July 6, 2020

Jackie Anne Blair is a nurse, and unknown to many of her patients and coworkers, she has autism. In a piece for Yahoo Life, Blair explains why many adults diagnosed with autism choose to "work invisibly"—and why having autism helps make her an "excellent nurse."

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An 'invisible' disability

Blair, who is currently in her 30s, was diagnosed with autism when she was 19 years old. At the time, her "specific type was still being referred to as Asperger syndrome," she writes.

Blair didn't tell anyone about her diagnosis when she was in college. "Due to the lack of information commonly available on autism at the time ... all I knew was the stereotypes that felt foreign to my place on the spectrum," she writes.

After graduation, she remained underemployed for years—"another issue many on the spectrum have," she writes. Eventually, Blair considered working in health care, but she was "extremely skeptical" of whether she would do well in the field.

Blair explains that while adults with autism work in a variety of different fields, they often do so "invisibly" to avoid discrimination. However, so-called "mask[ing]" can be more difficult in health care, which "can be an intensely overwhelming profession when you add sensory triggers, neurodiversity and systemic and interpersonal ableism," she writes.

Even so, Blair started working at a long-term care facility. And although when she first joined, she "experienced sensory overload in many ways," Blair ultimately "fell in love with the environment."

Blair writes she enjoyed working with people with developmental disabilities, whom she "had great empathy for." She added, "Over time, I became incredibly happy in my role working with individuals who were more similar to me than not, building an excellent rapport with my patients."

Becoming an 'excellent nurse'

Eventually, Blair had the "exciting and terrifying" opportunity to go to nursing school—and although she found the prospect daunting, her prior work had given her a "foundation to build on [that] made me a little more comfortable."  

Nursing school "was extremely difficult," she writes. She had decided to continue masking her diagnosis, and she had to tackle the same social obstacles she faced in high school and college—but this time, in nursing school, her grades depended in part on those social skills. 

She sometimes heard other students talking about her "within earshot," she even saw some of them roll their eyes at her. "Two students were consistently rather vocal about how 'annoying' they felt I was," she writes.

Other students used "autistic" as an insult for people they didn't like. "I knew my secret was not safe with any of them," Blair writes.

However, Blair graduated from nursing school with honors, and after getting licensed, she returned to the same long-term care facility to work as a nurse, in addition to part-time work with a local medical group.

Returning to her original place of work—as a nurse

As a nurse, Blair's "autism challenges [her] every day," she writes.

Blair says certain noise frequencies still make her nervous. She says she even listened to medical equipment sounds at home to get used to the noise at work.

But "[t]he biggest sensory obstacle is touch," she says. Many of her coworkers know she doesn't like being touched, and most of them respect that boundary. But "[d]espite constant reminders," some coworkers "still hug me or touch me without asking," Blair writes.

She sometimes struggles, too, when "[m]aking phone calls to patients regarding their health," she writes, "because there is no visual to go along with the intonation of voice." Blair says her tone tends to be either "flat or exaggerated."

"Patients prefer exaggerated," she explains, "and it is exhausting by the end of a workday."

Why Blair says her autism helps make her 'an excellent nurse'

Blair says that, after years of training and hard work, she has become "an excellent nurse, not despite my autism but because of it."

"My heightened senses make it so sometimes I can hear and see things others cannot," she writes, adding that her "sensitivity to touch assists in different kinds of palpation. If something seems abnormal in a patient's chart, I often perseverate about it until I can either figure it out or find someone who can."

She also is "fiercely and exhaustingly empathetic," she writes. "I honestly want nothing more than to help my patients. If I don't understand or don't know how to do something, I ask an annoying amount of questions until I'm sure I can do it safely."

Finally, Blair says she believes her diagnosis makes her less likely to judge patients for their conditions. "As your nurse, I understand that you are so very much more than the list of diseases, disabilities, and symptoms in your chart," she writes.

Blair hopes that the integration of more people with autism in workplaces will help reduce the condition's stigma, and that "as more of us 'unmask' … there will be a greater sense of understanding of the neurodiversity that surrounds us daily" (Blair, Yahoo Life, 6/29).

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