Former mobster, Nathan Hastings, was a detective with the Paul Williams Detective Agency. Nathan fell in love with Dr. Olivia Barber. Nathan and Olivia married. Olivia's sister Drucilla was her reluctant maid of honor, since Dru had a crush on Nathan herself. Dru commiserated with Neil Winters, who also was secretly in love with Olivia, but Dru and Neil ended up falling in love. It was obvious both couples were mismatched. The scholarly Olivia was married to the former criminal Nathan, and the former criminal Dru was with the well-educated Neil.

A pregnant Olivia was diagnosed with ovarian cancer, but refused to abort the baby to save her own life. Nathan Jr., known from birth as Nate, was delivered early to save Olivia's life. Liv had been planning to have a hysterectomy afterward, but the subject of her surgery and her cancer was never addressed further. A few years later, Drucilla had a daughter, Lily, and through the years, Lily and Nate were always best friends.

Years later Nathan and Olivia were not getting along because Olivia took her mentally ill mother's side against Nathan. So Nathan had an affair with the beautiful Keesha Monroe. Olivia became suspicious, and both Dru and Neil cautioned Nathan after they caught him with Keesha. Each time Nathan tried to end the affair, Olivia did something to drive Nathan back into Keesha's arms. But Nathan finally ended the affair, and he and Liv began trying to have another child. Just as Keesha was falling in love with Malcolm, he found out about the affair with Nathan and dumped her. Then Keesha began getting persistent calls from old boyfriend, Stan, who later died of AIDS. Keesha went to Dr. Liv, turned out to be HIV-positive, and had to tell Nathan. Dru decided to tell Olivia about Nathan's affair with Keesha. Liv was furious that Nathan had betrayed her, and had also endangered her and their son Nate with HIV. Liv kicked Nathan out and forbade him to ever see their son again. All three of them tested HIV-negative, but Keesha was doomed with full-blown AIDS and later died. Nathan became desperate to see his son, and kidnapped Nate. Life on the run was rough on Nate, so Nathan finally did the right thing, and was returning Nate to Olivia when he was struck by a car and killed.

Neil's brother, Malcolm, and Olivia were married a couple years later, and Nate was thrilled to have the exciting and fun-loving Malcolm as his new daddy. But eventually Liv began spending too much time at the hospital and not enough time on her marriage. Malcolm and Nate's nanny, Julia, were raising Nate. Olivia suddenly began being suspicious of Malcolm over nothing and ended up driving him into another woman's arms. Malcolm tried to patch things up with Liv and convince her she was wrong about him, but Liv suddenly couldn't decide if she wanted Malcolm back or not. Her mind was on Neil, the man to whom she was always drawn and much more suited. Much to Nate's disappointment, Malcolm asked Liv for a divorce and moved out.

Then the always work-obsessed Olivia started getting symptoms she refused to recognize and ended up on her deathbed with aplastic anemia. She further alienated Malcolm when she changed her will allowing Neil to raise Nate if she died. Dru returned to Genoa City with Lily in tow and donated bone marrow to save Olivia's life. Olivia's near-death changed her holier-than-thou attitude, but it was short-lived. Olivia decided that Malcolm was not a fit role model for her son, refused to let them see each other, and again set her sights on Neil. Malcolm sued for visitation and won. Nate loved Malcolm and still thought of him as his daddy, although it was never made legal. Then Malcolm disappeared in an accident on a photo shoot in Kenya, and was presumed dead.

Nate began getting close to his "Uncle" Neil then, but Neil was drowning his guilt over Malcolm's death in alcohol. So Olivia banned Nate from seeing Neil, too. Brad Carlton, husband of Olivia's best friend, Ashley, tried to step into the void. Later, Nate was happy to see his cousin Lily return to Genoa City from years living in Paris. Neil went on the wagon, and he and Drucilla were remarried.

Three years after he was declared dead, Malcolm showed up in Genoa City, very much alive, sporting cornrows and a bad attitude. Malcolm as out for revenge against the brother who he thought had stole his fiancée and left him for dead in Kenya. But mostly he returned to see Nate again. Olivia was resentful that Malcolm didn't make himself known to Nate as soon as possible, and made him wait to reveal himself until the 15-year-old Nate returned from boarding school at the end of the semester. Nate never returned, and Malcolm disappeared once again.

In November 2008, Olivia returned to Genoa City and mentioned that Nate was now in Medical School in Baltimore at Johns Hopkins University. Nate since mentioned that he had been on the Olympic swim team, competing in the fifty and 100 meter butterfly and freestyle, but had not gone further than Trials, due to concentrating on his medical degree.

In February 2011, Nate, a Rheumatology specialist practicing in Boston, returned to Genoa City to perform a partial liver transplant on undercover FBI agent, Ronan Malloy, using the liver of his half-brother Chance Chancellor. Chance had been called in from witness protection when he was found to be a donor match for Ronan. Chance came through the surgery fine, but as soon as Ronan's surgery was finished, Ronan was taken away by an unmarked helicopter under orders from the FBI. Nate was shocked and very concerned for his patient, saying it was very dangerous for Ronan in his condition.

