Zoé Langley RVN ISFMCertFN

I’ll start off by saying, not every neurodivergent or disabled person has the same experiences or faces the same barriers, this is just my experience training and working as an RVN with Autism and Fibromyalgia Syndrome (FMS).

I received a workplace diagnosis for Autism in May 2024, as is often the experience for people seeking a neurodiversity diagnosis in the UK, I have not been able to reach the stage of diagnosis with the NHS.

Growing up, I was the typical “Gifted Child” who was more mature than her age. Despite this, I often found I had difficulties engaging with my peers and forming friendships. I felt weird, like an outsider or alien, speaking a different language to those around me. Having not been considered for an autism assessment, as a “normal presenting” child, I had no idea why I could not, no matter how hard I tried, form lasting friendships with my peers, and later, colleagues.

Diagnosing Autism Spectrum Disorder (ASD) in women is very different to assessing a male, and ASD is underdiagnosed in the female population in both the USA and the UK. So, although ASD Diagnosis is improving, as a child in the 1990s I would not have been considered a candidate for diagnosis. This has led to the term “Lost Girls” being coined on social media – referring to the female population with undiagnosed ASD in childhood who are now identifying themselves or receiving a diagnosis in adulthood.

As an adult, I am quite open to discussing how Autism effects my sense of identity, how it created barriers and limitations in day-to-day life, but also the benefits to having a brain that is “wired differently”. However, there is still a persistent stigma around those with ASD. Female Autistics often face the same kind of response after they identify themselves, “You don’t look autistic” or “You talk too much to be autistic”. Whilst these comments are often meant in good faith, reassuring us that we can’t possibly be autistic because we’re too normal, these comments can be hurtful to hear as it feels like our identity is being questioned. I can only speak for my experience as a female autistic, but I can pass as a “normal person”. Although, this takes a lot of effort and has been ingrained in my personality since childhood.

A common term in neurodivergent circles is the term “masking”, this refers to a tendency to create personalities shaped by the environment you are in. There is a mask to be worn for every occasion. 

• With family, the devoted daughter who has no strong opinions on anything mask comes on.
• In nurse clinics, the “Professional RVN” mask comes on.
• In a clinic setting the “Friend and colleague” who can rapidly adapt to change and meet daily practice requirements comes on.

Masking takes constant cognitive effort to maintain, and in the veterinary environment, which can also be physically and mentally exhausting, I would often come home exhausted and occasionally non-verbal. When I’m at home or with close friends, I can allow my mask to come off, allowing those people I trust to see who I truly am. I now have some very close friends, some also ND, who WANT to spend time with me – not a mask – me! If you had told me when I was in secondary school I would have best friends who actively seek my company, and not just third-wheeling a friend group, I would have told you that you were lying.

In practice, the primary challenges I faced were two-fold: Communication & perfectionism.

As with anyone, when talking about topics I am interested in and have a lot of knowledge about, I can get very excited – very animated. One of my main interests is Cat Friendly handling. Unfortunately, when this happens, a bit of mask slippage can occur. Colleagues and managers would often tell me I am too aggressive, too blunt, and sometimes condescending. I had not seen the social nuances that would have told any other person this person did not appreciate my tone or choice of topic, or that they were finding the conversation confrontational rather than informative (which was my intention).

Studying at The College of Animal Welfare was a haven for me. I could pour all my energy towards a qualification, I also helped other students revise more difficult material. My forte was the theoretical knowledge, exams, assignments – the lot! I loved them, and still do. My desk neighbour was more practically inclined, with years of experience but struggled more with written work. We made the perfect team, I discovered my love for teaching in those moments. My tutors were wonderfully supportive and identified each one of our strengths and weaknesses and built upon our strengths. I still vividly remember our class coming up with a song to remember each step of the WHO handwash. Our tutor never told us to be quiet, or to focus on paper-based revision – she actively encouraged us to use whatever methods we needed to help the information stick. I only know the scientific name for walking dandruff because we used to say “Kayleigh tell ‘er she’s got dandruff!” (Cheyleteilla).

When I started a new role in a veterinary hospital the Hospital Manager had asked me to work with them to obtain gold ISFM status. This meant lots of time mapping out current practice protocols, areas for improvement and providing CPD on cat handling and cat friendly practice in house. As a new member of the team, the other vets and nurses were already curious, perhaps slightly cautious of how I would affect the team dynamic. My brain knew this, it had learnt this from previous experiences. However, I was just given a project I was incredibly passionate about, and I thought the team would surely be grateful for my knowledge and contribution, after all we all want to practice the best patient care we can, right? Whilst I’m sure all RVNs DO want to practice gold standard care, the team predictably shunned my efforts and alienated me from the rest of the team. I did achieve the gold accreditation, but I was left to do all the work myself and the announcement was met with equal measure disdain and excitement.

