This blog was authored by Stefanie Papaglimis – Clinical Lead for neurodevelopmental services at Xyla, where her team supports adults, teenagers and children through ADHD and autism assessment.

Nurses and midwives with ADHD and autism are an important part of the healthcare workforce. The strengths they bring help shape the care patients receive.

I’m Stefanie Papaglimis, Clinical Lead for Xyla‘s neurodevelopmental service, a private provider carrying out ADHD and autism assessments and post-diagnostic support for adults, teenagers and children.

Before that I spent over 20 years in the NHS, starting as a nurse in trauma and cardiac intensive care and later leading autism and ADHD pathways. Throughout that time, I’ve seen how much easier work can become once someone understands their needs and feels confident asking for support.

If you have, or suspect you may have, ADHD and/or autism, this article is for you.

It explores common workplace challenges, the often-overlooked strengths neurodivergent nurses and midwives bring to patient care, and practical adjustments you can ask for, with or without a formal diagnosis.

 

Common workplace challenges for neurodivergent nurses and midwives

No two neurodivergent nurses or midwives experience work the same way but there are some recurring themes:

Busy wards bring sensory demand on top of clinical pressure and shift work disrupts routine. On top of that:

• Being asked for something on the spot, with no time to prepare, is harder to process than the same request given in advance.
• An unsolicited phone call forces an instant switch in attention, with no time to prepare a response.
• Reading a room quickly and picking up on unspoken cues takes more effort than it looks like from the outside.
• Masking, managing how you come across so you don’t stand out, gets you through a shift. But it’s exhausting to sustain.

However, challenges are only part of the picture. Autism and ADHD aren’t a simple scale from mild to severe. Many people have what’s often described as a spiky profile, with significant strengths in some areas and support needs in others.

You might be exceptionally strong in one aspect of your role and find another genuinely difficult. That pattern is different for everyone.

One of the most common misconceptions I see is the assumption that a diagnosis tells you everything about a person’s abilities, including their social and emotional skills.

 

Strengths neurodivergent nurses and midwives bring to patient care

Too often, neurodiversity is discussed through the lens of challenge rather than contribution. In practice, many autistic and ADHD colleagues bring strengths that are highly valuable in healthcare, including attention to detail, pattern recognition and creative problem solving.

Those strengths often show up in day-to-day clinical practice through:

• Spotting a small change in a patient’s presentation.
• Catching an inconsistency in notes that’s easy to miss when a ward is under pressure.
• Bringing a different angle to a problem. It’s common for a colleague with ADHD to be the person a team turns to first when something needs a creative solution.
• Adapting quickly, especially if you’ve had to build your own ways of working around a system that wasn’t designed with you in mind.
• A strong sense of fairness and feeling things more deeply than what’s presented on the surface.

These strengths aren’t exclusive to neurodivergent colleagues, but they are characteristics I see repeatedly in autistic and ADHD people.

In healthcare, that combination of fairness, adaptability and emotional depth can shape meaningful relationships with patients and influence the way care is delivered.

 

Reasonable adjustments for neurodivergent nurses and midwives

The right support can make a significant difference to how manageable and sustainable work feels. Reasonable adjustments remove unnecessary barriers so people can perform at their best.

What works will vary from person to person. You may already have strategies that help you navigate the demands of the role.

The most effective adjustments often build on those existing strengths and ways of working, rather than replacing them with a standard approach.

 

If you’re a nurse or midwife

You’ve probably already found strategies that support you in your role.. Use these ideas for reasonable adjustments as a starting point to figure out what could make a real difference.

• If sensory sensitivity is an issue, ask about uniform alternatives.
• Ask for quiet points built into your shift, where the rota allows.
• Ask colleagues and managers to message or email before calling, rather than calling cold, so you’re not caught off guard.
• If you’re put on the spot, it’s fine to ask for time to respond or to reply by email instead.
• Ask for interview or meeting questions in advance, so you can prepare rather than perform under pressure.
• Ask for short, regular check-ins with your manager, rather than a one-off conversation.

Many people are unaware, but you don’t need a diagnosis to ask for reasonable adjustments. If you suspect you may have ADHD or autism, you’re entitled to ask for adjustments you think could help.

