nurses with Aspergers/autism?

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can anyone relate? i don't know what i'm asking for here really, other than i guess confirmation that i'm not alone? and maybe advice on how other nurses with autism/aspergers cope and blend in?

i feel like no matter how hard i try to act like the "normal" extroverted empathetic professionals around me, i still come off as weird/awkward/uncaring sometimes. an example- i work with geriatrics/older adults and I talk to them like they're...well, adults! because I assume that's what they want. Who wants to be talked to in an infantilizing way like they're children? But then other nurses/therapists/aides talk to patients in this way and the patients rave about how "sweet" and "caring" they are. So clearly I'm missing the mark here.

another example- i'm very task-focused. my productivity is amazing, and i get compliments on my actual work (IV starts, etc) but i'm so focused on what i'm doing that i apparently come off as uninterested in the patient because I don't make a lot of small talk because that doesn't come naturally to me at all, so whenever I try, I feel like it sounds forced and awkward. But if I don't do it enough, then I apparently am not caring enough. "resting *****face" when i'm concentrating on something (like oh idk, actually doing my job) doesn't help.

i'm good at anticipating patient needs and offering tangible/practical assistance (i.e. always being on top of pain meds and call bells, offering to take patients to the toilet instead of waiting for the aide even if i'm busy, etc) because i can do things like that, but i'm not great with making conversation, or knowing what to say/how to react when patients are upset or talking about their problems- i do try to make all the right facial expressions and say the right things, and i guess it works at least some of the time because i have had patients be like "you're such a great listener" and whatnot, but other times i feel like everyone can tell i'm just copying other people and have no idea what i'm doing when it comes to the "bedside manner" aspect of this job.

it's really frustrating and exhausting to put so much energy into trying to be someone i'm not. especially when i still feel like in spite of all this effort i'm just weird and annoying.

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I am right there with you. My default is that I can talk "shop" all day long but cant carry a social conversation worth a darn. So that is what I do, I do the whole educating the patient thing, ask them what they know about their disease, meds, plan of care etc. I really have to monitor myself as to when it is my turn to speak or respond. the more interested I get in the subject, the worse I am about interrupting or speaking out of turn. so I bite my tongue and just listen. I generally avoid the "group" when it's time for lunch, break or gathering at the nurses station and just find a place to myself.

Then I just do my job. But I am open about being an Aspie and if I think a conflict is developing I will go talk to the persons directly and explain that I am not being uncaring, rude, distant etc. I avoid gossip like the plague, but I wonder if this avoidance gets people labeled as antisocial or uncaring etc? But I have ASD and I am doing my job and communicating as best I can. I encourage them to please speak directly with me anytime they have an issue with something I did or said. Hopefully this will work for me as I am just starting out in this profession

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Specializes in Psychiatry, Community, Nurse Manager, hospice.

You sound like a great nurse to me. I would personally appreciate being treated like an adult and not talked to in a sing-song voice. I hope no one does that to me when I'm old.

Patients may think you are weird, or even annoying as you say, but they will appreciate what you do for them and that you attend to their needs. I would rather have a nurse with a flat affect who brings my meds on time, attends to my toilet and bathing needs and takes care of my pain, then one who is a schmoozer and doesn't attend to my needs.

Focus on your strengths. If you feel like your Asperger's is really affecting your job, go to a weekly therapist who specializes in Asperger's. My son got tremendous benefit from that. It was all about social cues. It can keep your social skills sharp.

I like the way my aspie family members respond to me when I am blunt and direct. If they upset me I can give them clear and concise directions on how not to do it again and they actually never do it again. It's refreshing.

If you find patients are engaging you in conversation, focus on listening and reiterating what they said in your own words. That is usually all anyone needs.

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Specializes in Medical-Surgical/Float Pool/Stepdown.

Aspie mom here. My "high functioning" aspie child, that's not really a child anymore, eventually just figured out how to act/react to those around him while being himself. He's gotten pretty darn good at maneuvering the world around him but he hasn't lost sight of him being him which is what makes him so amazing!

Instead of trying so hard to mirror behaviors you think others expect, are you able to look into other areas of nursing that may be a bit less people-soaked...even night shift can cut day an on the amount of exhausting interactions but still let you do the things that you're good at. You might try your hand with ICU or PACU type settings where you still need those people skills but I would hope you could be more task oriented (mixed with a ton of critical thinking and knowledge) as well. Good luck to you. You are not alone!

