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Diversity in nursing: why it’s time to think neurodiversity

How a nurse network aims to help staff thrive and make workplaces more ‘autism-friendly’

How a nurse network aims to help staff thrive and make workplaces more autism-friendly

  • Neurodiversity refers to varied ways in which the brain processes information, and covers dyslexia, dyspraxia, dyscalculia, autism and attention deficit hyperactivity disorder (ADHD)
  • As one in seven people in the UK are thought to be neurodiverse, employers are becoming more aware of the needs and particular attributes of such staff members
  • Workplace support networks for nurses can help realise the potential of neurodiverse staff, and offer a place to share experiences
Picture: iStock

A support network for nurses with conditions such as autism and dyslexia has been set up to help healthcare employers create environments in which such staff flourish.

How a nurse network aims to help staff thrive and make workplaces more ‘autism-friendly’

  • Neurodiversity refers to varied ways in which the brain processes information, and covers dyslexia, dyspraxia, dyscalculia, autism and attention deficit hyperactivity disorder (ADHD)
  • As one in seven people in the UK are thought to be neurodiverse, employers are becoming more aware of the needs – and particular attributes – of such staff members
  • Workplace support networks for nurses can help realise the potential of neurodiverse staff, and offer a place to share experiences
Abstract image of showing a group of people's heads, al in blue, with one in yellow standing out and facing in the opposite direction
Picture: iStock

A support network for nurses with conditions such as autism and dyslexia has been set up to help healthcare employers create environments in which such staff flourish.

As the name suggests, the NeuroDiverse Nurses UK network embraces the concept of ‘neurodiversity’ – the umbrella term many use to describe those whose brains learn and process information differently.

One in seven people in the UK are neurodiverse

This includes dyslexia, dyspraxia, dyscalculia, autism and attention deficit hyperactivity disorder (ADHD).

Estimates are that one in seven (more than 15%) people in the UK are neurodiverse and the network reflects a growing recognition in the nursing profession that more understanding is needed.

‘More than ever our NHS needs a diverse workforce, not just in ethnicity or gender, it needs a diversity of thought and neurodiverse people are key’

Joan Pons Laplana, founder of NeuroDiverse Nurses UK

Network for neurodiverse nurses

The idea behind the network is to support neurodiverse nurses with resources and managers to help them thrive, says founder and senior digital charge nurse Joan Pons Laplana.

‘We want to create a to-do list for people who want to be more autism-friendly.’

What is neurodiversity?

Neurodiversity and neurodivergence are terms that refer to the different ways the brain can work and interpret information.

The terms attempts to highlight that people naturally think about things differently, with different interests and motivations, naturally better at some things and poorer at others.

Most people are ‘neurotypical’, meaning their brains function and process information in the way society expects.

However, according to ACAS, the Advisory, Conciliation and Arbitration Service, an estimated one in seven people people in the UK are neurodivergent, meaning that the brain functions, learns and processes information differently.

It should be noted some contention exists around the validity of the term ‘neurodiversity’, which was first coined by sociologist Judy Singer in the 1990s.

Some people – for example some parents of children with autism or severe learning disabilities – feel it does not represent these conditions accurately or risks trivialising them.

Seeing the potential of neurodiverse individuals, rather than perceived limitations

Joan Pons Laplana, founder of  NeuroDiverse Nurses UK
Joan Pons Laplana, founder of
NeuroDiverse Nurses UK

Part of the problem is society often only sees limitations in neurodiversity, Mr Pons Laplana suggests, which leaves neurodiverse people doing battle with stereotypes.

‘I want people to see the potential we have.

‘More than ever our NHS needs a diverse workforce, not just in ethnicity or gender, it needs a diversity of thought and neurodiverse people are key.

‘We need to think outside the box to continue to deliver the best care possible and neurodiverse people are fantastic at that.’

Recognising the potential of diversity in the NHS workforce

Chief nursing officer for England Ruth May was diagnosed with dyslexia in 2018.

She has spoken publicly about the challenges of her condition, including stigma, but has also highlighted the positives – reasoning skills, problem-solving, emotional intelligence and creativity.

‘We need to encourage people to talk and get assessments and then find out what we can do to fulfil the potential they have for themselves and our organisations’

Ruth May, chief nursing officer for England

Chief nurse for England Ruth May

In a blog, she wrote that people are often afraid to seek out an assessment because of worries it could damage their reputation at work and impede their chances to progress.

‘We need to create the conditions to help people to speak up and be proud of these differences in the workplace,’ she wrote.

‘We need leaders and managers to start the conversation; to encourage people to talk and get assessments and then find out what we can do to fulfil the potential they have for themselves and our organisations.’

The NeuroDiverse Nurses network says it has had backing from the RCN, NHS Employers, and NHS England and Improvement.

The RCN is holding a number of events this autumn to collect the experiences of neurodiverse nurses, which the college says will inform its guidance on the topic.


Learning support for neurodiverse nursing students

Final-year nursing student  Shaun Williams
Final-year nursing student
Shaun Williams

The path is not always easy for neurodiverse people who want to become nurses, and the first challenge can be in qualifying.

It is the responsibility of universities to ensure students’ needs are met – and reasonable adjustments made – and this is embedded in the Nursing and Midwifery Council (NMC) educational standards for programmes.

A complex diagnosis

Shaun Williams, who is entering his final year of learning disability nursing at Keele University, was diagnosed with autism, ADHD, dyslexia and dyspraxia after embarking on his course.

