Nurses with ADHD don't always speak up at work

Nurses with ADHD or autism feel that they have special strengths that are valuable in the profession. But a chaotic work environment with stress and lack of understanding are obstacles in the way. And they don't always talk about their diagnosis at work.

What is it like to work in healthcare if you have ADHD or autism as a nurse? Are there even nurses who have these diagnoses? These are the questions that Asa Hedlund searched for answers to.

– It really started when I had a work-related meeting with a psychiatrist who told me that autistic people don't work as nurses because they don't care about people and don't empathize with them. Since I'm an autistic nurse and know many others, it's clear there's been a big misunderstanding here, says Asa Hedlund, a nurse and researcher.

Nurses with ADHD or autism

This prompted her to show that these nurses existed and the next step was to create one Interview study To learn how work life works for nurses with autism, ADHD, or both.

– I understood that there are also biases against ADHD in care because it is associated with poor organizational skills and “neglect.”

ADHD or autism is not a disease without neurological and psychological differences, just a different way of being. An estimated four percent of adults in Sweden suffer from ADHD. Common symptoms are attention problems, impulsivity, and hyperactivity. About two percent suffer from autism. You may find it difficult to communicate and adapt in social interaction with others, have a strong focus on certain interests and find it difficult to deal with unclear situations or changes.

Asa Hedlund sees no reason to believe that ADHD and autism will be less common among nurses than in other professions. When she did the study, she was open about the fact that she herself was autistic.

– My insider view means that the people I interviewed probably dared to be more open because I didn't have any negative prejudices but I was 'one of them'.

The nurses participating in the study feel that they have special strengths that are useful in their work: they are enthusiastic, creative, brave and dare to say what they think. They may have exceptional talents such as photographic memory or digital memory. Many of them say they are good at picking up details that others miss. They are very sensitive to the feelings of others, which can be difficult, but it also means that they understand quickly when something is wrong either with the patient or in the work group.

But they feel that stress in the physical and organizational work environment weakens their strengths, which is why I describe this group as an unused resource, says Asa Hedlund.

Communication with patients is no problem

Contact with patients is not seen as a problem. However, social interaction with colleagues, for example in the cafeteria, may be difficult for people with autism to handle.

Chaotic and unpredictable days are annoying for both diagnoses. Numerous sensory impressions, sudden and loud noises, and bright or flashing lights can also be disturbing.

Five of the interviewees were on sick leave due to stress and four were working part-time for the same reason.

– The work environment is challenging for many nurses, even without a diagnosis. If you have ADHD or autism, you may be more sensitive to sensory impressions, unclear expectations, and unpredictable organization. It was the things they referred to as problems, not the profession itself or the work tasks.

Asa Hedlund and co-author Malin Jordal believe that managers need to adapt the work environment to the individual needs of employees. It could be about giving someone the opportunity to work without hassle when dealing with medications and keeping records or supporting an employee so they don't throw themselves into too many projects. In future research projects, they should look further into possible measures.

Tell the half-manager

Only half of those interviewed told their manager and colleagues about their diagnosis. For some, it was not necessary, while others were concerned about how they would be treated.

– It's a shame if you feel like you want to tell me, but don't be so bold. But this is understandable because there are a lot of negative prejudices around these diagnoses. Asa Hedlund says there is a need for increased knowledge in healthcare and working life about different patterns of neurological functioning.