Precepting While Neurodivergent: What the Supervising Nurse Carries
A neurodivergent nurse precepting a student may bring something to that relationship which is hard to obtain any other way. Some have already worked out which parts of the role are load-bearing and which are habit, because they have had to. They can say the reasoning behind a clinical decision out loud, having rarely been able to rely on it transferring by osmosis. A preceptor who has built explicit structure for their own practice has, in effect, already written most of the teaching material. Precepting is often absorbed into a full patient load as an extra duty, and that arrangement costs a neurodivergent preceptor more than most.
What the standards ask of a supervising nurse
The Nursing and Midwifery Board of Australia (NMBA) Registered nurse standards for practice set out seven standards. Standard 3, maintaining the capability for practice, includes criterion 3.1, which asks the registered nurse to consider and respond in a timely manner to the health and wellbeing of self and others in relation to the capability for practice, and criterion 3.3, a lifelong learning approach to continuing professional development of self and others. Standard 6 addresses the supervision of delegated practice, through criterion 6.3 on delegating appropriately according to scope and criterion 6.4 on providing effective timely direction and supervision so that delegated practice is safe and correct.
Two things follow from that wording. Self sits alongside others inside the same criterion, so a preceptor’s own capability sits within the standard itself. And the NMBA glossary defines the people a registered nurse holds professional relationships with as including colleagues and students, which places students within the relational standards. The glossary also treats supervision as covering managerial, professional and clinically focused forms. None of that specifies workload, protected time or a second pair of hands, and that is where the arrangement is actually decided.
Where the arrangement breaks, and what holds it up
The pressure points are structural. A preceptor holds a full patient allocation while narrating reasoning aloud, checking a student’s work, and staying available for questions arriving without warning. For a nurse whose neurodivergent cognitive profile makes interruption expensive, that is a doubled load carried across the same shift. Research with registered nurses describes the effects of dyslexia on practice, and a perceived stigma and lack of understanding among colleagues that affected disclosure and access to support (Major & Tetley, 2019), and a study of student nurses found that student nurses’ decisions about disclosing dyslexia in clinical practice related to co-workers’ attitudes, expectations of support and concerns about discrimination (Morris & Turnbull, 2007). A cross-sectional study of nurses with ADHD and/or autism examined that group’s work environment and health (Hedlund & Jordal, 2025), and work on neurodiversity in employment frames workplace intervention as adjusting the fit between the person and their environment (Doyle, 2020). In an opinion piece in Nursing Times, a senior vascular access nurse describes always having felt different from colleagues as a nurse with ADHD (Layzell, 2024).
The arrangements that preceptors and educators commonly describe as supportive are mostly about allocation: a reduced patient load on precepting shifts, preparation time before the student arrives, a written learning plan the student keeps, a named second contact, and the role appearing in the roster and the performance conversation. Where none of that exists, the preceptor absorbs the gap through their own adaptive strategies, and the burden of adaptation is structurally misplaced.
One assumption is worth naming on its own. Precepting is often described as role-modelling, which carries an implication that the student should finish up practising the way the preceptor does. A neurodivergent preceptor may work through written checklists, ask for information in a set order, or build in structure a colleague would not need. Presenting that as one legitimate way of practising safely, rather than as a deviation to be explained away, teaches the student something more durable than the technique itself. It also makes it safer for the next student to say what they need.
Precepting is where the profession reproduces itself, and the conditions attached to it decide who is willing to keep doing it. A neurodivergent nurse who finds the role unsupported may decline it the following year, and the students who would have gained most from that supervision lose the chance. The structural argument here runs through mentoring, neurodiversity-affirming clinical education, and the placement conditions set out for neurodivergent nursing students. The Australian Nursing and Midwifery Federation (ANMF) and employer nursing education units are among the bodies that deal with workload and role recognition in precepting.
References
Doyle, N. (2020). Neurodiversity at work: A biopsychosocial model and the impact on working adults. British Medical Bulletin, 135(1), 108–125. https://doi.org/10.1093/bmb/ldaa021
Hedlund, Å., & Jordal, M. (2025). What about neurodiversity among nurses? A cross-sectional exploration of work environment and health among nurses with ADHD and/or autism. WORK: A Journal of Prevention, Assessment & Rehabilitation, 80(3), 1287–1295. https://doi.org/10.1177/10519815241289852
Layzell, C.-J. (2024). ‘As a nurse with ADHD, I had always felt different from my colleagues’. Nursing Times, 120(7), 15. https://www.nursingtimes.net/opinion/as-a-nurse-with-adhd-i-had-always-felt-different-from-my-colleagues-12-06-2024/
Major, R., & Tetley, J. (2019). Effects of dyslexia on registered nurses in practice. Nurse Education in Practice, 35, 7-13. https://doi.org/10.1016/j.nepr.2018.12.012
Morris, D. K., & Turnbull, P. A. (2007). The disclosure of dyslexia in clinical practice: Experiences of student nurses in the United Kingdom. Nurse Education Today, 27(1), 35–42. https://doi.org/10.1016/j.nedt.2006.01.017
Nursing and Midwifery Board of Australia. (n.d.). Registered nurse standards for practice. https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards/registered-nurse-standards-for-practice.aspx
This post contains general information only and does not constitute legal, medical, or professional advice. Information is accurate to the best of the author’s knowledge at the time of publication. For advice specific to your situation, please consult an appropriately qualified professional.