slothinscrubs

This started as a discussion post for my nursing theory class.

Which is funny, because it ended up being one of my favorite classes so far. I know, nursing theory doesn’t exactly scream “fun”. It gets a bad reputation for being abstract or disconnected from “real” nursing, but I really believe understanding why you practice the way you do matters.

I didn’t choose nursing because I love blindly following protocols (I do not). I chose it because I care about taking care of people thoughtfully and ethically, and about constantly asking whether we can do better. Nursing theory gave language to that instinct. It made space for questioning practice instead of just accepting it and for imagining a future where care grows alongside the people it’s meant for.

So yes, this was technically a discussion post, but it’s something I have honed in on all throughout my neuroscience studies and now into my nursing studies.

Sooo instead of letting it live and die in a learning management system, I’m putting it here.

evidence-based practice is great… and also complicated

Evidence-based practice (EBP) is designed to standardize care by applying interventions that have been shown to work in large populations. In theory, this is a good thing. It helps reduce variability, improves outcomes, and gives nurses a scientific foundation for practice.

But in areas like neuroscience and mental health nursing, EBP can get tricky.

Because this population-based framework often collides with the principles of neurodiversity, which emphasize that cognitive variation isn’t something broken or pathological — it’s part of being human.

And that raises an uncomfortable (but important) question:

When “best evidence” is based on studies that aim to normalize neurological difference, are nurses practicing beneficence or are we unintentionally causing harm?

when “improvement” isn’t actually improvement

The neurodiversity movement challenges the idea that conditions like autism, ADHD, or Tourette’s are deficits that need to be corrected. But much of the research that informs nursing and behavioral interventions is still built on a deficit-based lens.

Outcomes are often measured in terms of:

• reduced repetitive behaviors
• improved social conformity
• increased executive functioning

Not necessarily:

• autonomy
• comfort
• subjective well-being

For example, evidence may support behavioral interventions that statistically reduce repetitive behaviors. But for many neurodivergent individuals, those behaviors are self-regulation tools, not symptoms that need to be eliminated.

When nurses apply evidence without stopping to ask why a behavior exists or who defines improvement, we risk reinforcing ableist assumptions about what it means to be “healthy” or “functional.”

And that’s where the ethical tension lives: population-level efficacy versus individual dignity.

this is where nursing theory actually matters

This is one of the moments where nursing theory stops feeling abstract and starts feeling essential.

Carper’s patterns of knowing — specifically the balance between empirical knowing and personal knowing — are really helpful here. Empirical knowing gives us the science. But personal and ethical knowing remind us that patients are experts in their own experiences.

Parse’s Theory of Human Becoming pushes this even further by reframing health not as the absence of difference, but as the process of living meaningfully within one’s own pattern of being.

Taken together, these theories challenge nurses to ask better questions:

• Is this intervention supporting adaptation, or enforcing assimilation?
• Are we prioritizing comfort and autonomy, or compliance and appearance?
• Who gets to define what “better” looks like?

maybe the evidence needs to change too

Honestly, I could write an entire separate post about this, but it’s worth saying here: neurodivergent individuals should be meaningfully involved in the research process itself.

If EBP is meant to guide ethical care, then the people most affected by that evidence should have a role in shaping it. Lived experience offers insights that can’t be captured through external observation alone.

The future of evidence-based practice in neurodiverse care shouldn’t be about normalization. It should be about individualized outcomes that prioritize autonomy, self-expression, and neurobiological authenticity.

Because evidence should serve humanity — not homogeneity.

A reminder from a student nurse who absolutely overthinks discussion posts:
good nursing asks us to keep questioning what “best practice” really means.

— sloth in scrubs 🦥