Any other autistic nurses out there?

Nurses Disabilities

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I went to an autism conference recently put on by a friend who has Asperger's, and I related very strongly to some of the things that the presenters were saying about people with autism. I don't have all of the characteristics they talked about, but some of the ones I do have are: difficulty picking up social cues such as body language, difficulty scanning the environment in order to find something, and difficulty knowing where my body is in space (problem with proprioceptors). Does anyone relate to this?

Im really glad this thread exists. Im glad to know there are other nurses out there on the spectrum. There are a multitude of signs and expressions of autism. It's not a "checklist" so much as your brain being wired differently and processing the same data in different ways, sometimes that makes it more difficult to cope and sometimes it makes it easier. Just like every NT person is unique, every NAt person is also unique, and comparing adults to children is insulting to autistic adults and unfair to autistic children. Would you compare your nine year old to a college graduate? No.

I know autism presents differently in women as opposed to men and females can pass as neurotypical more easily than their male counterparts. This in turn has lead to the disproportionate rates amongst the sexes. Also self diagnosis is considerably well respected amongst the autistic community.

1 Votes
Specializes in CICU, Telemetry.

I have Asperger's. It's why I like (and hate) the ICU and night shift. Intubated, sedated patients and less family members around to interact with. They're literally one giant, complex science/math problem that I get to spend my night trying to solve. I also have an encyclopedic memory not only of scientific information, but also of hospital and unit protocols/policies/procedures/titration protocols for meds. I'm really open with my co-workers about my Apserger's and about my strengths and weaknesses. They know that they can come ask me literally any academic or patient care question, and there's a 95% chance that I know the answer off the top of my head, and a 100% chance that I'll look it up and get back to them because I want to know for future reference. The flip side, they know that when nuisance alarms are constantly going off for no reason CONSTANTLY ALL NIGHT, that I'm probably going to get sensory overloaded and get really grumpy and eventually need a break. So they keep an ear out and I go sit in the empty break room in perfect dark and quiet for 5 minutes to get it together, and then I can get right back out there (and make my co-workers adjust their alarm parameters)

Sensory issues are difficult because I also hate being touched. It doesn't bother me when a patient touches me in an anticipated way with an end-goal (e.g. to get them out of bed, roll on their side, support themselves while walking), or when I touch them to assess them, but I hate when co-workers will touch my hair or put a hand on my shoulder or hug me. I literally shy away like a child who has been in an abusive home. Clothes are difficult for me, my new job has uniforms and I need to wear undershirts and compression shorts under them because they have seams. I buy seamless socks or wear my socks inside out. Tagless and seamless clothes are AMAZING, and if they had been around in the 80's-90's, maybe I wouldn't have been a TomBoy who wore all her brother's hand me downs. I don't wear glasses because they feel funny on my ears. I put my stethoscope in a pocket or just at the nurse's station because I can't stand the way it feels around my neck. I keep my hair long enough for a ponytail, but not long enough for it to touch the back of my neck because I don't like that.

My main deficits at work were social interactions with co-workers before my diagnosis/before I was open about my diagnosis, and the fact that I have difficulty thinking or performing complex tasks or talking when IVs are beeping, vents are alarming, etc. It seems not to be an issue during a code, though. I don't know what the adrenaline rush does, but I can somehow tune out all non-essential noise and it truly does not bother me. I can't wait until we understand more about the brain.

To the poster who said if you weren't diagnosed before 5 you're not actually autistic...well, most of the points that need to be made in that regard already have, but the final one: Asperger's was added to the DSM in 1994. While the Syndrome was named in the 1940's, we began to accept it in the US around 1994. Still mainly in males (as is still the case). Many of us (myself included) were over 5 years old in 1994. Riddle. Me. That.

I spend days after work exhausted and drained and just wanting to be alone after all that interaction with other people. But I do actually love my job, helping people, and how my co-workers not just accept but appreciate me for my differences.

