Increased access to health insurance and health care, increased complexity of patients in our aging society, and challenges in primary care team staffing are among many current challenges to providing high quality, effective, and satisfying care to all patients. At the same time, the team is expected to attend to the equally important need for prevention, health promotion, and care coordination and management of the population at large. The demand to manage multiple, comorbid complex chronic illnesses are overwhelming the primary care system and causing waits, delays, and a shifts toward receiving primary care in inappropriate settings such as the emergency room (ER). Solutions cannot be limited to producing more physicians, nurse practitioners (NPs), and physician's assistants (PAs) as primary care providers, but rather in looking at all members of the primary care team and ensuring that each member is contributing at their highest level based on education, training, and licensure/certification. One professional, the registered nurse with a Bachelor of Science in Nursing (BSN-RN), has traditionally been underutilized as a core member of the primary care team. Supporting BSN-RN practice as a key member of the primary care interprofessional team is a strategy that will help meet the needs of our patients. BSN-RNs have the knowledge, skills, and abilities to assume critical roles in prevention, health promotion, management of acute and episodic illness, chronic illness management, transition management, and complex care management and coordination, as well as supporting the work of the entire interprofessional team (Josiah Macy, Jr. Foundation, 2016; American Academy of Ambulatory Care Nursing ([AAACN], 201). Transforming the role of the BSN-RN in primary care requires the coordinated responses of policy makers, academic institutions, accrediting bodies, primary health care providers and other primary care team members. In 2015, the Health Resources and Services Administration (HRSA) provided financial support (HRSA-16-066) to nine universities to develop educational models that provide BSN students to gain more clinical experience in community settings (HRSA, 2015). In late 2017, building on those successes, HRSA initiated a new funding initiative (HRSA-18-012) and called for proposals addressing strategies focused on recruiting both current and future nurses to practice careers in primary care, utilizing their full scope of practice as a member of primary care teams (HRSA, 2017). Fundamental learning from these projects demonstrated that BSN-RNs are an essential component for quality care. Therefore, policies which impede primary care organizations from investing in the BSN-RN as a core member of the primary care team must be addressed.

The Institute of Medicine identifies nurses as being in a position to become a powerful force for change in our healthcare system through their leadership. The impostor phenomenon is a psychological pattern in which individuals doubt their skills, talents, or accomplishments, or may have internalized fears of being exposed. In a time when nurse leaders are needed the most, these feelings may prevent nurses from advancing their careers and to lead. While a plethora of studies have examined this phenomenon and its negative impacts to mental health and career progression, there is little on the experience among nurses and none among nursing leaders or how to manage it effectively. Fellows of the American Academy of Nurses are considered nursing’s most accomplished leaders in education, management, practice, and research. These successful leaders have been recognized for their extraordinary contributions to nursing and health care. This qualitative study used a phenomenological method designed to gain insight into how these successful leaders have experienced impostor feelings. Ten nurse leaders were interviewed about their career progression, and their experiences with the impostor phenomenon were revealed. Findings were analyzed and the six essential themes that were illuminated from those shared experiences were: (a) Welcoming Opportunities, (b) Extended Sphere of Support, (c) Willingness to be Courageous, (d) Embracing the Journey, (e) Willingly Expressing Humility and Authenticity, and (f) Navigating the Impostor Process. The findings from this study will contribute to the body of knowledge about the impostor phenomenon within the context of the nursing profession and leadership and may benefit other nursing professionals experiencing similar feelings to mitigate them.