Neurodiversity has received growing attention in recent years, and yet its presentation in the nursing and midwifery workforce has received limited attention.
Given our professional pride in caring, connection, and empathy, there may be some denial that neurodivergence even exists in nursing, but this reflects the broader cultural misunderstanding of its many and varied experiences.
Neurodiversity is an umbrella term for neurodevelopmental differences in thinking, learning, and processing. It includes attention deficit and hyperactivity disorder (ADHD), the autism spectrum, dyslexia, dyspraxia, and dyscalculia. It is estimated that between 15-20% of the general population may identify as neurodivergent, with similar figures expected among clinicians. Data from the 2024 Australian Public Service Employee Census found that 8.8% of respondents were divergent, and a further 9.3% reporting that they might be. The true incidence of neurodivergence in the nursing and midwifery workforce is unknown, partly due to persistent underdiagnosis, especially among women and gender-diverse individuals.
Stigma is a significant issue, with neurodivergent nurses often believing that their neurotype will be seen as a personal and professional deficit, leading to a disclosure dilemma. Many choose not to share their identity, fearing workplace discrimination, and worries about career progression. This fear compels neurodivergent nurses and midwives to mask their authentic selves, acting as if they are neurotypical. Maintaining the protective shield of masking is emotionally and psychologically exhausting, potentially affecting the individual’s mental health and leading to burnout.
Neurodivergent clinicians bring skills and capabilities that can significantly improve patient care. Contrary to unhelpful stereotypes, neurodivergent people are often immensely empathetic, feeling drawn to nursing and midwifery. They can excel at building strong therapeutic relationships with clients. The cognitive dynamism that can be part of neurodivergence can include strengths such as creative thinking, lateral problem-solving, and seeing issues from a range of perspectives. The ADHD brain, for example, can be highly adept at handling complexity and high-pressure situations. Attention to detail and hyperfocus can also be traits of autism, with high levels of pattern recognition being highly valued in patient monitoring and medication management.
Anecdotal evidence in Australia suggests that nurses with ADHD might be drawn to high-intensity specialties, such as emergency nursing, where the pressure in clinical situations can paradoxically help these nurses feel calmer and more focussed in using their problem-solving skills. Nurses on the autism spectrum often excel in research, clinical governance, and occupational health and safety, where defined protocols and processes are essential. The fact that neurodiverse patients and consumers can be found in all areas of healthcare means that the lived experience and awareness of neurodivergent clinicians can support therapeutic relationships and improve patient outcomes.
While neurodivergent nurses bring a range of strengths to their work, clinical settings can cause stress to sensory processing and executive functioning. Busy hospitals can cause sensory overload from noise and external stimuli, affecting concentration and causing anxiety. Executive functioning challenges, such as difficulties with multitasking, time management, and preparing handover information, are common, and can be worsened by time pressures and fatigue.
As Australian employers must comply with the Disability Discrimination Act 1992, managers must ensure reasonable workplace adjustments to ensure equal access to work and career progression for all employees. Adopting a neurodiversity-affirming approach requires a shift from a deficit model, instead embracing a strength-based paradigm that addresses the need for societal adaptation to neurodiversity, rather than “fixing” the individual. It is important to build a psychologically safe environment where staff can be authentic without fearing repercussions for disclosure. Accommodations should be personalised, not generic. Managers need to be able to have supportive conversations with staff and be willing to think openly about adaptations such as having a quiet area for documentation, flexible work arrangements, modifying lighting or noise in the unit, and adapting job descriptions to reallocating tasks that might pose specific difficulty. Some changes to working environments and practices can also benefit neurotypical staff. Ensuring interruption-free processes while preparing and administering medications and ensuring a quiet, calm break room can be positive for everyone. Investing in training and mentorship to improve staff awareness can reduce stigma and build positive regard. Staff education should ideally be delivered by neurodivergent clinicians to extended mentorship for new grads to help neurodivergent clinicians to thrive.
Supporting neurodivergent nurses and midwives enriches our profession, improves patient care, and ensures our workforce reflects the community we serve.
