Is this discipline or discrimination for being autistic?

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Is this discipline or discrimination for being autistic?

Dear Nurse Beth,

I have been recently diagnosed as being autistic (the old moniker would have been Aspergers). I have been on the same unit for 10 years. Recently, there have been issues where my behavior has come into question and it is related to having autism. I am working with a therapist to help me and working on getting an official diagnosis.

What rights do I have as someone that most likely has a disability that is recognized by ADA. I am a former teacher and the parent of 2 special needs kids. In school, they were protected by wrightslaw, which basically asserts that a child's unwanted behavior may be related to a disability and therefore, they cannot be reprimanded. They wanted to write up my child because he wouldn't "follow a direct command" (to eat) when his blood glucose was under 40.

I am being "talked to" about things that are related to me being horrible in reading people in certain social situations. I have no malice or ill will toward anyone and I truly don't "get" what it is that I have done.

Sorry this is a little rambly-I tend to wander. Edit as you need if you decide to address this issue. There is one thread about being a nurse and autism, but it hasn't gotten much traffic. Would love to hear your insight. Thanks!

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14 Answers

Specializes in Tele, ICU, Staff Development.

Dear Recently Diagnosed,

Autism is a covered disability under the Americans with Disabilities Act (ADA). The ADA is intended to prevent the discrimination of employees with a disability. You need to consult with an attorney to find out all of your rights under the law.

To be protected by the ADA, you have to be able to perform the essential functions of the job, with or without accommodation.  As an example, if interaction with your coworkers is deemed an essential function and you are unable to interact with your coworkers (ex., giving and receiving report), your employer does not have to retain you. Contrast this example with that of a coworker who complains you're unfriendly because you can't read social cues, which is not the same thing.

Talk With Your Manager

You might want to start by having a frank talk with your manager. While you don't have to disclose that you have a disability unless you are requesting an accommodation, it may help put the situation in context for her to know that you're autistic, how it affects you, and that you are working with a therapist.

You say you are only recently diagnosed.  Assuming you've performed your job successfully for 10 years, and your behavior has remained the same for 10 years, it's fair to ask your manager why feedback on your performance has suddenly changed.  

 As far as the "talks" (which are really verbal counselings), ask for specifics. You could ask if there have been any patient complaints, or if this is just about social interactions.

Ask your manager for help. Let her know you want to partner with her for your success.  "Specifically how would my performance look different if I met job requirements in this area?" This clarifies which (if any) actual job requirements you are failing to meet.

If the verbals progress to written discipline, it should include a performance improvement plan (PIP). A PIP protects you, because it requires your manager to identify attainable goals that you can accomplish. Without measurable goals, the feedback is not constructive and you are not given the opportunity to improve.

Read "What to do When You Receive a Warning at Work"

Talk to your union rep if you are in a union environment.

Good Fit

There was a new graduate nurse named Edison who was hired to a busy Tele unit. He came across as aloof and his preceptor, "Lisa", described him as "robotic". Technically he did well, but it didn't seem to be a good fit. Fast forward 10 years and Lisa was having surgery in a neighboring hospital. Imagine her surprise when in walked Edison-her CRNA. He was confident, professional, and very good at his job in the OR. He had discovered his niche and excelled at it. Word had it that he was highly requested as a CRNA- and especially by nurses !

It can be exhausting to try to figure out social cues all throughout your shift. Only you know what the optimal level of interaction and best setting are for you. Luckily there are literally hundreds of options in nursing.

Best wishes and thank you for writing in,

Nurse Beth

Resources

If you think you have been discriminated against in employment on the basis of disability, contact the U.S. Equal Employment Opportunity Commission (EEOC).

National Organization of Nurses with Disabilities

Fellow high functioning ASD here. This is a specific reason I accepted an offer to work the operating room. No shame in playing to your strengths. 

10 hours ago, Nurse Beth said:

Thanks for sharing ? Any words of wisdom for our OP?

Well, truthfully, I specifically targeted OR after shadowing it because I realized it was the best possible choice for someone with my issue.

Aside from that, I am open and up front about my diagnosis. I can’t hide it for very long, I’m very "Sheldon Cooper"~ish. I make it a point in my interactions with others to regularly receive feedback on my interactions and am 100% blunt to ensure I have not unintentionally offended anyone in interactions if I have a tinge of doubt. I also set ground rules by encouraging people to directly and clearly tell me any time that I have said or done something that might have been considered rude or crass to ensure that I know and can modify my behavior, because I am clear with them that if this occurs it is not intentional.  I make it fairly clear early on that I am incapable of processing subtext and take everything literally. I also personally am incapable of lying and will avoid direct questions that make me uncomfortable if the situation is not one that requires my input for work related reasons. 

I think the most valuable lesson I can share is to set realistic expectations, communicate clearly, and have them teach back that they understand where you are coming from. 