So yeah, you can be a nurse with an ASD. Plenty of adult females have undiagnosed ASDs because the Psych profession only just started to realize that women present differently. It's going to take a long time for the medical community at large, and then the general population to realize this. And it will take longer because it's women. Just like how chest pain in women must be 'anxiety' and not an MI. The concept of 'female hysteria' in medicine is something that I don't think I'll live to see the end of. There's definitely progress being made, though.

2 Votes

Love hearing from all those on the spectrum. Recently diagnosed, age 60. Nursing since 1994, age 38. Seems so many other factors can affect; I.e., health status, ageing issues, part of the country, birth order, etc. Have had some really nasty, unethical supervisors and co-workers who recognized my diversity and went for my jugular, but have also had some really wonderful co-workers and supervisors. Health issues that also went undiagnosed by medical profession made it almost impossible to have the energy to continue to compensate for my neurodiversity, so not working in field for several years. Continue to work on finding my tribe, and going from there....

1 Votes

I noticed the most recent post was in 2017, but reading the whole thread gave me hope. I thought I was alone. I, too, believe I'm somewhere on the spectrum. One of my kids is diagnosed high functioning autism, the other one is also on the spectrum. I also returned recently to nursing after a 20 year break.

After reflection, I realized that where I currently work IS a bad fit for me, being on the spectrum, especially where the facility aims to have a high customer service rating (like a 4 star hotel), and I have a limited social skills. Does anyone have suggestions on a branch of nursing that requires a lot of technical skill and little social interaction?

1 Votes
8 hours ago, mrst84 said:

I noticed the most recent post was in 2017, but reading the whole thread gave me hope. I thought I was alone. I, too, believe I'm somewhere on the spectrum. One of my kids is diagnosed high functioning autism, the other one is also on the spectrum. I also returned recently to nursing after a 20 year break.

After reflection, I realized that where I currently work IS a bad fit for me, being on the spectrum, especially where the facility aims to have a high customer service rating (like a 4 star hotel), and I have a limited social skills. Does anyone have suggestions on a branch of nursing that requires a lot of technical skill and little social interaction?

I have been working in psych for the past 8 years, and it is a pretty good fit for me for a number of reasons. One is that I've always been interested in psych. Also, our hospital does not use press gainey or other customer satisfaction surveys, which seems to be standard in psych. Interaction with family members is quite limited as they do not come on the unit. Visitation only happens a few times a week and it is off the unit, so our family interaction is usually limited to short phone calls. I still struggle a lot with the stress as we are usually quite busy on day shift. The night shift is usually less busy, but sometimes they get a lot of admits.

I have no experience with it, but OR sounds technical with less social interaction. Someone earlier in the discussion said they liked ICU on nights because the patients are sedated and there is less contact with families.

Blessings to you! You are definitely not alone. I hope you find a niche that works for you.

Thanks for the encouragement. It has given me food for thought. My next question for everyone out there is, since I'm "self-diagnosed" as being on the spectrum, would it benefit me to declare it on employment applications? I can see both sides of the argument, especially the "con" as giving the potential employer reason NOT to hire you as they don't want to "deal" with a disability. I've seen this first hand with my 19 year old son and the pain job interviews and denials cause him. But on the other hand, if it's disclosed, they have to give you the accommodations to do your job successfully.

For example, the only thing I have a "problem" with is speaking. I can get my point across successfully with patients, and peers. I suck at speaking with families. They ask me a question and I tell them the truth (which I discovered is a trademark of the spectrum) as much as HIPPA allows and I get reported. And it's either from my tone, or my verbiage or something I'm entirely clueless about. I'm at the point I'd rather not talk to family members at all! And let me tell you, getting written up about something you are clueless about is very detrimental to one's self confidence. This is one of the big reasons I was out of nursing for 20 years.

So, should I check the box as "yes" on the application, and hope the facility believes in the ADA, bring up the issue in an interview, or check "no" and repeat a pattern? So far, I've checked the "refuse to answer" box when that is an option.

Thanks for any opinions. And yes, I'm going to be looking for a new job.

