A nurse’s journey with autism: challenges and rewards

Introduction

Autism is a form of neurodiversity that both the general public and health and social care professionals are becoming increasingly aware of, although there remains much to learn about the condition. It is perhaps less well known that there is an increasing number of nurses, healthcare assistants, nursing associates and student nurses who are autistic. This article was written by an autistic author who has been a registered learning disability nurse for over 30 years. The article will briefly highlight what autism is and how it impacted my experience of being a nurse.

What is autism?

Autism has a 1–2% incidence among the general population (Autistica, 2024), meaning that there should be about 700 000–1.4 million autistic people in the UK (Office for National Statistics, 2024). There are 748 528 nurses on the permanent Nursing and Midwifery Council register in the UK as of November 2023 (Farrah, 2024), which means that there could be about 7500–15 000 autistic nurses across the country.

The National Autistic Society (2024) defines autism as:

The National Autistic Society (2024) also outlines the common characteristics associated with autism:

• Communication issues: many autistic people will experience difficulties with interpreting and using both verbal and non-verbal language, such as gestures or tone of voice
• Social interaction: as an autistic person, I engage and interact with the world and people differently to those who are not autistic (often identified as ‘neurotypical’)
• Repetitive behaviours: with its unwritten rules, the world can be a very unpredictable and confusing place to some autistic people. This is why many autistic people may prefer to have strict and rigid routines, so that they know what is going to take place, they can control the environment and what happens within it. Changes to such routines can also be very distressing for autistic people and make them very anxious
• Sensory sensitivity: autistic people may experience over- or under-sensitivity to various sensations, including sounds, touch, tastes, smells, light, colours, temperatures or pain

My experience of being an autistic nurse

There is very little in the way of published research into the lived experiences of nurses who are autistic, with an article by Hedlund (2023) being one of the few to explore this. There may be a number of reasons for this, including the possibility that the lived experiences of autistic nurses are similar to those of neurotypical nurses and, therefore, do not warrant the attention of research. Otherwise, this could also be, in part, a result of autistic nurses not being comfortable in disclosing their diganosis in a workplace environment. Nurses may fear that disclosing their autism diagnosis, and the negative connotations that may come with this, could invite discrimination by managers, colleagues or both. There is anecdotal evidence that disability discrimination continues to be prevalent, despite being illegal under the Equality Act (2010), particularly in terms of autistic nurses being ridiculed, having reasonable adjustments denied or ignored and lacking access to professional development and even promotion.

Reflecting on my personal experiences of being an autistic nurse, I would like to pose myself a question: how has my autism affected me within the workplace? There are no easy answers to this question, and readers must keep in mind that my experiences will not be the same as any other autistic nurse’s, as we are all different. As the saying goes, if you have met one autistic nurse, you have met one autistic nurse! 

The question posed above can essentially be divided into two parts: have these experiences been largely negative or largely positive in nature? My answer to that question is, both. On the negative side, in one work environment I was coerced into disclosing my autism to my colleagues (or felt that I was being coerced) before I felt ready and comfortable to do so. Today, I am ‘out and proud’ as an autistic person, but that has not always been the case. There were likely to have been occasions when I was bullied and seen as an easy target because of my autism and lack of self-confidence, but I cannot prove this. Events such as these produce a ‘gut feeling’ picked up from comments and behaviours of others around me. That being said, my autism has served to open more doors than it has closed, including: 

• being elected as a National Autistic Society Council member
• lecturing and presenting at conferences about autism
• being appointed as deputy chair of the Birmingham Autism and
• ADHD (attention deficit hyperactivity disorder) Partnership Board
• authoring books and journal articles on autism
• commencing a part-time PhD at Aberdeen University
• being an autism advocate at the Royal College of Nursing
• being elected as a public governor at two NHS trusts in Birmingham

As an out and proud autistic nurse, I wear my autism as a badge of honour. Autism does not have to be a negative life sentence, a curse or a superpower, and in my experience, it is simply what you make it.

Conclusions

Sometimes, I hate my autism for the ways that I have engaged with people and hurt them in the process, for which I apologise. Sometimes I love autism for making me the unique and weird person that I am. Through both its challenges and rewards, autism has shaped my journey as a person and a nurse, creating unforeseen challenges but also rewards. By embracing neurodiversity, we can not only grow a more inclusive healthcare environment, but also enrich it with the unique perspectives that are offered by autistic individuals.