In the first instance, speak with your line manager about these adjustments. To formalise your request, you can ask for a referral to your Employer’s Occupational Health Service.

 

If you manage a team

Supporting a neurodivergent colleague doesn’t require you to have all the answers.

The most useful thing you can do is create an environment where people feel comfortable talking about what helps them work at their best.

Start with “What’s already working for you?” rather than “Here’s our standard approach.”

People often know what helps them succeed, even if they haven’t previously described it as an adjustment.

• Avoid making assumptions about what someone can or can’t do based on a diagnosis.
• Focus on outcomes rather than expecting everyone to work in the same way.
• Give clear expectations and priorities, especially during busy or fast-changing periods.
• Treat adjustments as an ongoing conversation, not a one-off decision.
• Create opportunities for people to share concerns privately and without judgement.
• Involve neurodivergent colleagues when developing policies, guidance or workplace initiatives that affect them.

Reasonable adjustments sit within the Equality Act, and organisations must meet their duty properly. But supporting neurodivergent colleagues is about more than compliance.

Neurodivergent staff contribute to patient care, service improvement, innovation and problem solving across healthcare.

Different people need different things. Genuinely inclusive teams treat that as normal rather than as an exception to manage.

 

Exploring an autism or ADHD diagnosis later in your nursing or midwifery career

Some of the nurses and midwives we see for an assessment recognise a few things in themselves first:

• Feeling exhausted from masking at work.
• Finding unexpected interruptions particularly hard to manage.
• Thriving with routine but struggling when it changes suddenly.
• Having always felt different from colleagues, despite doing the job well.
• Recognising themselves in autistic or ADHD adults’ stories.
• Perimenopause symptoms making autism or ADHD symptoms more apparent in yourself.

If any of that sounds familiar, it doesn’t mean you need a diagnosis. But it might be worth exploring, including whether medication is something you want to discuss with a clinician.

This comes up particularly often for women, who make up around 87% of the nursing and health visiting workforce in England. Autistic traits in women are still widely missed or misread as anxiety, perfectionism or simply coping well.

Assessment tools and public understanding of autism were built around how it tends to present in men, so a career spent successfully masking can delay recognition for decades.

If this is something you’re navigating yourself, Xyla has written more on late autism diagnosis in women.

Demand for ADHD and autism assessment has grown considerably, which is why increasingly more people are exploring a private assessment route to get answers faster.

If you’d rather talk it through than read more, Xyla also offers a free, no-obligation consultation to help you decide what, if anything, you want to do next.

 

Frequently asked questions

Do I need a diagnosis to ask for reasonable adjustments?

No, a formal diagnosis is not always required for an employer to consider reasonable adjustments.

Under the Equality Act 2010, what matters is whether a condition has a substantial and long-term impact on day-to-day activities. In practice, however, a diagnosis can sometimes make conversations about support easier.

Does neurodivergence count as a disability under the Equality Act?

Autism and ADHD can meet the legal definition of disability where they have that substantial, long-term effect.

Not everyone will meet that threshold, but many neurodivergent people do. Where that is the case, employers have a duty to consider reasonable adjustments.

What if my ward genuinely can’t make the adjustment I need?

Not every adjustment is possible everywhere. Infection control rules can limit uniform changes, and some roles need more in-person presence than others.

Where something isn’t feasible, your manager should still be able to explain why and work with you on what else could help.

Do I have to tell my whole team, or just my manager?

Just your manager or HR, if that’s what you prefer. Reasonable adjustments are agreed between you and whoever needs to put them in place. How much your wider team knows, if anything, is your choice.

 

Support and resources for neurodivergent nurses and midwives

If you’re a nurse or midwife who’s neurodivergent or wondering if you might be, you’re not alone.

An open conversation with your manager is a good place to start, even without every answer worked out.

For information and advice, the National Autistic Society and ADHD UK both offer guidance for adults, including on workplace rights and reasonable adjustments.

What I’d like to see are workplaces where people can make the most of those strengths, get support where they need it and build fulfilling careers without feeling they have to hide who they are.