The Integrity Nurse: Turning Lived Experience into Innovation for Youth Mental Health
Doctoral nursing student Lydia Nichols has built her career on equity, integrity, and trauma-informed care. She hopes her Duke education will help her launch a youth clinic.
Lydia Nichols is an alumna of Duke University School of Nursing who has now returned to pursue her Doctor of Nursing Practice (DNP) degree. A passionate advocate for health equity and community-driven care, she is the founder and owner of both a consulting firm, Integrity Nurse Consultants LLC, and a youth mental health nonprofit, YouthTHRIVE. But she says she is now pursuing an even larger venture: opening up a pediatric behavioral health clinic. As a student in the Nurse Innovator and Entrepreneur specialty certificate program, she hopes to gain new skills, education, and connections that will help her realize this dream.
Content notice: This article contains discussion of suicide. If you or someone you know are experiencing suicidal thoughts, call or text the Suicide and Crisis Lifeline at 988.
Overcoming Challenges to Become “The Integrity Nurse”
Before returning for her doctoral degree, Nichols previously completed Duke’s Master of Science in Nursing (MSN) program to become a pediatric nurse practitioner. She was selected from among her class to deliver a commencement speech, where she spoke about what makes Duke students different and encouraged her fellow nursing graduates to “keep climbing.”
“I talked about climbing the Duke Chapel stairs and how that relates to climbing through life’s challenges,” said Nichols, “and how important it is make sure that we reach back and pull up the next generation of nurses.”
By then, Nichols had already demonstrated her commitment to helping nurses overcome challenges in the workplace, having founded her own business in response to an incident she encountered while working as a pediatric nurse.
“In 2017, a 10-year-old patient headbutted me in the face, fracturing my cheekbone,” said Nichols. “My boss said to me that day, ‘Maybe we withheld some information.’ And that experience showed me that, while nursing is regularly rated the most honest profession, nurses are often put in compromising positions at work. There’s this culture of ‘we don’t want to get in trouble’ and of withholding information that can affect safety for both nurses and patients.”
"It should be a badge of honor as a nurse to say that my integrity is non-negotiable."
“I left the bedside and started Integrity Nurse Consultants in 2018, with the mission to teach nurses and nursing students to recognize integrity-comprising situations and respond with integrity,” Nichols continued. “We need to have these conversations in nursing orientation. It should be a badge of honor as a nurse to say that my integrity is non-negotiable.”
Nichols is now known as “The Integrity Nurse” and has been a featured speaker at various conferences and events.
“Integrity is my superpower,” said Nichols. “It’s what I truly lead with.”
A Turning Point: Insights into Trauma-Informed Care
Before Nichols came to Duke, she was managing her consulting business in Washington and did not plan on returning to nursing. But when trauma hit her family, she changed course.
“My son had been living in North Carolina with his father, a recently retired veteran,” said Nichols. “Five years ago, he died by suicide. I dropped everything and moved to North Carolina.”
"When suicide touched my family, everything changed,” Nichols continued. “The experience deepened my understanding of trauma, grief, and the gaps that exist in mental health support for both veterans and youth. It was a turning point that made this work deeply personal."
Nichols connected her personal experience with broader trends in the state, leading to a profound commitment to addressing mental health needs in the community.
“When I came to North Carolina, I saw the need,” Nichols continued. “Suicide is now the leading cause of death for North Carolina youth ages 10 to 14, and one in five North Carolina high school students reported seriously considering suicide in 2021. For me, those numbers represented children, families, and communities that needed support."
While attending a North Carolina Nurses Association conference in 2022, Nichols learned about Duke's Pediatric Nurse Practitioner program and saw that as integral to her mission.
“As someone who started with a GED, the MSN represented so much more than a degree. It was proof that where you begin does not determine where you can go,” said Nichols. “Returning to school became non-negotiable because I knew I wanted to expand my impact in advocating for children and families.”
In addition to pursuing her MSN, Nichols began volunteering and doing community advocacy work, including teaching trauma-informed yoga to children. When she saw an advertisement for a grant from the UNC Suicide Prevention Institute, she applied and was selected. This grant allowed her to kickstart YouthTHRIVE in 2024, along with a special arm of Integrity Nurse Consultants called Integrated Wellness Care Management Solutions, which is focused on Medicaid populations, care coordination, behavioral health support, and trauma-informed wellness services.
Nichols is currently engaged in stigma reduction in elementary and middle schools, which includes building “calm corners” to support students’ mental health.
“It's like a reset room that allows the child to just socially and emotionally regulate themselves, and it’s outfitted based on the school,” said Nichols. “We've got hands-on fidgets, we've got yoga mats, we've got tactile things on the walls.”
Nichols was the keynote speaker for the 2025 Student Mental Health Summit at Mitchell Community College and currently serves on the Board of Directors for Black People Die By Suicide Too. She said she hopes to continue to raise awareness around youth mental health and suicide in the Black community through her work with nurses, too.
“What I'm looking to do now is to bring that conversation into the school's nursing department, and to help them have those conversations with the kids,” said Nichols. “I think trauma-informed approaches should be part of the core curriculum for all nurses—how to meet someone where they are, acknowledging their unique lived experiences and recognizing our own healed or unhealed traumas.”
“I'm on an assignment in life. I'm extremely purpose driven,” Nichols added. “Everything that I do, I believe is a calling.”
Choosing Duke Again: Education, Innovation, Partnership
After graduating with her MSN in December 2024, Nichols chose to continue her education through the DNP program, channeling the same interests that drive her business and nonprofit into new projects and avenues.
“For my DNP project, I'm creating conversation cards for school nurses to have trauma-informed, culturally appropriate conversations with Black and Brown girls as it relates to their menstrual cycle,” said Nichols. "We have evidence that shows missed school days because of menstrual poverty, and we need to equip school nurses—especially those in diverse schools, who might not look like the population they serve—to be able to have those conversations so they can provide resources.”
Nichols will be collaborating with the School of Nursing’s HEEAT Lab, which is focused on addressing health inequities in the Black community. The lab’s Co-Director Ragan Johnson, DNP, FNP-BC, CNE, FAANP, will serve as her DNP project chair.
“I absolutely couldn’t see myself at any other institution because I see that Duke walks the talk,” said Nichols. “I’m gaining top-notch knowledge and education that’s applicable, and I have instructors who want their students to succeed and will walk alongside us to get us there.”
Meanwhile, Nichols says she is also gaining valuable insights and professional development through the School’s Nurse Innovator and Entrepreneur specialty certificate program, directed by Professor Iris Padilla, PhD, MBA, MSN, APRN, FNP-BC, FAANP. She hopes to utilize new networks, skills, and opportunities in launching her pediatric behavioral health clinic, building on all her previous work.
"I’m gaining top-notch knowledge and education that’s applicable, and I have instructors who want their students to succeed and will walk alongside us to get us there."
“My vision is to create a place where children, adolescents, and families can access behavioral health support before they reach a crisis,” said Nichols. “I want families to have a trusted place to turn for mental health services, care coordination, wellness support, and prevention-focused care.”
“There is so much innovation here at Duke; I’m in the right place for sure,” Nichols added. “I think the clinic will be a staple in this community, and I’ll have my Duke education to thank for that.”