Committment to Excellence

A few weeks ago I was honoured to be selected to give a speech at Duke University School of Nursing to commemorate their annual Commitment to Excellence ceremony.  Here is my speech:


    Good evening Fellow ABSN students, Faculty, and Guests,
    My name is Nathan Hatch, and I’m a fourth semester ABSN student at Duke University School of NURSING!  I stand up here looking out at all of you in amazement and excitement and sincere gratitude.  Who would have guessed that a small town kid from California like me, would end up standing here, at a renown institution like Duke University.  Seriously, a little less then a year ago I was sitting where you are all today.  New, naive, and foolishly, just a little bit indignant at having to sit there and listen to people talk about “excellence.” But here I am, three semesters later, a little older, hopefully a little wiser, and a witness to how the faculty and staff of the School of Nursing have stood to the meet the commitment to develop, deliver and promote excellence in education, nursing care, and community involvement.

    One of my favourite quotes on excellence is from Murali Chemuturi, and as I read it I want you to hold it in your mind as I’ll be referring back to it.  “Excellence,” he says, “is a continuously moving target, pursued through actions of integrity.  It is being the frontrunner, providing safe and reliable service to others, meeting all obligations,” and yet, “continuously learning and improving in all spheres, to pursue that moving target.” I cannot think of a better working definition for excellence in the practice of nursing.  To have integrity, striving for safe and excellent care for others, and committing to being lifelong learners. It requires a strong dose of humility and constant self-examination.  Excellence starts with a question.  A question I will end with later.

    In my studies here at the Duke School of Nursing there is a term that has been given to us that I consider as an umbrella mindset for nursing practice, and some of you may know it as the Holistic approach to medicine.  The Holistic approach, to me, is stepping away from reactive medicine, and instead being proactive, and considering all options of care.  It is how we as nurses (and future nurses) can maintain a mindset of excellence.  To think critically through the nursing process about what we know, while analyzing all spheres of influence of our patients, and assuming responsibility to educate ourselves about what we do not know, in order to maintain the highest level of service to our communities and the people that place their lives in our care.  
    As of now, we sit here because we have been chosen by members of this University who see us as individuals meeting the standard of having “outstanding character, ability and vision” to be the next generation of leaders in this ever changing field of medicine. While this is a great honour, I challenge you to be more than just that, because after all excellence isn’t simply meeting someone else’s standards, it is setting your own and exceeding them.
    I want to tell you a little bit about Esther.  A woman who led me to aspire to join this amazing profession.
    I met Esther nearly three years ago, when I stepped off a crammed 15 passenger van which was currently holding 32 people, into a tiny highland village in Kenya which I was to call home for a time.  Esther is a nurse who’s energy and dedication was the key in transforming the unassuming Dispensary in Ngorika, to a place of excellence in healing.  I went to Kenya as a Public Health Volunteer full of ambitions and expectations in the hopes of making some small difference in the community that I was placed, never expecting to meet a woman who would so inspire me and change the direction of my life forever, and it all started with a simple question of curiosity.
    “Kwa nini hapa Ngorika, Esther? Why here? You could be working ANYwhere else in Kuyu-land, or even Nairobi at any of the best hospitals. Why this Dispensory? Why Ngorika?”
She turned to me and smiled as if the answer was completely obvious, “They need me. Yes, I could have gone anywhere I chose, and cared for any number of sick or injured people, but that is all I would be doing -- mending, fixing. As a Nurse I want to heal. In Ngorika I can do that. Yes, I can mend people’s bodies but I can also mend the system broken by corruption, I can heal the hearts damaged by tribalism, here I can mend the soul.
Who else is there but me?”

That is the question.  And you may be answering, “Plenty, there are plenty of people who can.”  I know I have said that to myself many times through this program, comparing myself to others. Thinking, “They are so much better at this then I.” or “I know so little, how am I supposed to do this?”  But then I recall my first day of clinical in the hospital. During Maternity.  Being the Greenest of the Green.  I was placed in a room with a laboring mother, her knowing little of English.  And against such barriers I was able to provide comfort and care, to which I was asked specifically to remain throughout her birthing process.  In that moment, I felt like I knew next to nothing.  But I utilized the knowledge I had and gave my best to provide safe, and effective care, and it made all the difference.
So, considering that rhetorical question, and do everything in your power to hit that moving target called excellence.  As you move forward in this program, and work with this wonderful faculty who will push you in every way imaginable; Think critically, breathe deep, and aim high.

Thank You.