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Specializes in Med/Surge, Psych, LTC, Home Health.

I appreciate the fact that you talk to your patients like they are adults.

That's what they are, and I get very annoyed at nurses and aides that

speak to patients in that baby-talk way. Now, some nursing home residents

may get to the point that they actually like being spoken to that way,

and you know... whatever. However, I've seen nurses and CNAs'

actually speak that way to patients whom they don't even know well.

Makes me angry.

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thank you so much for taking the time to encourage me and give me some really good ideas to consider. i'm on break at work right now and will reply in more detail later, but i just wanted to say i did read all your replies and very much appreciate them.

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Patients may think you are weird, or even annoying as you say, but they will appreciate what you do for them and that you attend to their needs. I would rather have a nurse with a flat affect who brings my meds on time, attends to my toilet and bathing needs and takes care of my pain, then one who is a schmoozer and doesn't attend to my needs.

true, but it seems like everyone else i work with can do both- schmooze *and* do the work. :p

If you find patients are engaging you in conversation, focus on listening and reiterating what they said in your own words. That is usually all anyone needs.

this is a brilliant idea. i'm going to consciously try to do this when patients are going on about their family/health/personal problems and i don't know what to say. thanks!

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Aspie mom here. My "high functioning" aspie child, that's not really a child anymore, eventually just figured out how to act/react to those around him while being himself. He's gotten pretty darn good at maneuvering the world around him but he hasn't lost sight of him being him which is what makes him so amazing!

that's awesome!

Instead of trying so hard to mirror behaviors you think others expect, are you able to look into other areas of nursing that may be a bit less people-soaked...even night shift can cut day an on the amount of exhausting interactions but still let you do the things that you're good at. You might try your hand with ICU or PACU type settings where you still need those people skills but I would hope you could be more task oriented (mixed with a ton of critical thinking and knowledge) as well. Good luck to you. You are not alone!

thanks for the good ideas :) re: changing jobs/practice settings, i would actually like to eventually work as a coach for teens and adults with ASD/ADHD/LDs. i've just started a degree program that will help me with that, and my current job works with my school schedule. so i'm going to try to treat this job like part of my schoolwork- i.e. using the techniques and information i'm learning to 'coach' myself before i can start coaching others. :p

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But I am open about being an Aspie and if I think a conflict is developing I will go talk to the persons directly and explain that I am not being uncaring, rude, distant etc. I avoid gossip like the plague, but I wonder if this avoidance gets people labeled as antisocial or uncaring etc? But I have ASD and I am doing my job and communicating as best I can. I encourage them to please speak directly with me anytime they have an issue with something I did or said. Hopefully this will work for me as I am just starting out in this profession

I would like to do this, but am afraid of having it used against me if people at work know. otoh, it might take some of the pressure off to explain so people don't just think i'm awkward and flat-affecty* for no reason (*not all the time, but when i'm tired or stressed or working back-to-back shifts, i don't always have the energy to constantly be monitoring how animated my facial expressions are).

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I loathe the baby talk to patients and you sound like the kind of nurse I love to work with. I say this as a very extroverted person as well, I can small talk with just about anyone. I think you should keep doing what your doing! I want the nurse who knows her/his stuff, could care less if he/she can be sociable.

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Specializes in Psych, Addictions, SOL (Student of Life).

Even though I don't have Asperger's of HFA (High Functioning Autism) which is what they are calling it now. I have been married to a man on the spectrum for 17 years. I have witnessed his struggle and even experienced problems in my marriage because of it. Still he is the smartest man I know and once you get to know him he is considerate, kind and sweet once you know how he expresses these things. I applaud you for wanting to discover new ways to connect with people and Push past the social boundaries of this disorder. There are some books you may want to read if you haven't already. One is The Complete Guide to Asperger's by Tony Atwood which is pretty much the Asperger's bible. Also two books written by people with HFA that are quite good ore Look Me In The Eye by John Elder and Journal of Best practices by David Finch. The prevalence of HFA is significant and we meet people in all walks of life who have it. I applaud you for wanting to reach out and connect.

Peace and Namaste

Hppy

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Oh my god :lol2: It sounds like I wrote this, as well.

I recently got diagnosed with Autism, which basically explained everything that was "wrong" with me. I always felt like an alien. My brain doesn't work the same way other peoples' do, you know? I always got called "weird" and I never connected with people. I don't make friends easily (and i'm like 95% okay with that- my best friends are my family and my pets).

