Lillian Goodman, 78-year-old nurse, health career educator and administrator gives one of her classic answers: “The idiotic saying, ‘a job well done.’”

Then seriously, she adds, “There should be a lot of satisfaction from a career in a field that has an impact on society. I would say that along with teaching, [nursing] is one of the few fields where you could say that.”

For Lillian, it seems her own expansive career in nursing has brought her decades of satisfaction and continues to do so. Her journey through life began in a small town in New Hampshire, where she was raised. “In the era I grew up in, there were three ways to go,” she recalls. “You got married, you became a teacher or you became a nurse. I had an incredible high school biology teacher, Mr. Flaherty, who was also the football coach. He inspired me tremendously to think about scientific questions. My mother’s stories about growing up amidst the Armenian Genocide, along with Mr. Flaherty, pushed me toward nursing.”

In 1949, Lillian enrolled at Elliot Hospital in Manchester, N.H. “We were what was in those days called ‘diploma school nurses.’ We trained, worked and lived there.” With self-deprecating humor, she shares an embarrassing memory from those formative days. “When I was a student nurse at Elliot, I was on evening shift. It was very busy—the charge nurse went to dinner and put me in charge. I was very excited and anxious, and we had a new admission, a very young, good-looking man. I was 18, he was 18 and I was so nervous! I said, ‘Excuse me, sir. I have to take your vital signs.’ I picked up his arm and started taking his pulse, and everyone started laughing. I asked, ‘What’s so funny?’ He said, “You took my brother’s pulse, not mine!’”

From those youthful misadventures, Lillian went on to earn her OB-GYN and RN licenses in 1952, and went to work at the Margaret Hague Maternity Hospital in Jersey City. Three years later, she found herself in California working as an OB Supervisor at Kaiser Permanente Sunset. In 1957, she married a physician and started a family, taking nine years off to raise her two children. When she returned to the workforce, it was as an OB-GYN and med-surg nurse at Holy Cross Hospital in Mission Hills.

At a certain point, Lillian recalls, she became interested in teaching, and obtained a vocational credential and a B.A. in Liberal Arts from Redlands College. By the early 1970s, she had embarked on a new phase of her career, as the director of a private vocational nursing school, training LVNs. In 1978, she joined the Los Angeles Unified School District (LAUSD), supervising high school and adult education health career programs for LVN, CAN, EMT, MA, X-ray and dental assistants. Along the way, she picked up her M.A. in Education Administration and an administration credential. By the time she retired after 27 years of service, she held the position of Director of Vocational Nursing Program/Health Careers Specialist.

With more than 60 years of experience in the field of healthcare, Lillian is outspoken about changes that she has seen in the system over the years. “Hospitals are now owned by large corporations,” she laments. “It’s not [supposed to be] a product. Efficiency models shouldn’t be the criteria.” Of her many passions, nursing remains first, and Lillian expresses concern that the field is under threat. “We need to put more money into educating nurses. At the community college level, there are waiting lists so long that potential nurses give up. We also need the pay to be commensurate. Nursing needs to be a viable profession.” To this end, she feels that negative practices such as older nurses eating their young are anachronistic, and can be addressed and minimized through “professional development and education for the more experienced and seasoned nurses to interact with the new nurses.”

Next: How Lillian teaches…

As members of the Persian Jewish minority in her native country of Iran, Niaz and her sister faced a future of fundamentalist religious persecution. Her mother, Mahnaz Shadnai, was a nurse, while her father, Homayoun “Benny” Farzadfar, ran an orphanage with the Red Cross. Shadnai recalls that while she was happy in Iran, “I didn’t like the way my daughters were treated.” In 1998, they immigrated to the United States for what Shadnai hoped would be “freedom and educational opportunity” for her girls. They settled in California, where they had some relations. “It was hard,” Niaz recalls. “The heartache my family and I went through to get here felt endless. We didn’t speak the language and my parents had no jobs.”

The family persevered and started life anew. Niaz remembers entering third grade and quickly mastering English. She graduated from high school in 2006, then enrolled at Los Angeles Pierce College to take her nursing prerequisites, where she earned a spot on both the Dean’s and President’s list of honor roll students. Meanwhile, her father had opened a dry cleaning business, while her mother became a med-surg nurse, a position she holds today at Kaiser Permanente in Woodland Hills, Calif.