The element of requiring perfection in my nursing care and hospital protocols was also a significant barrier. As my brain is wired to function very logically and pragmatically, I found my brain almost had a sort of directory of gold standard SOPs compiled from what I had learnt in both college and on the job. I could recall anatomy and physiology information quite rapidly and apply it to cases, my nursing care and new concepts (although I would often forget “more important” information, like my age). However, communicating these concepts and areas of improvements to other members of the team was incredibly challenging. When I was training, I now recognise I would have autistic meltdowns when I could not apply logic to understand a concept. If it doesn’t make sense, how can it be correct? How can I remember this information if 1+1 now equals 4? Enquiring how or why something works the way it does was often met with defensiveness. Colleagues would misunderstand my need for complete depth of understanding as challenging their own knowledge or sometimes, even challenging their qualifications.

As an RVN, I would query protocols or procedures which were not “Gold Standard” or potentially outdated. I would discuss improvements I would like to be made or things the practice could improve on to provide better patient care. Often, I was met with the age old “we’ve always done it this way”, occasionally I would be met with more flippant remarks like “Is nothing ever good enough? Can you not just leave things alone?”. Unfortunately, in areas I am passionate about, I cannot leave something alone, unless I understand the reasons why we can’t make certain changes or understand the evidence for keeping the protocol the same. I especially could not leave protocols, or the lack of, alone if I felt they negatively effected patient wellbeing.

Eventually, we came to a compromise, the hospital put me in charge of clinical audits. Assessing areas of the practice to identify areas of improvement. I loved carrying out clinical audits, the information was factual and could lead to robust evidence-based improvements in practice. No subjective opinions or mindsets could affect my clinical audits!

During my time training as a student, I also started developing pains in my limbs and hands. I went to the doctors, who sent me for physiotherapy, neurological function tests, blood tests, rheumatology etc. No one could find out why I was experiencing burning, bolts of pain and aches in my limbs, why I felt like I had to sift through sand to find my thoughts, and why I seemed exhausted all the time. It took me seven years to get a Fibromyalgia Syndrome diagnosis from a private health care provider. During this time, I was trialled on different medications to manage my symptoms. I eventually started Amitriptyline, a neurological depressant often prescribed for migraine sufferers, which could only be taken at night because it causes drowsiness. Unfortunately, the dose needed to be increased every six months or so to control my symptoms as my body became resistant to its effects. The higher the dose, the more difficult it became for me to wake up in the morning.

I went from being a chronically punctual, detail orientated, organised person to someone who could barely get to work on time. This obviously had a significant impact on my mental health, I suffered from anxiety and depression due to the effects of the medication, undiagnosed neurodivergence, home-life factors, and experiencing the symptoms of a chronic pain condition without a diagnosis.

Receiving my Fibromyalgia diagnosis allowed me to come to terms with my physical symptoms and I began to accept I have a life-long disability.
Realising I am Autistic allowed me to forgive myself.

There is still some stigma surrounding those who are “self-diagnosed” or “self-identified” with neurodivergences. Whether you have a formal diagnosis or are self-diagnosed, your identity is valid. Identifying myself as Autistic, I underwent a workplace assessment (not an official diagnosis, but a tool for employers to understand your needs) which agreed I was likely ASD. This was a small part of my assessor’s day, but this helped me put my entire life into context. I understood WHY I felt like I was speaking a different language, I understood WHY people found me abrasive, I understood WHY I had such difficulty making lasting friendships. I understood WHY I am different, I’m not weird or broken, I am proudly autistic.

If you feel you identify with some of the topics I have discussed, or simply have an unshakeable feeling of being different to everybody around you, consider getting a neurodiversity assessment. This does not have to be from the NHS, this could be through your workplace or via The College of Animal Welfare if you are a student.

If you are a student at The College of Animal Welfare and wish to find out what support is available to you, or identify with anything that Zoe has written and want to chat to someone, please feel free to contact Lucy or Chloe, our Learning Support Team on learningsupport@caw.ac.uk.

They are here to listen, advocate for you, and work alongside you to create the conditions you need to thrive in your studies. They can help you to explore what adjustments, resources, and guidance are available to support your unique strengths and needs.