After surgery, Malcolm was there when Nate visited his cousin Lily to give condolences on the murder of her husband Cane. Neither Nate nor Malcolm was surprised to see each other, so viewers were left to assume that they have been in contact since Malcolm returned from the dead.

Dr. Nate has appeared sporadically afterward, once at the wedding of Malcolm and Sofia.

In July 2018, Nate showed up in Genoa City at the behest of Neil to secretly handle the illness of Victor Newman, and was living with Neil in Neil’s penthouse. Hilary Curtis took an immediate dislike to Nate, and was insulting, accusing him of not being able to get a woman. Neil explained that Nate had been in love and about to be engaged when Carolyn, the love of his life had died.

When a pregnant Hilary was in critical condition following a car accident, Dr. West tried to save both Hilary and her baby. Dr. Nate took over despite Hilary refusing, calling him egotistical and rude. The baby didn’t make it, and Hilary had suffered a ruptured liver and aortic tear. Hilary thanked Nate for saving her life. But Nate told her lover Devon to prepare himself, that Hilary had a disseminated vascular coagulation and was going to die. Devon arranged for them to marry in the hospital, and she died in his arms later that day.

Dr. Nate took over Nikki’s care for her MS, and offered help to Victoria as well. He warned all three Newmans that they needed to take his medical advice or they would no longer be his patients. Nate also taught martial arts to kids at the community center.

Nate realized that Devon was spiraling out of control with wild parties and new friends taking advantage of him, all to mask his pain and panic attacks over losing Hilary. Nate talked to him and got him to see a therapist.

Dr. Nate was the ER doctor on duty when Nikki Newman was brought in after she she stepped off a curb into the path of a car and ended up with a brain contusion and unconscious. She was on her deathbed when Victor managed to sneak in during the night and get her to wake up. Victor coerced Dr. Nate into helping him take Nikki away in an ambulance to safety. But her blood pressure spiked on the way. Afraid she would die, Nate went back for medication, then met Victor at an airstrip. The plane took off, but the police were able to stop the plane, and Victor was arrested for kidnapping. Nikki claimed she made Victor take her out of the country for protection and would sue for wrongful prosecution. Nate and Nikki were cleared of charges.

On April 23, 2019, Lily was released from prison, and Neil was there to welcome her. They traveled to Genoa City to attend the grand opening of Society, a new restaurant venture by Devon and Abby Newman, featuring head chef Lola Rosales. Neil felt exhausted and laid down for a nap upstairs at Devon’s penthouse, promising to meet them there later. When Neil failed to show up, Devon went home to check on him. Devon came down his stairway in tears, having discovered that Neil had died of a stroke in his sleep. Everyone in Genoa City Neil whose life Neil had touched was saddened and shocked by the news of the death of their friend. Family and friends gathered for Neil’s funeral in tears, where his foster daughter Ana sang “Amazing Grace”. They shared remembrances and stories of how Neil had touched their lives and made them better. Everyone then gathered at Devon’s penthouse to celebrate Neil’s life, reminiscing, honoring, and playing his favorite jazz. Malcolm took a group photo. He ended it with a toast; “to Neil Ellis Winters, music lover, businessman, philanthropist, humanitarian, best friend, father, grandfather, best brother you could ask for.” Neil’s will was read a month later by Michael Baldwin. Devon was willed Neil’s half of Hamilton Winters, making him Chairman with stipulations; one of them being that Nate would have a board seat and be given a monthly stipend and Neil’s penthouse. Nate was shocked and honored that he would be carrying on the Winters legacy with Devon. Nate and Victor exchanged secretive comments because Nate was consulting with Victor who had paroxysmal nocturnal hemoglobinuria disease. When experimental treatment had no effect, Nikki persuaded Victor to tell the family. Although he intended to fight it and win, Victor discussed put Victoria in charge of Newman while he took experimental treatments that promised side-affects.

Nate began spending time with Abby Newman who had been burned so many times by love that she continually tried to resist him. They began showing up together at family get-togethers, and Victor let them know he approved. Adam offered Nate double what Neil paid for his penthouse, so Nate sold, and bought Cane and Lily’s house. Abby went to dinner there one evening, and they ended up making love. But afterward, Abby let him know that they were not a couple, and turned down his advances, confusing Nate with her mixed signals. Nate won her over and they became lovers.