——- Edit:

LOL, case in point, it took me an hour to realize I should have thanked you for asking. Thank you. 

I been a nurse for twenty years now in same facility. I always know social interactions have been painful for me and over the years it's becoming more apparent that I have to mask and mimic other co workers to be successful. So I know that I am undiagnosed. I have been called a squirrel or on the spectrum by my co workers including bullied and marginalized.

I started to deviate for my own well being to rise and received my PCCN and CEN. Still my facility chooses clueless extroverted people and therefore I watched my type males especially never finished their probation period. I have never had a performance evaluation besides that's how bad my facility is.

With your gifts that we have is that we drive and guide others of our knowledge including policy, we become that resource nurse or charge nurse. 

Unfortunately, we should be a part of staffing education especially inclusive diversity. I stick around to write occurrence reports because I am secretly driving change with the knowledge I have. I am done with the bullying and marginalized I am okay who likes clicks away. I wear a badge pin SNL character Molly Katherine Gallagher to break the ice and encourage others to wear Elon Musk one to show greatness.

Remember there is a sentinel alert called diagnostic overshadowing with patients austism, gender transition, substance abuse that causes harm. Maybe education to staff and awareness is what your manager needs have in her PIP. 

Hang in there!!

I would contact the disability office at work asap. Once your disability status is determined, you will be protected under disability laws.Most managers are not trained to understand disability. It will help when the proper office intervenes on your behalf.

I have this same issue. Very few social interactions as far as sustained conversation and am a very nice person. Very uncomfortable sometimes sitting with others. I don't get jokes either and don't laugh at them. Some jokes I do get but others while everyone is laughing I don't get it. I take things literally also and speak it literal terms. But God didn't make everyone the same. ?

Specializes in Community health.

The question of how you have been successfully employed on the same unit for 10 years, and are suddenly having trouble, is a huge one. Did you get a new manager?  Did expectations change?  New coworkers? This is a really different situation from starting a new job and realizing that you’re struggling because there are social/communication requirements that are tripping you up. 

I wish Nursing schools gave students as much training in accepting different co-workers as much as they give to patient diversity.
As an immigrant I have been at a loss to understand innuendos, joke around and fit in, in spite of the advanced degree I have obtained.
I have been deliberately misled into believing ethnic slurs were standard terms to address minority persons and even lost a job as a result. I have been set up to walk into situational traps, I have been called ‘shy’ while I am not, passed up for hiring, promotions, and recognition, so much so that I have accepted this as a fact of life and now I work sometimes just for the money, sometimes just for those I serve and sometimes only for the higher power.

Specializes in orthopedic/trauma, Informatics, diabetes.
On 12/8/2022 at 3:36 PM, CommunityRNBSN said:

The question of how you have been successfully employed on the same unit for 10 years, and are suddenly having trouble, is a huge one. Did you get a new manager?  Did expectations change?  New coworkers? This is a really different situation from starting a new job and realizing that you’re struggling because there are social/communication requirements that are tripping you up. 

new manager started it about 2 years ago and then the best manager ever left and now we are back to NO manager and some upper management has gotten involved and it seems to have become this person's personal mission to hound me. Can't get help until an official ICD10, but it could be weeks to get in to see someone. 

It's gotten so bad that I may look for another job. It is ironic that I have been there 10 years, worked extra for the last 3 years of Covid while continuing work with practice councils and committees. Teaching new RNs policy and ortho specific stuff. I've always gone above and beyond, which I choose to do. I love what I do. I do know that there is one or two people that don't understand me and have caught the ear of management. Too bad this person loves to do their homework for their NP Program while at work. Doesn't ever seem to get caught, although I don't think it would matter. 

As a ND person, this is all very upsetting b/c I don't know what it is they want from me. Therapist said they are treating me as having a behavioral issue when it is really a neurological one. 

It's a really hard pill to swallow when you realize that being a loyal employee means nothing. And that they care nothing for me. ? 

Just throwing this out there, but I would initiate a workplace harassment claim with HR based on disability immediately. 

Specializes in orthopedic/trauma, Informatics, diabetes.
On 12/20/2022 at 6:01 PM, foxypaws said:

Just throwing this out there, but I would initiate a workplace harassment claim with HR based on disability immediately. 

I have sort of started the process, and I think they are figuring it out. the person that's involved in this thinks that playing "Dr Google" for mental health is OK. I am a former teacher and have a masters in teaching; I have education regarding neurodiverse learners/students/people. EBP is preferable. Not something printed off the internet. 

I actually have a meeting today with some of the org disability group. And, employee health has a mental health resource that might help me get tested sooner. SO stressful to do this to me at this time of year ?

Specializes in Tele, ICU, Staff Development.
On 12/2/2022 at 4:45 AM, foxypaws said:

Fellow high functioning ASD here. This is a specific reason I accepted an offer to work the operating room. No shame in playing to your strengths. 

Thanks for sharing ? Any words of wisdom for our OP?

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