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At the Podium

How I learned to calm the butterflies and deliver an engaging speech

Nurse Keith Carlson stands at a podium in front of the Supreme Court

I was on stage at the annual conference of the National Nurses in Business Association and I was nervous. This was one of my first national speaking gigs. Naturally, I had the jitters. was on stage at the annual conference of the National Nurses in Business Association and I was nervous. This was one of my first national speaking gigs. Naturally, I had the jitters.

My speaking career was just beginning, so it felt like my reputation in this tight-knit community of nurse entrepreneurs was at stake. There were friends, colleagues and many strangers in the audience. I needed to deliver.

Scanning the seats for friendly faces, I caught the eye of Kevin Ross, RN, my then-business partner and podcasting co-host, and then spotted Renee Thompson, RN, DNP, DMSRN, CSP, one of the most accomplished nurse speakers in the country as well as my very dear friend. Kevin and I smiled at each other, Renee gave me two thumbs up and I was off to the races.

Once I began to speak, my nervousness evaporated. As I’ve come to recognize, when I stand on stage, my inner standup comic often comes to the fore. When Kevin began to heckle me in a friendly and supportive way, his humorous banter set the tone. The room was soon filled with laughter and nods of recognition.

My moment had come, and I seized it with gusto. That experience taught me that I could overcome my reticence, summon my courage and deliver a talk that engaged my audience.

First Time Anxiety

Years ago, if you’d told me I’d be willingly, even Years ago, if you’d told me I’d be willingly, even happily, speaking on stage to hundreds of nurses, I would’ve told you to get lost. For me, as for most people, my anxiety about public speaking was greater than my fear of death. Writing and podcasting helped me gradually become comfortable sharing my thoughts in public, but the idea of standing in front of a live audience remained deeply intimidating.

My first speaking engagement came back in 1996, when I was selected by my fellow students to be the commencement speaker at our pinning ceremony. It wasn’t easy, but I was able to use humor as a means of allaying my fears and entertaining the audience while also being sincerely reflective about the privilege of becoming a nurse. By coupling humor with the pathos of fellow class members who had suffered tragedy and come out shining, we moved from humor to tears and back again in the course of my 15 minutes at the microphone.

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Taking the Stage

Becoming an accomplished orator requires many high-level skills that I didn’t develop overnight. Mistakes were made, my early speeches were less than memorable and I soon realized that the learning curve is steep.

To discover and refine my own style, I’ve worked with a movement coach (knowing what to do with your hands is a common challenge) and a speech coach as well as learning how to create engaging PowerPoint presentations.

It’s paid off: Over the last seven years, I’ve spoken at national and regional conferences, presented workshops and had a thoroughly good time meeting many incredible nurses throughout the United States. In California, I’ve presented on the power of joy to revitalize your life and career. In Washington, D.C., with the U.S. Capitol in the background, I took to the outdoor stage to rail against high nurse-patient ratios. In Texas, I discussed empowered nurse leadership.

Later this year, I’ll have the opportunity to present an all-day workshop on enlightened nurse leadership, giving me a chance to make this a signature topic. Nurse leadership needs a massive infusion of forward-thinking innovation, and speaking to nurse leaders hungry for inspiration is my sweet spot.

With more than five years of professional speaking under my belt, I’ve grown more confident and continue to work hard at not making a fool of myself. Are there occasional butterflies? Sure. Is every speech impeccable and perfect? Absolutely not. I’ve learned so much, but there’s no end to the process of improvement, just as there’s no end to the clinical nurse’s need to learn and evolve.

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Do I enjoy empowering nurses? Totally. It’s a privilege to be on stage, so I owe it to my audiences to make it as compelling and entertaining as I can. My writing, podcasting, coaching and speaking all serve the same purpose: inspiring nurses. That is where the rubber hits the road for me, which has given me the strength to persevere through the learning curves and rough patches.

Performance Pointers

What can you do if you’d like to be part of that process, but are scared out of your mind at the thought of approaching the microphone? Here are some basic suggestions to help get you started:

  • Learn to like the sound of your voice.  (This is an area where podcasting can be a big help, whether you’re hosting your own or making a guest appearance on another nurse’s podcast.)
  • Study TED Talks and other recorded or televised speeches to learn what you like and don’t like about others’ speaking styles.
  • Find someone who can mentor or coach you on how to write an effective speech, project your voice, use your body and command the stage. (This can be several someones! Not all great speakers are great speechwriters and vice versa.)
  • Find topics you feel passionate about and use that passion to cut through your fear.
  • Join a chapter of Toastmasters International, which will give you opportunities to practice speaking in front of a forgiving yet generous audience who will give you constructive feedback.
  • Practice, practice, practice! 

I plan to continue sharpening my skills as a motivational and keynote speaker — and to have loads of fun while doing so. My mission is to become the best speaker and presenter I can be while continuing to inspire nursing audiences in the United States and eventually abroad.  When I remember that newly minted nurse who gave that 1996 commencement speech, I smile at his utter lack of guile, his total cluelessness and the authenticity that captured the hearts of his audience.

Here’s a secret I never would have dreamed back then: Speaking is a thrill. Today, I actually relish the notion of getting in front of those ready to listen, laugh, feel and think. An experience I once dreaded is now a siren song, and I’m grateful for every opportunity my career presents to answer that call.


KEITH CARLSON, RN, BSN, CPC, NC-BC, has worked as a nurse since 1996 and has maintained the popular nursing blog Digital Doorway since 2005. He offers expert professional coaching for nurses and nursing students at www.nursekeith.com.


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