened.

  42. I see that LW has already gotten back to us about taking a different job so I hope this is still useful, but the thing that I recommend the most is redefining success. With physical therapy, you’re thinking in terms of strengthening, stretching and balancing until the patient is able to walk or isn’t in pain, but what if you had goals like:

    Down in dumps Patient’s day was brightened by having something to do and someone to pay attention to her for 15 minutes.
    When I left, Patient was still humming catchy tune we hummed together to give rhythm to the exercises I had him doing.
    Patient tried to catch the ball each time I threw it (even if she only caught it once).
    Patient told me about his son’s visit and smiled.
    Angry demented patient didn’t try to bite me.

    All of these things are improvements, but you don’t know that when you’re new. If you change your goals to things like making someone feel better temporarily, even for a few minutes, you’re likely to succeed, and that’s huge.

    1. Really excellent perspective, Clarry!
      You don’t need to be Magic PTA and make patient Perfect to be successful. Helping them feel better, emotionally or physically, is part of success. Every smile, every laugh, every sigh of relief is a step on the path of success.

    2. Thanks for the note of support. I’ve had physical therapy as a patient, but I’ve mostly worked retail and food service. Sometimes my list for a successful day looks like:

      Half the customers who walked in the door spent an extra moment looking at the display of merchandise I built.
      I was able to answer the questions about the sale merchandise– even if no one bought any.
      Two customers said they’d come back later– though they didn’t buy anything at the time.
      Boss said I got it right when I lied about his not being in the office when he really was.

      My favorite success, though in some ways it had nothing to do with me: One woman had forgotten her glasses and expected me to go around the store with her and read the labels on absolutely everything. That wouldn’t bother me except that other customers needed my help. I asked her politely if she minded if I served some of them and got back to her. Normally this is just a courtesy and the customer taking all my time says to go ahead. This woman said no! I was stuck, but I caught the eye of a guy who had previously been looking impatient, read one more label for the time-sucking customer, then said excuse me to her and rang up the man’s purchase before she could object. He said nothing, but he grinned at me. I patted myself on the back for that and awarded myself salesclerk of the year award when all I did, essentially, was tell a guy he had to wait.

      There’s another bit advice normally given to writers with writer’s block: It’s to write something bad. Sit down and type X number of pages of bad writing. That’s disjointed, clicheed, half sentences, whatever it is that’s bad, just keep typing it. (If when you’ve been doing this for a while, you can look it over and find a few good ideas in the drivel you’ve written, you can rework it into something better, and call it a success.) You can use it with physical therapy or any job. It goes: Go into work and spend time there. Decide in the morning that you’re going to do a bad job, but you’re just going to stay at it for the length of your shift. Then, later, you might find that you did some good, and that’s terrific.

      Thing is, many jobs are rewarding over the long haul. You can’t see improvement in only a few days, but you might be able to see it over several months.

    3. So much this. The PT’s I worked with shrunk my world from Insurmountable back down to I Can Do This. And, not only in the moment, but long after we were done.

  43. At school, the important thing is to master the material. Success is measured by Being Able to Do The Thing correctly without needing help.

    At work, the important thing is to get the work done. Success is measured by Getting The Thing Done correctly and on time.

    That’s a hell of a difference, and many people have trouble with it. Especially because nobody talks about it – it’s another one of those Everybody (but me) just magically knows this somehow.

    My first job was many years ago, but I still vividly remember the moment that I figured out “It’s more important to my boss that this thing get done on time than that I show that I’m capable of doing it all by myself.” And then when I figured out, “It’s more cost-effective for the company if I go ask for help after I’ve been stuck on a task for, say, an hour, than if I beat my head against the wall for a whole week before asking for help: it saves them 4.8 days of paying me for no results!”

    It was hard, and I was horribly embarrassed, but I did it. And my boss was perfectly nice about it, because of course he didn’t expect me to walk in the door Able To Do The Thing. He knew he’d have to train me, and that for the first few months, I would need help in order to Get The Thing Done. And that was part of his job, and part of my more senior coworker’s job: teach the new hire What The Thing Is And How To Do It. If there was some part of The Thing that I was having extra trouble mastering, it was my manager’s job to notice, and make sure I got extra training on that part.

