As an Autistic Nurse with Burnout, I’m Calling for Clinical Resources

Everyone shows the highlight reel of their life. But what happens when the truth is much darker than the reality you’ve portrayed for so long?

I am an autistic nurse, and I don’t fit into corporate boxes well.

Becoming a Nurse Before My Autism Diagnosis

I became a nurse for all the right reasons: to support women and prevent others from having the experience I did. I was 15 years old with severe abdominal pain. My father took me to the emergency department in the middle of the night.

At 3 AM, while crying, I had my first pelvic exam alone with the ER doctor. The same doctor repeatedly told me I was lying about not being sexually active. I was not lying, and my pregnancy test was negative, but my appendix nearly exploded while they wasted time investigating me.

Symptoms of Autism Spectrum Disorder in High-Performing Women

Autism traits are lifelong, but diagnosis is often delayed because it doesn’t look like the textbook (male-modeled) criteria. Girls who are socialized to hide their neurodivergent skills become women who mask their ASD traits.

This results in an internal, not external, presentation that others cannot see. High-masking women shut down instead of melting down; they experience anxiety symptoms and sensory overwhelm.

I thought everyone rehearsed conversations, role-played appropriate social responses, and studied social cues to understand others better.

They said I was always too much: too sensitive, too extra, too much empathy, too passionate.

High-masking women manage sensory sensitivities quietly for routine control. However, crowds, noise, light, and technology can create a sensory nightmare for neurodivergent folks.

The emotional depth of an in-person conference could cost me three days in bed, replaying every exchange. So could the wrong email.

One perceived misstep, and I’d be convinced I’d ruined something, unable to relax, no matter how many times someone reassured me it was fine.

My special interests are socially acceptable: reproductive health and writing.

People assume I look at them with normal enthusiasm, rather than as the diagnostic clues that dinosaurs and trains are.

Autism Burnout Symptoms

Many nurses burn out.

I would argue that most nurses will face some form of burnout or depression disorder in their career.

But autism burnout is different from occupational burnout or clinical depression. Typical occupational burnout is characterized mainly by exhaustion and a reduced ability to face challenges.

This past year, I experienced autism burnout. The ambivalence was a crushing emptiness and overwhelm, unlike anything that I’ve ever felt before.

Every choice carried too many mental, emotional, and sensory possibilities, completely overwhelming me. I experienced withdrawal and emotional dysregulation, often vacillating between numbness and overwhelm.

I could not mask. It was a capacity collapse like nothing I’ve ever felt before.

During that week, I felt completely dysregulated: sighing or singing, rubbing my feet on the ground, and twirling my hair. I could not tolerate meetings that could have been emails.

I bought five different-colored crop tops with good texture and wore them every day, so I didn’t have to worry about choosing which shirt. The menu was the same food on repeat, so I didn’t have to choose that either.

If I heard more than 3 sounds at one time, I’d have to leave the room. I could not handle bright lights or loud air conditioning. Blankets suddenly hurt my skin.

Clinically, I knew that skill regression or loss and executive dysfunction were symptoms of autistic burnout, but I didn’t know what that looked like. My brain was so burned out that I literally could not possibly put any energy into thinking or making decisions.

Why Autistic Burnout Happens in Healthcare Careers

I couldn’t find a comparable study of autistic nurses, but a 2023 survey of autistic doctors found that 77% had considered suicide. Of the 46% who requested workplace adjustments and support, only half got it.

Bullying in Neurodivergence

I can’t comprehend somebody being mean. There’s no logical reason for hate and cruelty.

Neurodivergent women in high-stress, traditional fields (like nursing) are absolute magnets for toxic, hyper-normative personalities.

It is well-documented and researched that neurodivergent individuals are significantly more likely to be bullied just for existing.

Take a moment to sit with that.

If you don’t fit their social script or process things differently, people sense it. The especially toxic circle, like sharks, instead of offering basic human empathy. They weaponize coldness and condescension to make you feel irrational or ‘too much.’ It’s a classic insecure-hierarchy play.

When the mean girls circle at work…

I’ve been a target my whole life by mean girls. I never understood why I didn’t understand the rules in the social playbook that seemed to be understood by everyone else.

If a workplace claims to value “diversity” or “teamwork” on paper, but leaves you in tears or dreading every shift, the culture is broken, not you.

Sometimes an autism diagnosis gives you the peace to realize, “It was always about them. It was never about me.”