1 Votes
Specializes in CICU, Telemetry.

I personally would not and do not admit it on employment applications. Most nursing jobs have a probationary period where they can fire you for essentially any reason. If I were a manager, having employees with disabilities means more paperwork, complaints, accommodations...and a lawsuit if you ever fire them. I didn't tell anyone at work about my autism until well after the probationary period ended. But I won't claim to know what is going to be best for you. I'm certainly no expert.

About those family discussions, I've managed to work out an algorithm for what to say to most questions that remains truthful but doesn't step outside the law or my scope. If you want to post or DM me any specific scenario or questions, I'd be happy to share how I would respond.

1 Votes
On 7/17/2019 at 12:14 PM, CCU BSN RN said:

I personally would not and do not admit it on employment applications. Most Nursing Jobs have a probationary period where they can fire you for essentially any reason. If I were a manager, having employees with disabilities means more paperwork, complaints, accommodations...and a lawsuit if you ever fire them. I didn't tell anyone at work about my autism until well after the probationary period ended. But I won't claim to know what is going to be best for you. I'm certainly no expert.

About those family discussions, I've managed to work out an algorithm for what to say to most questions that remains truthful but doesn't step outside the law or my scope. If you want to post or DM me any specific scenario or questions, I'd be happy to share how I would respond.

I’m totally curious as to your algorithms and how you respond because I too have a lot of trouble talking to family members and even the simple question, “How is she doing?” baffles me into silence. Now this can be an easy question if, say, the hospice patient has been actively dying for two days, of which this family member has been mostly present or kept in the loop, what they really are asking is “Is my mom still alive?” .... but I’ve been asked this about a dementia patient on a dementia unit and I was so confused as to how to answer. We are standing there looking at mom who is sitting there and calmly mumbling word salad to her unit mates which has been her baseline for two years. I mean, I wanted to say, (not meanly) “She is incapacitated by dementia, so not that great, although I didn’t know her when she was A&Ox3 so I really can’t compare” This is how flummoxed I was by the question. I think I just awkwardly mentioned what she had for dinner, probably not the answer they were looking for, and then I spent the next four hours over-analyzing her status in my head, trying to wrap my brain around what info they were looking for. My point being, 90% of the time I have no earthly idea what to say to these family members when they ask how the pt is doing, and it seems like such an easy question, because if they are in a facility, they are all not doing good... period. I moved to night shift for this very reason, however, I’m now going to be starting a new job which is evenings so back to being confused around family.
Picking up clues from observing other nurses in the same situation, I would say that my algorithm answer each time should be “Good, she is doing good” (unless of course the patient has taken a sudden turn for the worse and at that point this would be a “updating the family member” situation) The reasoning for this is that this seems to be what they want to hear. So by default I say “Good” to answer that question, UNLESS I have to update them on an issue or a decline. But I’m not gonna lie, that question baffles me every time and I’m sure the look on my face is complete confusion until I can spit out my pat answer...”Good”. Any advice that you can give me in this area would be soooooo helpful! And I’m new here so I’m not sure how to DM people.

1 Votes
Specializes in CICU, Telemetry.

Updating family... I start with asking them when they last got an update and usually its only a few hours ago so I can just say 'he's still doing well, nothing exciting to report' then I toss in one medical sentence such as ' we almost have him weaned off pressors/ should be able to take the breathing tube out before morning/etc. Then if they're awake/extubated I'll either offer to give the phone to the patient, or I'll try to give them a sentence that proves that I know something personal like 'he's really mainly concerned about being hungry/wanting to eat, but his gut isn't awake yet from surgery so I can only give him ice chips at this point'. I'll close by asking if there's anything in particular that they're concerned about or if they have any questions. Often they want CT/ECHO results or to know if the edema is better or if they're out of afib. Helps to identify what they're most concerned about so you can tailor the conversation. Then I end the convo with a 'well, take care, I'll let him know you called, he really is doing quite well, but we have your number and will call you if there are any unexpected changes in his condition.

This formula typically keeps updates to 5-7 minutes, so even if you have 2 patients and have to give 2 updates per patient, you're still keeping family management to 20 minutes for the shift, which isn't terrible.

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