    Having a degree or a certification in a field doesn’t mean “This person can now Immediately Do Any and All Jobs In This Field!” It means “This person has the required background and skills to Learn What The Thing Is And How To Do It in a reasonable amount of time.” At my workplace, we allocate 3-6 months for a new hire to come up to speed and gradually move from “needing frequent help and supervision” to “occasionally needing help when encountering new or complex tasks.” We plan for reduced productivity from other staff during this period, because if Mary is spending part of her time training/supervising New Hire Joe, then that’s less time she is available to do her own work.

    I know my particular work experience doesn’t map directly onto PT, but the general point about different standards of success in school and on the job is common enough that I thought I’d share.

    Best of luck to the LW & to all the new-job-starters out there!

    1. “If there was some part of The Thing that I was having extra trouble mastering, it was my manager’s job to notice, and make sure I got extra training on that part.”

      And actually, it’s part of the subordinate’s job to bring this to the manager’s attention if the manager is unable to notice it.

      That’s what I think is so, so amazing about our Letter Writer (Grace). That she asked for help! That’s major competency there!

  44. I don’t know how the curriculum is in PTA school, but in nursing school in our final semester we had a class focusing on ‘role adjustment’ and making the transition from student nurses to RNs. See Patricia Benner’s spectrum of Novice to Expert but the very, very short version is that it takes a LONG TIME to be even proficient at the job of nursing, and EVEN LONGER to become truly an expert. EVEN STILL I felt completely at sea when I started my first job. It did get better! I’ve been working for a few years now and most days are good days…but I still came home in tears not long ago after a particularly trying shift during which I felt like I couldn’t finish the most basic of tasks without a) asking for help; b) getting called away to do something else; c) taking 3 trips around the unit gathering supplies because I couldn’t focus long enough to just get one thing done (because I was too preoccupied with all the other things I had to do!).

    Nursing is a second career for me, and my first career was in the arts. The work environment and the concentric circles of management in a hospital are SO VERY DIFFERENT from my previous experience that I think I may never master the environment (even though I think I’m usually pretty good at taking care of the patients by now).

    So, LW, I’m glad to see you’ve had the opportunity to work on this from a different angle, and I wish you very much well. Health care is hard, in part because it’s just physically difficult and in part because we’re expected to compartmentalize our own feelings around patients/clients and this can lead to compartmentalizing around our co-workers and it’s VERY EASY to think “no one has ever had as terrible a day as I am having, and done as poorly as I am doing, because they all look so calm and flawless!” I’m not gonna say “they’re faking it 100% of the time,” but each of them has good days and bad days, just as you will. If you have the opportunity, thank the people who help you out on the bad days (with out self-flagellation; just genuine thanks) and look for times when you’re the one who can help someone else out. I might love you forever if you help me reposition my patient, and I know it’s a good chance for you to get some ROM exercises in there, too!

  45. Something that I maybe read here or maybe on another site, was about allocating yourself time to feel a feeling that is overhwelming you currently. So maybe its grief over a relationship ending or maybe its anger at a family member or maybe its new job stress. Remember that energy is finite and you want to save some mental capacity for when you are at work, not wipe yourself out at home each night and on the wknd by worrying and then be an exhausted mess at work.

    So set yourself 15-30 minutes each night, or second night, soon after you come home, to spill out all the feelings and worry. Make a private tumblr or just a word document and verbal vomit. Even record a video or audio is thats more your thing. You could spend some of the time, maybe the last 5 minutes, coming up with possible ways to work on issues you have. Like say today you had trouble remembering your locker combination so tomorrow you’re going to take a picture of each step with your phone. Or you couldn’t grasp a concept so you’re going to ask a coworker what text they found best for learning it. But you don’t have to because your worries may not be problems with you that require fixing but just adjustments that will adjust themselves with time.

    After that allotted time, you do not let yourself worry spiral into anxiety hell. If you catch yourself, say nope, save that for next time. Now I will play candy crash or walk the cat or do handstands. All those things are important for recovery after the intensity of new job days. You need a life outside of work. * if your industry suggests you do continued learning right after you graduate, that doesnt count as your worry time, but make sure you’re actually studying and not panicking about your perceived sucking at this weeks topic.

    Maybe ask your close friend or partner or parent you often talk to, to be supportive of this allotted worry time. If they hear or see you worrying outside that time, they can gently remind you to put it aside.

