When Sarah Finch looks back on her nursing journey, one moment stands out clearly—the day she met a trauma patient as a Professional Nursing Assistant at Duke Health.

It was 2014, and Sarah was finishing her nursing degree at East Carolina University. She had joined Duke Health’s Professional Nursing Assistant (PNA) Program for what she thought would be a summer job. She had no idea how much the experience would influence her career.

Assigned to the 7 West ICU—a unit she hadn’t envisioned for herself—she expected to gain clinical experience and move on to pursue a pediatric specialty. Instead, caring for a trauma patient opened her eyes to the fast-paced, life-changing work of critical care. It was a moment that revealed a specialty she hadn’t planned on, but one she quickly realized she loved.

“That was a very defining moment for me in my career, really in my life,” she recalls. “I realized, this is what I want to do. That experience shifted my interest to critical care and emergency medicine. Sometimes the opportunity you didn’t choose becomes the one that shapes your path.”

Building a nursing career at Duke Health
Growing up in Apex, Sarah always knew that working at Duke Health carried meaning.

“It meant something to work at Duke as a nurse,” she said. “When I graduated, I knew that’s where I wanted to be.”

In February 2015, she returned to Duke Health as a new graduate nurse in the Emergency Department. Over the next several years, she embraced new challenges—becoming a preceptor, charge nurse, unit educator, and eventually an assistant nurse manager.

“Duke has always provided me with supportive colleagues and teams that make all the difference,” she said. “The culture here encourages you to take the next step and supports you while you do it.”

Her career path also included a leap outside of emergency medicine when she took on a role in ambulatory oncology at Duke University Hospital. Though she learned deeply from that experience, she felt drawn back to her first passion: emergency care.

Innovating in a new role
In January 2025, Sarah stepped into a role that hadn’t existed before—Nurse Manager of Operations at Duke Regional Hospital with responsibilities for the Behavioral Health Emergency Department, Interventional Psychiatry, and Behavioral Health Outpatient services.

“It’s an incredible learning opportunity,” Sarah said. “I get a little piece of all of it, the emergency department, procedural care, and outpatient services. And because this position is new, I’ve had the chance to really look at how things have always been done and ask, ‘How can we make it better for the team, patients, and leadership?’”

Sarah has spent her first months in the role listening, meeting with teams, gathering input, and identifying both successes and challenges.

She sees her role as one of empowerment: “Just because something has always been done one way doesn’t mean that’s how it has to stay. Duke gives you the space to innovate, and that’s powerful.”

Leading by example
For Sarah, leadership isn’t always about sweeping change. Often, it’s the little things.

“If I walk past a counter and see trash, I pick it up. That one action might not change anyone’s life, but if someone sees me do it and decides to do the same, those small actions add up,” she said. “Leading and innovating doesn’t always have to be about big things. Sometimes it’s the little things that ripple out into bigger change.”

She also sees mentorship as central to her work. Inspired by the advice and guidance she received from her own mentors, she now strives to create those same “light bulb” moments for the next generation of nurses.

“There are people throughout my career whose voices I still hear in my head today,” she reflects. “Their advice continues to guide me, and I want to be that person for someone else. At the end of the day, I just want to make a positive difference.”

Why she stays at Duke Health
Asked why she continues to build her career at Duke Health, her answer is simple: the people.

“There are plenty of health systems and opportunities, but I don’t have a reason to leave,” she said. “Duke continues to surprise me in good ways—with the people, the opportunities, and the support. Coming here out of school was the best decision I could have made, and I wouldn’t change it.”

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