Mr Williams had to take some time out when he started medication for ADHD and admits some elements of his course have been difficult – including the relentless pressure of a 37.5 hour-a-week timetable.

Support from his university has increased – including two hours a week of one-to-one skills tutoring and having a sympathetic tutor.

‘But time management is very difficult,’ he says. ‘That is more to do with my ADHD. I can very easily misinterpret a question and that means I can research things I do not need to.’


The sense of validation that comes with diagnosis

For many people like Mr Williams, a diagnosis that comes in adult life may be almost a relief.

‘You know it is not just you, you just go about things differently and you try to come to terms with it,’ he says.

RCN learning disability nursing network chair Jonathan Beebee says: ‘Getting that diagnosis of autism is validating their experience and helps them understand what is going on in their lives.’

For others, arriving at a diagnosis can be a long process.

Mr Pons Laplana believes he has Asperger’s syndrome, an autism spectrum disorder (ASD).

Having observed the process of his son being diagnosed with Asperger’s, Mr Pons Laplana has no doubt he too should have a diagnosis.

But following a GP referral a year ago, Mr Pons Laplana is still waiting to see a specialist for assessment.

The nurse, who works at Sheffield Teaching Hospitals NHS Foundation Trust, recalls being ‘written off’ by a teacher when he was 14.

‘For the past 30 years I have been obsessed about achieving and winning awards,’ he says. ‘My wife was always asking why I felt I had to push boundaries.’

He concludes now that much of this intense focus was a manifestation of neurodiversity.

‘I realised I was so dependent on who my manager was and whether they created an environment where I felt supported,’ he adds.

Employers’ positive perceptions of neurodiversity in the workforce

Some employers have become more aware of the different attributes neurodiverse employees may possess, and have actively sought to recruit them for potential qualities such as attention to detail and pattern-spotting.

A few have set up neurodiversity networks, including Sussex Partnership Foundation Trust.

Nurse Rebecca Simmons, who helped  set up the staff network at Sussex  Partnership Foundation Trust
Nurse Rebecca Simmons, who helped
set up the staff network at Sussex
Partnership Foundation Trust

Here, neurodevelopmental service lead nurse Rebecca Simmons and child and adolescent mental health services specialist nurse Pete Bull were instrumental in setting up the network after being diagnosed with autism in adulthood.

The network feeds into the trust’s equality group and has the chief nurse as its executive sponsor.

Since its inception last year, the network has met around half a dozen times, bringing together an estimated 50 members of staff.

It has linked with the education and training department, leading to changes in the trust’s documentation and processes. It also made a funding proposal for a clinic to enable staff to be assessed and diagnosed quickly, offered help to managers struggling to make reasonable adjustments, and made a short film on the topic.

Ms Simmons, who has ADHD, says: ‘Neurodiverse people often struggle with self-care and boundaries and not giving 400% every day.’

But, she adds, they often pick up the sort of details other people miss, which can be a useful trait in nursing.

What managers need to know: tips from neurodiverse nurses

  • Be aware you may have neurodiverse nurses and not know it. They may have chosen not to disclose their status or not even realise themselves
  • Employers are required to make ‘reasonable adjustments’ for employees with disabilities – neurodiverse conditions are covered by this
  • Not all neurodiverse nurses are the same and people with the same condition may have different needs – don’t make assumptions but instead ask them what would help
  • A common issue among people with autism is sensory overload, including dislike of, or reaction to, loud noises or intense light. In many workplaces easy adjustments can be made that would help
  • Some people with autism may find sudden change and disruption to routine unsettling – sharing plans well in advance can help
  • Those with dyslexia may need more time to read information and may have difficulty processing complex spoken instructions
Child and adolescent mental health nurse Pete Bull
Child and adolescent mental health nurse
Pete Bull: staff members’ experiences
can help them support patients

Nurses’ personal experiences can help patients

Personal experience can be valuable when dealing with patients with similar conditions.

Mr Bull says it can be helpful for young people with autism to realise someone looking after them is also autistic and can combat potential negativity towards the diagnosis.

But there can be challenges.

Ms Simmons finds hot-desking difficult and says she sometimes ends up having to stay late at work because she has been distracted by other things.

Remote working can be difficult as well, with the nuances detected in body and facial language – which can help people with autism to ‘read’ others – missing in video calls.

How NHS managers can create workplaces that support neurodiverse staff

NHS Employers head of diversity and inclusion Paul Deemer says work is being done at a national level to ensure all managers understand neurodiversity and how it is fits into disability.

Along with other organisations, NHS Employers is running a workshop on the value neurodiversity in the workplace on 19 October.

Last year, the NHS adopted the disability equality standard, which allows employers to compare data on how the experience of staff with disabilities compares with that of the general workforce.

The hope is this will help create more inclusive workplace environments.

With a fresh focus on the needs of neurodiverse people, positive change for nurses with those conditions appears to beckon.

Supporting neurodiverse nurses: what does the NMC say?

The Nursing and Midwifery Council (NMC) expects that nurses ‘maintain the level of health they need to carry out their role’ but that employers should also make reasonable adjustments to support staff to practise safely.

Any nurse who feels a health condition or disability is affecting their ability to practise safety and effectively, and is unable to manage the impact of this, should tell the NMC as soon as possible.

The NMC says having a condition like dyscalculia would not be mitigation in a fitness to practise case if, say, a drug calculation error was being examined, unless the employer had failed to make reasonable adjustments.

Alison Moore is a health journalist


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