    At first you may need more time to note down your worries. But as the days go on you will find less new things to worry about because you will have written them down already on previous days and you will be less likely to want to repeat yourself. Try not to write things like “jimmy has cuter hair lackies than me” which isnt so constructive but more “I feel my attire isn’t smart enough”, which you could work on.

    Some things you write you could ask your mentor or friends for feedback on. Your mentor could reassure you and say that your hair lackies are perfectly appropriate for work and do not need to be cuter. They may say how about I let you shadow me doing that task today. Take their feedback seriously. In fact, write it downdown and make it solid. Someone told me that I am professional enough. That makes it as worthy as your worries and may help outnumber them.

    I hope this makes some sense. I’ve found itfound it helpful after breakups when I sense myself sliding into hermit depression mode. Giving my worries an allotted time and format was like saying yes these are real feelings but they are not everything in my life so I will not let them take over.

  46. You are so wonderful, LW. Love yourself fiercely, a job is just a job, and it’s okay not to do well in it, and it’s okay to keep learning for the rest of your life. xxxxxx

  47. …yes. Yes, I think you *are* me.

    I did OK in my GCSEs, but could have done a lot better if I’d put in the work I never had to put in before. The subjects I got very good grades in both at GCSE and A-level were exclusively the subjects that were exam-based only and did not require the completion of coursework or modules.

    Now I still struggle if I don’t get something straight away because I never got used to having to ask for help.

    1. You’re not quite me, then: I was SO. HAPPY. to be the last year allowed to do 100% coursework :p

  48. LW, when I first read your original post I thought that it was all about your anxiety and imposter syndrome, but having read your update I started to wonder if there was more going on. You recognised some “shady” things there, and the introductory training was not the best. Could your panic attacks and extreme anxiety be a response to the actual situation?

    If you had subconcioulsy recognised problems in this job, how would your back brain let you know there actually was a problem? You are already hyped up because this is your first job, so you are already reactive. You are also probably used to ignoring anxiety and worry just to get along day to day, so just adding a little anxiety is not going to work. And your system does have a well rehersed and effective way of getting your attention: full on existential-threat-to-existence panic. So that’s what your brain did, very effectively.

    I think those of us with extra anxiety can have real problems recognising real vs self generated threats, and I think this is also a reason to get therapy; to help you pay attention to the real threats of the outside world, sort your intuitions out in a reasoned way, and not just dismiss them as the brain weasels actiing up again.

    Now this may not strike a chord with you at all but I just thought I’d throw it out there as food for thought. It seems like you have come through this crisis and found a place to work that suits and I am so glad to hear that. But your weasels are not going away so at some stage it would be good to tame them.

  49. Dear LW,
    you said ‘I had 3 clinicals in 3 different settings for a total of 17 weeks’. Rather than run your mind through the thing that didn’t work (and the main reason it didn’t work was that you had a panic attack and decided to prioritise your self-care; which is not necessarily a ‘bad’ decision), you should concentrate on what DID work for you. What was it about those places that made you go, repeatedly, ‘I love my career’ and continue with your program and put in all the hard work you had to do to graduate?

    Once you understand what kind of environment/case load/instruction/support you feel comfortable with, you might be able to identify better what, exactly, set off your panic button about this job. There’s no guarantee that you will be able to *get* all this, but those are definitely questions you can ask during the interview (remember: you get to decide whether you want to work there, it’s not just about saying what they want to hear or begging them to employ you): how does your potential employer plan to ease you into the job, what kind of training will they be giving you, who will teach you how things are done in this particular place (e.g., how to keep records, who creates/monitors treatment plans, how much input you will have), etc.

    Jedi hugs if you want them. Stepping out into a new role for the first time is hard.

  50. Oh, man does this sound familiar. The part about the exceedingly high standards while in school versus real world expectations is *still* something I have a lot of trouble with—and I turned 40 last summer. In my case, it was mostly my parents’ doing. They meant well, but weren’t really cognizant of exactly what was going on with me (Which is to say, they were both gone by the time I was diagnosed as Asperger’s/autistic at 37). As a result, school was pretty hellish from 1st grade to the end. In our house, your were expected to take the most difficult classes available and get As in them. Bs were acceptable, and a C was considered a failing grade. So I *really* feel your pain there.