Neuro-Inclusive Gap

From incorporating more neurodivergent nursing students in pre-licensure programs to supporting them in their nursing careers, we need to start early.

But this also means addressing modern nursing textbooks, which are not written from a neurodivergent perspective. Nurses are being taught about autism using negative language.

Traditional healthcare systems, and even mission-driven nonprofits, fail neurodivergent clinicians.

In a nutshell, we highly skilled, neurodivergent nurses are being pushed out of the bedside and the boardroom.

Professional organizations are meant to set the standard for obstetric and reproductive nursing in this country. Unfortunately, these organizations ultimately fail the clinicians and patients they claim to serve.

I nearly fell over when seeking perinatal resources supporting autistic nurses or helping nurses to care for neurodivergent patients.

In the year of our Lord 2026, I could not find any neurodivergent clinician facing guidance.

Very few published resources exist for caring for neurodivergent patients. I could not find any guidance for clinicians who are neurodivergent themselves.

Let me restate that.

The nursing profession remains institutionally silent about the neurodivergent clinicians within its ranks.

When I spent my entire career wondering why I felt so unheard, it’s because healthcare genuinely has no idea what to do with us.

In fact, no US nursing organization, obstetric, perinatal, or otherwise, has published actual institutional guidance, a position statement, or a practice standard on neurodivergence in nursing.

When ROI matters over caring for nurses and their communities, we have absolutely lost the plot.

Autism Testing as an Adult

If this resonates, late autism diagnosis is common in women. Early studies show neurodivergent people are drawn to caregiving professions for the very traits that go unrecognized: hyperfocus, pattern recognition, and deep empathy.

One nursing journal put it plainly: the true incidence of neurodivergence in nursing and midwifery is unknown, because underdiagnosis and workplace stigma keep people from ever finding out.

The AASPIRE Autistic Burnout Measure (ABM) is a preliminarily validated screening tool for autistic burnout. In a 2024 study of 238 autistic adults, it correlated strongly with depression, anxiety, stress, and fatigue, and moderately with camouflaging and well-being.

*Masking and camouflaging are often used interchangeably.

As an Autistic Nurse Leader, I’m calling on traditional healthcare and nonprofit professional organizations to do better. Provide resources for neurodivergent nurses and neurodivergent clients.

Journals: The Autistic Healthcare Experience

Male-modeled diagnostic criteria & delayed diagnosis in women
“Underdiagnosed and Misunderstood: Clinical Challenges and Educational Needs of Healthcare Professionals in Identifying Autism Spectrum Disorder in Women.” PMC, 2025.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12382651/

Neurodivergent people self-selecting into caregiving/medicine (hyperfocus, pattern recognition, empathy)
“See the Medical World Through Neurodivergent Doctors’ Eyes.” The Hospitalist.
https://blogs.the-hospitalist.org/content/see-medical-world-through-neurodivergent-doctors-eyes

The true incidence of neurodivergence in nursing/midwifery is unknown
“Are We Paying Attention to Neurodiversity?” Australian Nursing & Midwifery Journal.
https://anmj.org.au/are-we-paying-attention-to-neurodiversity/

Autistic Burnout Measure (ABM) validation and correlations
Mantzalas, J., Richdale, A. L., Li, X., & Dissanayake, C. (2024). “Measuring and validating autistic burnout.” Autism Research.
https://doi.org/10.1002/aur.3129

Bullying — 2.4x greater risk for autistic students
Systematic review, International Journal of Bullying Prevention, 2026.
https://link.springer.com/article/10.1007/s42380-026-00352-6

Autistic doctors — disclosure, accommodation, and suicide risk
Shaw, S.C.K., Fossi, A., Carravallah, L.A., Rabenstein, K., Ross, W., & Doherty, M. (2023). “The experiences of autistic doctors: a cross-sectional study.” Frontiers in Psychiatry, 14.
https://pmc.ncbi.nlm.nih.gov/articles/PMC10393275/

No US nursing organization has published institutional guidance on neurodivergence.

• AWHONN Respectful Maternity Care of the Neurodivergent Population: a single-page SBAR touch on neurodivergent patient-facing care
• AANA Neurodiversity in Anesthesia (CE): Paid course about “Understanding and Supporting Neurodivergent Colleagues, Students, and Patients” with a disclaimer that the content doesn’t represent AANA’s institutional position

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