Master of Science in Nursing student, Leah C. Rothchild gave the 2024 Commencement address for the School of Nursing during MGH Institute of Health Professions' May 10 ceremonies at the Boston Convention and Exposition Center. President Paula Milone-Nuzzo introduced Rothchild to the audience:

After graduating from Florida Atlantic University with a degree in interdisciplinary studies, Leah worked as a certified recovery support worker providing peer mentorship to individuals with substance use disorders, and as a care coordinator for women and children experiencing housing insecurity. She simultaneously volunteered with the New Hampshire Human Trafficking Collaborative Task Force, and the New Hampshire Harm Reduction Coalition.

Guided by her lifelong dream of a career that would allow her to contribute to the physical and mental health of children, Leah pursued her MSN studying to become a pediatric nurse practitioner. During her three years at the IHP, Leah has been recognized for her leadership and dedication to equity, justice, patient care, and advocacy. She served as a student government class representative, a peer mentor, a teaching assistant, a member of the School of Nursing Advisory Board, and she currently represents the state of New Hampshire as a Graduate Nursing Student Advocacy Leader.

While studying at the IHP, Leah discovered her passion for global nursing through opportunities to work and study in Uganda, Malawi, and India. Leah believes that global health partnerships are vital to improving health outcomes, increasing understanding of social determinants of health, and sharing knowledge to create sustainable change. She looks forward to future opportunities to build cross-cultural professional relationships and collaborate on innovative solutions to complex health problems across the globe.

Leah looks to a future where all children have access to equitable, high-quality healthcare. She is excited to begin her new role as a pediatric nurse practitioner and hopes to incorporate increased mental health services into pediatric primary care to provide more comprehensive care to her patients.

Leah Rothchild:

Hello everyone, and a huge congratulations to all of today’s graduates. I know there were times when many of us thought we wouldn’t make it to this day, but here we are. We did it. 

As we approached this momentous day, I spent a lot of time reflecting on what I’ve learned and how I will apply it to my future practice. I remembered the triumphs and successes. And then, suddenly, I was struck with embarrassment when I remembered my failure in a lab simulation during my very first semester. Of course, the lab is designed to be a safe space where we can make mistakes and learn from them with no real consequences for our patients. But like so many of us, I strive for the unrealistic goal of perfection, and I beat myself up for these mistakes.

We had just learned about respiratory assessments and tracheostomy care in class, and as I entered the lab, my partner and I began taking vital signs on our patient. For family and friends here today, our patient was a mannequin—that is the beauty of lab. So we are assessing our patient, and we notice that she has a tracheostomy and her oxygen saturation is low. As we began nervously whispering to each other about what we should do next, the blue light came on inside her mouth. Again, family and friends, you might be wondering what this means. This is how they display central cyanosis on a mannequin. And if you aren’t sure what that means, the short answer is that this patient needs oxygen fast. 

My partner and I ran to the hallway, gathered supplies, and began suctioning the patient’s tracheostomy, without sterile technique or pre-oxygenation. Spoiler alert, it didn’t help. When the simulation ended and we debriefed, the instructor asked what we had noticed about the patient’s position in bed. We replied that the head of the bed was fairly flat and the patient was slumped slightly to the side. Her poor oxygenation was due to her position in bed. All we needed to do was elevate the head of the bed and reposition her. 

I was so mortified by my oversight in that moment that I almost began to cry. How could I have missed what was right in front of me? Something so simple? How could I have forgotten one of the most important lessons of my first semester: Try the least invasive intervention first. I was so eager to practice these new high-level nursing skills we had learned about in class, and I had this misguided belief that by advancing my nursing skills, I would somehow abandon the basics; the fundamentals.

But as I gained more experience, both as a student and as a practicing nurse, it became increasingly obvious to me that the most advanced nursing skill is looking at the big picture. It is knowing what the patient needs in the moment, whether that is an invasive, aggressive, life-sustaining measure; or something simple yet equally salient.

As I reflect on this idea, I am reminded of my student nurse experience in a neonatal intensive care unit in Uganda. On my second day there, my preceptor had me assist in providing resuscitation to a premature infant in cardiac arrest. This is what I thought nursing was about: I was fighting for this baby’s life with each chest compression. Ultimately, our efforts were unsuccessful, and the baby died. My job as a nurse was over, I thought. But I watched as a Ugandan nurse delicately wrapped the infant in a beautiful blanket and handed her to the frightened mother who fell to the floor, cradling her motionless daughter. And then I watched my preceptor drop to the floor beside her and place a hand on her shoulder. They did not share a spoken language, but they shared a profound moment of human connection, compassion, grief, and empathy. My preceptor knew that there was nothing else that could be done to sustain the infant’s life, but there was more that could be done to support a mother whose world will never be the same. That is nursing.

Nursing is more than the medical care we provide. It encompasses medical interventions, health guidance, but also compassionate care. We have the unique privilege of walking through illness with our patients—through highs and lows, challenges and recoveries, tragedies and miracles. We must allow ourselves to feel the intricate emotions woven into each patient journey; to step back and view the whole picture, and to address the full depth of our patients’ needs. As we leave here today and prepare to enter our new nursing roles, my hope for all of us is that we always remember the pathophysiology, pharmacology, patient education, and physical examination techniques that we have spent so much time studying.

But above all else, I hope we always remember to care for our patients as comprehensive and complex humans; not as symptoms, checklists, or diagnoses. It is this genuine connection that truly allows us to fulfill our calling as nurses.