    Then all of a sudden you’re out in this new, unfamiliar world working with people you don’t know and can’t predict while still trying to maintain the frankly ludicrous standards from school. And for all but a very, very few people, *it just doesn’t work.* It can’t.

    I was pretty much trapped into going into law school by my parents, but I’ve never once worked as an actual lawyer, because I realized far too late in the process that while I can run myself into the ground, work my butt off while ruining my health in the process for 3 years of law school, I cannot and more importantly *refuse to* do the same for the next 30-40 years of my life. It is just not happening.

    Also, I don’t think anyone has pointed this out, but working in a nursing home/elderly care environment is *extremely* stressful. I took care of my Mom the last 4 years of her life, when she was in a nursing home due to advanced Parkinson’s and dementia, and just spending a Saturday with her every other weekend left me completely passed-out-asleep all of Sunday and draggy as hell for the following week. Residents there are generally not the happiest people–a lot have lost their independence they’ve had their entire adult lives, often are abandoned by family and friends, and have major health issues, or some combo thereof. They’re often pretty miserable (and justifiably so), and all too often take it out on the staff.

    I honestly would rethink your choice of a nursing home for work, at least for now. Get some experience in a much less stressful environment first–enough that you can honestly and fairly objectively say to yourself that, yeah, at least most of the time, you have a pretty good idea what you’re doing. That’s amazingly hard to do fresh out of school, and when you add mental health issues to it, it can be an utter nightmare. It certainly was for me.

    If you’re like me, and I think you are, one of the toughest things you will have to learn to do is to stop being your own worst critic and cut yourself some slack. And I can’t tell you how to do it–it’s just one of those things where you will hit a point where you just can’t do everything you think you should be and have to accept that despite what you learned, despite your previous life experiences, this is the way it’s going to have to be, because you will run yourself so far down you can’t function.

    My Mom was like this after my Dad died unexpectedly. Dad was obsessively neat/clean person, and the house always looked like it was ready for a magazine photo shoot. But after he died, Mom just couldn’t keep up with the massive workload that required. I would be on the phone with her for hours while she cried, moaned, and wailed that everything was falling apart–which it wasn’t, but it certainly felt like it to her. I finally had to explain to her that one person can’t do the work of two, and literally said in frustration, “Mom, sometimes you just gotta leave the junk mail on the counter until later, and that’s okay!”

    This is probably already TL;DR, but I just have to add that I know– boy, do I know–that it feels like the world is coming down around your ears and all of your plans for life are falling apart at the seams. The thing of it is…. that’s life. And not just your life, believe me. You made it through a tough career training program, and know what? If you made it through that, you’ll make it through this. Money is tight, so you might have to get another job in the meantime doing something else–retail, office temping, whatever–so you have some money. And it *sucks*. Definitely pursue some sort of mental health treatment if at all possible–for me, I have to give priority to spending my $$ on my meds, because they’re what keep me functional enough to work and make the money in the first place. You learn to cut things down to the essentials, and do some things yourself to save money. (If y’all never hear from me again, then my attempt at changing my own brake pads this weekend *probably* didn’t turn out too well. 😛 )

    But you’ll make it. You’re tougher than you think you are. I certainly am, even though I’ve had to learn it the hard way.

  51. I 100% understand. I am an occupational therapist and work in an in-patient rehab facility full time. There are days and patients that are so rough I’ve cried at work and other times where it is incredibly rewarding. When I first started after I graduated it was very hard and I felt like I had the title of therapist without knowing anything! You grow so much your first year treating and pick up a lot from other therapists. Also, it helps to remember there are many settings you can treat in that are all different and may be a good/better fit in the future (acute, in patient rehab, outpatient, etc.). I know nursing home and outpatient are not my settings but they are great for others, it totally varies. Some things that help me are 1) getting involved in something fun outside work 2) having people to talk to that understand the job/the trials whether a family member, doctor or friend 3) and my anxiety meds I got during grad school + daily self care I learned in therapy for my OCD. When I was new I also spent time thinking of treatments and ideas before each patient so I didn’t feel put “on the spot” if I had to change something up or if what I picked was too easy/too hard. Our job is tough and you are not a failure, it sounds like it was maybe just a bad match or a lot of built up stress. I’m sure you’ll find your niche! In the mean time, hang in there and go easy on yourself ❤

Comments are closed.