I literally got yelled at by my friend as a kid because I never showed emotions to her gossip and "surprising" stories, and I get called "Spock" because of my lack of facial emotions. I, too, can't do small talk. I detest it, but if there's an engaging conversation that I feel I can learn something from (or where I can share my strong point of view) then I tend to be hooked. But I'm not the person to build rapport with co-workers and customers (or in this case, patients). I'm good at my work. I'm detail-oriented and understand how and why I have to do things a certain way, so it mostly comes naturally. But conversation, does not. When some of my "friendlier acquaintances" at work would start trying to talk to me more, I'd gradually try to avoid them so it wouldn't become anything more...

I know people think I'm strange, and I've finally come to accept that I'm not going to "fit in" with people. :down: I get self-conscious, though, because I don't want people to dislike me or think I'm rude, so I, too, fake emotions and make my face and voice more animated, though sometimes I just don't give a hell and let myself be serious, but most of the time my technique is to be overly-polite. I get sick of people telling me to be happy, though, or to smile, you know? I also copy other people's outward personality. I sometimes hang out with my husband's friends, and a lot of times I watch his "friend-building" personality and mimic it, at least so I'm able to get through the day with other people. One big problem, I've noticed, is that the people who are willing to gossip and form cliques, particularly with the managers (ughhh) are the ones who get promoted, not necessarily the ones who are more professional.

A clear example of how I don't "fit in" is how one time, I was with a group of friends I had in 5th grade, and one of them started singing Boulevard of Broken Dreams, and one by one they all joined in, and after the chorus, they started busting out laughing and group hugging and I stood on the outside, thinking "What was funny about that?! Nothing witty happened. You guys knew the lyrics to a popular song, why is this special?" I don't really "play around" and it seems like people show a lot of emotion and laugh at things that aren't funny, to me (at least) and I just don't ever bond with people. I don't get them. I talk when I have something to say that's important, for "functionality". :sour: And although I'm quite day-dreamy and can have a witty sense of humor, I'm quite literal in my behavior, I guess I could say.

And one other thing- I start my CNA course the week after next, but a few months ago I almost completely decided to quit nursing because I was afraid of what kind of CNA I would be to patients (I think, for me, it'll be necessary to work as a CNA for awhile because I'll get a 1.5 point boost when I go to apply for nursing school). This was before I got diagnosed as Autistic. Like I said, I know I'm strange and weird, and I imagined myself working with patients personally- you know, helping them to the bathroom, wiping them, trying to feed them, and I kept thinking that it would be so awkward for the patient, because there's this person who seemingly doesn't know how to talk (partially true, again, I don't "get" small talk and I really don't know how to do it. I didn't figure out until I became an adult that you're basically "supposed" to say the random things happening in your life or talk about things going on :sarcastic: I just started paying attention and analyzing what other people do.) Imagining myself being quiet, and just being this big weirdo... Imagining the patient thinking I'm weird and creepy as I take care of them... It overwhelmed me and gave me an anxiety attack and I canceled my doctor appointments to get TB tested (for the CNA program).

Eventually I decided I didn't want to do anything else. My mom talked me into going back, too, saying that she read that some people don't want a super, cutesy nurse who baby-talks them. My step-grandmother actually snapped at a nurse who kept talking to her like she was some cutesy kid. I know I won't be the "traditional" caring nurse, who "heals people with love", but that's okay. I'm interested in nursing because I love biology and the human body. I look up picture of gangrene and of deformities for fun, and read medical treatment articles for fun. I think I can still be a good nurse, I just think that I need to learn how to do things like say "Good morning" to my co-workers, and learn how to ask questions that are simple and involve peoples' daily life or interests. That, and again, I think being positive and polite (it's hard, when I come home I instantly become serious and practically mute because I need to "recharge". One conversation lasting over 5 minutes makes me physically tired and quiet the rest of the day) makes people have more respect for me or at least like me more. It's important to be able to work with others in nursing, right?

Anyways... SO SORRY for such a long post. I'm just so glad to see that there are some people I can relate to. I never knew what was "wrong" with me, and I've felt like an outsider my whole life, just observing people, wondering why I'm so different, or how I'm going to succeed at a career when I can't network or connect with any of my co-workers or management. I feel a lot better knowing that there's a reason why, finally, and that there are other people who are experiencing the same thing. :inlove:

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