Nursing in Moments: Surgical Nurse Nathan Welsh Offers His Thoughts on “The Year of the Nurse and Midwife”

DAISY honoree Nathan Welsh, BSN, RN recently gave a speech at a DAISY event at Carle Foundation Hospital in Illinois, where he works as a surgical nurse. The DAISY program spotlights courageous nurses that regularly go above and beyond for their patients. Welsh is no exception. He has been working around the clock as his facility grapples with the crisis of the pandemic.

This all comes during the Year of the Nurse and Midwife, a special commemoration of the 200th anniversary of Florence Nightingale’s birth.

2020 has been anything but typical. Instead of singing his own praises, Welsh spoke from the heart about his experiences and struggles working on the frontlines of the pandemic. He talked about what nursing means to him – even in the face of so much stress and anxiety.

Read the full speech below:

“When they asked me to speak today, I was told that the theme was going to be the year of the nurse. My first response was, ‘Really? THIS year is the year of the nurse? THIS year where it feels like everything’s on fire all the time and every conversation begins with hand washing and ends with PPE, and we’re all trying to get people to do things that are good for them, even when they don’t want to do it…All right, 2020 really is the year of the nurse in that regard. That sounds like many shifts I’ve had.’

But the theme still felt a little strange to me. ‘The Year of the Nurse’ – it just didn’t feel quite right. The more I thought about it, the more I realized the scale seemed all wrong. I don’t think of nursing in years. Of course, we all have those professional milestones and obligations that help us mark the passage of time: Our yearly attempt to resurrect the CPR dummy or our yearly opportunity to get our favorite Carle branded merchandise on our anniversary of hire, or my yearly reminder that I don’t know nearly enough about stroke scales. But those are things we do for nursing. That’s not what nursing is.

I think sometimes it makes sense to think of nursing in terms of weeks. The inpatient setting certainly lends itself to that. A patient comes in with an issue at the beginning of the week, but we always have an eye toward the door. We always have an eye toward getting them better and getting them home, back to a place where their world makes sense. Certainly, more sense than the hospital often does. Even if nursing could be measured in years, being a patient never should be.

Sometimes, though, it feels even smaller than that. It feels like nursing ought to be measured in shifts. There are days where we live 12 or 8 hours at a time, where every moment feels like a constant rush, a push, an urge, trying to get to the end of the shift and hoping that when you pass the baton you leave the unit and the patients just a little bit better than when you found them.

But I think the reason ‘The Year of the Nurse’ feels like a strange way to say it for me is because, in my mind, the best nursing happens in moments. It could be the moment when all of your education and experience reveals a problem that no one else can see because no one else is there. Sometimes it’s when subtle things come into focus and you can all of a sudden explain to a patient what their body’s been going through or explain to a physician what their patient has been going through. I think we all know stories of problems that would have slipped through the cracks if not for a diligent nurse following up, following the sense that something just doesn’t feel right. Tracking it down until they finally get an answer.

Sometimes it’s the moment when we know something is not right and we have to take a stand about it. I don’t think any of us relish standing toe to toe with a doctor or administrator, but I know everyone here will stand and say, ‘Something is wrong and I will not let it go unaddressed.’ That’s a moment too.

As often as not, though, I think great nursing happens in the moments in between. See, our patients’ schedules are packed full with protocols and tests. They go from this to that, take this at this time. And what’s left over are the moments in between. Where it’s just the patient and the nurse, in the room. I think those are the moments that can change lives. The moment that a patient has been stoic for their entire course of treatment finally decides that YOU are the one, and THIS is the moment when they are finally safe to voice their fears, ask their questions, connect. The moments when a question they have asked many times is finally answered in a way they can understand and connect with. I put it to you colleagues that most of the nurses who have earned a DAISY have earned it in moments like these. I think we all have the opportunity, but DAISY nurses are the ones who take advantage and make that moment work for them.

This year is not like anything I’ve seen in my lifetime. COVID has changed our lives in ways large and small. Things change fast, but our lives outside of work have slowed. Medical professionals at every level are facing challenges and risks that they hoped never to see. I think these days people are more isolated, more scared than ever before. And more in contact with health care than anyone ever hoped. Now every encounter is heavily structured for maximum safety and very little is unscripted, but the moments in between still remain. Moments when a scared person needs a hand to hold or a lonely person needs someone to talk or an unspoken issue needs a voice. Now more than ever people need to connect with another human, if only for a moment. And that’s why I think 2020 really is the year of the nurse.”