From Bedside Nurse to Family-Centered Caregiver


Michelle Spehr always wanted to make a difference. Growing up, she watched her mom, a pediatric nurse, have an impact on the lives of children every day. From then on, she knew she wanted to do the same.

From working in hospital intensive care units to earning her Master’s in nursing and Doctorate in Nursing Practice (DNP), to being a child welfare nurse at SaintA, Michelle has definitely made a difference.

Change of Pace

“I noticed in Indiana, parents didn’t know or understand some medical needs of their children.” She says there was no one to help parents figure out the diagnosis and the appointments the kids would need. “Working with families who needed help interested me.”Before coming to Milwaukee, Michelle worked at a hospital in Indiana in the neonatal and pediatric ICUs. While she loved her time there, she says, she wanted to change gears. “A lot of hospital work is done reactively, not proactively.” So, she began to look for jobs in public health.

Michelle Spehr


For almost two years, Michelle has been at SaintA, and she says this position addresses some of the issues she noticed before her switch from a bedside nurse to a family-centered field nurse.

“I help parents get what they need and make the transition (from appointments to home) smoother, at least medically, and that’s one way to make the kids safer.”

No Typical Day

Michelle does home visits for all SaintA children under 3 years-old, who enter out-of-home care. She performs developmental assessments and refers families to any services they may need.

When a child has medically complex needs, she continues home visits every three months, and consults with case managers regularly. “Every day is different”, she says. “Some days I’m out in the field all day doing home visits and other days I’m in the office answering questions, charting, and attending case meetings.”

While there’s no typical day as a child welfare nurse, she does admit she has her favorite part of the job: the home visits.

“I really love to spend time with children and families. I enjoy being on the ground, playing with them, interacting with them and seeing that my job is making a difference in their lives,” she says.  

A Different Perspective

Sometimes, she says, in healthcare, we think providing a diagnosis and medication will easily fix the problem, but home life influences every case. Michelle always tries to ask herself, “How can we make this medical plan successful for this specific home environment?”

Despite all their efforts, there are still many challenges that nurses can’t control, like a child who needs to be transported back and forth to the hospital or siblings who need childcare. For many parents, there are the logistics of catching the bus or simply managing the volume of appointments. That’s when additional resources are made available to families.

“We try to see what other support the family has – like a grandma, dad, or anyone who can help them get back and forth.”

Sometimes additional health services are needed, too. “We try to provide families with resources like in-home behavioral therapy,” says Michelle. “We bring that mental health piece into the home so it’s not another appointment.”

Growing into the Job

Being resourceful, understanding and accommodating are other major criteria for the job. Right now, Michelle is the only nurse at SaintA and it’s given her a chance to become a leader in her field. “People come to me with questions,” she says. “I feel like an expert.”

Are you an RN looking for a change of pace? We are hiring nurses!

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