Nate had been secretly treating Victor for paroxysmal nocturnal hemoglobinuria, a rare blood disease that destroys red cells. When experimental treatment had no effect, Victor opted for another treatment with side-affects which included diminished mental capacity. He became forgetful, and a one point experienced an episode where his only hope was to ask Jack for help. Nate realized that someone had tampered with Victor’s medication, test results showed double his dosage. Victor called a family meeting saying he was going to Europe, and taking Nate with him. Victor suddenly collapsed, had no pulse, an ambulance was called, but Victor was declared dead. It turned out to be a plot of Victor’s to prove that Adam had tampered with his meds, hoping he would show remorse. Nate, Nikki, Billy, Victoria, Nick, Abby and Paul were all in on it. And when the dust settled and Adam was exposed, Victor forgave him and let him leave town, and Newman life went on as usual. Nate felt conned, and told Abby they were over, that he felt like he had to throw away his conscience to be with her and her family. Then the medical board tried to take away his license to practice in Wisconsin. Nate hired Amanda Sinclair, his case being he had gone along with it because he thought Victor’s life was in danger. Amanda won the case and they began dating.

Elena proposed creating a low-cost clinic for New Hope residents and anyone needing low cost medical care. Devon thought it was a great idea. They convinced Nate to oversee medical protocol for people in recovery, and Nate and Elena would work there part time. Devon, Nate, and Elena went to check out a location they had in mind for the New Hope clinic, when a teenager named Jared came in with a deep cut he had received by being shoved against a security gate by two guys who had looted his grandfather’s store where Jared worked. Nate and Elena tended to his wounds, and they gave him supplies for him and his grandfather. The next day, Devon bought the rundown building. Jared returned, upset that his grandfather had passed out. They got the elderly man to the hospital, but he later died. When the trio tried to comfort Jared, he ran off. Later Jared fought with their landlord, and ended up in jail. Amanda got the charges dropped. Jared had been a foster kid until he found his grandfather, who had agreed to take him in. Amanda shared that she too had grown up in foster care and got him to open up. Jared told how his grandfather had been a domino master, that his shop was rented, and he didn’t know how he could possibly keep it. They gave him a job working at the clinic. Seeing this new side of Amanda, Devon decided to forgive and befriend her. They asked her to give legal assistance at New Hope, and she agreed.

Amanda and Dr. Nate Hastings began to get close and started dating. Both were very cautious, not wanting to rush things. But one evening after a grueling day at the clinic where they had saved Jared from an overdose, Nate and Elena were overcome with lust and had sex on an exam table. They both realized it was a mistake and vowed to never speak of it again. But Elena felt so guilty that she ended up confessing to Devon, and he asked her to move out. Devon told Amanda and she broke up with Nate. Elena quit working at the clinic to avoid Nate and moved into the apartment above Crimson Lights as Lola’s roommate. Devon found Elena and Nate together in the lobby bar of The Grand Phoenix and started a fight with Nate. Nate refused to fight, but Devon shoved him into a table causing a glass to break and severely cut Nathan’s hand. I turned out that tendons had been cut and Nate would not be able to do surgery again. After months of indecision over what to do with his life, Nate began to oversee surgeries and teach, and was offered the job of Chief of Surgery at Memorial. Nate quit his side job with ChanceComm as online doctor with AskMDNow, and it was offered to Elena who accepted. Elena and Nate had an on again/off again romantic relationship throughout. Elena considered a job offer in Baltimore as an attending physician in the ER. But she ended up saving Nate who was allergic to crab with an EpiPen. Nate asked her not to take the job, to stay there with him, and they ended up having sex. Elena turned down the job. By the end of the year they were living together in Nate’s house. Ashland offered Nate a corporate job at Newman-Locke. Nate had a hard time with the thought of leaving medicine but finally decided to accept the job, depending on what it entailed.

Nick came to Nate with the news that Ashland had faked his cancer. After confronting Ashland who denied it, Nate then decided he didn't fully trust Ashland and looked into it. Nate confronted Ashland that he had found no evidence of cancer on the x-rays following Ashland's heart attack as he claimed, also no record of Ashland getting chemo treatments, calling him a liar. Knowing that Nate had obtained them illegally, Ashland threatened to get his medical license revoked. Nate shamed Ashland for faking a disease that so many innocent people were suffering from and deceiving Victoria and himself as part of his plan. Nate presented Victor with the information and the Newmans managed to convince Victoria of Ashland's deception. Elena was proud of Nate for what he did to help. Tired of constant home repairs and wanting to reclaim his inheritance from Neil, Nate bought back the penthouse from Chelsea and he and Elena moved in.

Lily offered Nate a job at Chancellor which was merging with Hamilton-Winters. Lilly proposed that Chancellor-Winters become two-fold with the Hamilton-Winters division focusing on entertainment and media and Chancellor on merchandise, hospitality, commercial real estate such as concert venues and hotels. Devon and Lily would still be in charge of their division. Devon made Nate his COO and renamed LP Streaming to Hamilton Streaming to honor his mother. Jill arrived in town to attend the launch party. Devon had Nate give a speech but warned him to just give an overview, not to tell any details of their plans. Not liking their strategy, Nate wanted to give details. So with Imani’s urging Nate plunged ahead and told of their podcast plans. Devon did not approve, but Lily and Billy agreed that it piqued the interest of their audience and made them hungry for more. Nate continued to overstep, and Devon got more and more upset with him.