Yet they had barely settled into their new lives when disaster struck. Three years after their arrival in the United States, Niaz’s father was diagnosed with colon cancer. The initial bout was successfully battled into remission, but a few years later the cancer reappeared, this time in the liver. At the age of 18, Niaz found herself helping care for her ailing father, who would pass away in December 2006. As heart-wrenching as it was for her at the time, today she can look back at the experience as transformative. “For the duration of my father’s sickness, I was faced with wonderful healthcare providers, such as nurses like my mother, and others who took care of my father. The experience I went through made me even more passionate and sure about nursing. It was those healthcare providers who made my experience with my father’s death, the hours leading up to it and the moment it happened, as good as they could be, and nothing can be more significant than that.”

As a young girl in upstate New York, Pattie Jakel felt the calling. At the age of 15, she found herself caring for her grandmother, who was stricken with colon cancer. Years before that, around the seventh grade, Jakel took one of those career aptitude tests, which—no surprise to her—revealed that her interests pointed toward nursing. “The man [who administered the test] was condescending,” she recalls now. “He told me, ‘All little girls want to be nurses—you’ll change your mind.’” Luckily for the countless patients and colleagues who have either been under her care or have worked with her during an emotional and challenging 27-year career, the man was wrong.

Earning her RN from Hartwick College in 1982, Jakel found work as a traveling nurse as part of a program instituted in the 1980s to combat a nationwide nursing shortage. She spent three years working in nine cities, in regions of the country as varied as the deep South, New England and the west coast. Her sojourn came to an abrupt halt when she reached Los Angeles. “I stopped because I fell in love,” she recalls. She met her husband, a French architect, at Kaiser Permanente in Woodland Hills, where his business partner was hospitalized with cystic fibrosis. “[His partner] played matchmaker…he died a year before [my husband and I] were married,” she remembers wistfully.

Nineteen years later, Jakel is still married to the architect and is the proud mother of two teenagers. They’re a very physically active family, enjoying recreational activities such as snowboarding. Jakel recently spent eight days in New York with her daughter Mackenzie, who won several awards at a dancing competition. Her children join her in volunteer work at a no-kill animal shelter, located not far from their home in West Hills, Calif.

Nursing and family have been the focal points of Jakel’s life, and she has found a way to balance words and deeds. On top of her many years on the floor in scrubs, she has been an outspoken advocate for nursing. “I have one talent in this world,” she modestly proclaims, “and that is being a good public speaker.” Jakel makes regular presentations at national and local conferences, teaches oncology classes for nurses in training at UCLA and volunteers for the American Cancer Society and the Leukemia and Lymphoma Association, educating parents and volunteers. She’s also coauthoring a chapter for a book being written for primary care physicians on the challenges of caring for geriatric cancer patients in the home.

Jakel left nursing for a nine-year period to work on a NIH-funded research project, where she was involved in studies on cancer, Alzheimer’s, memory, methamphetamine addiction and cocaine addiction. Due to spending cuts, her position was eventually eliminated. Jakel was stung by this turn of events, especially as it happened a week after receiving her 20-year pin for service. “The administrators had no idea what I was doing,” she says. “It showed me I needed to be more verbal. I had to tell them that I had patients I had worked with for nine years that I needed to say good-bye to, like one woman with brain cancer.”

Today, Jakel is the CNS in a 26-bed Oncology Unit at Santa Monica-UCLA Medical Center and Orthopaedic Hospital. Following her around for a day, it’s obvious that she has earned both the respect and friendship of her staff, blending professionalism with a lighter, personal touch. During a typical morning shift, she jokes as she looks over statistics with Terry Taylor, the ACP who is on the verge of retirement. Roaming the halls, Jakel makes frequent stops for consultations with nurses, orderlies and resident doctors. As expected, not everything runs as smoothly as she would like. She rubs her forehead in frustration when given some bad news about a mistake almost made in a patient’s medication. She knocks on the door of a patient she describes as particularly elderly and frail, to make sure he hasn’t had an accident. “Falls are a huge issue,” she explains. “Medicare will not cover falls, bedsores, things like that. The hospital is responsible if someone hits their head, gets a hematoma and dies.” Emerging from the patient’s room, she continues, “The first line of defense is the family, to remain at the bedside, but sometimes it’s hard to get family members to stay here. It’s like a break for them.”

Jakel stops to mentor Monique Acosta, an RN, and Monica Coles, a nursing student. The conversation turns to a 19-year-old patient who recently died from gastric cancer. As they speak, a condolence card is being passed around and signed by everyone in the unit. “Ashley was an angel, and that’s a word I don’t often use to describe patients,” says Jakel. “She was so sweet and so brave, she never once complained….”

Dr. Michael Marra, a professor of Asian Languages and Culture at UCLA, is in the advanced stages of Leukemia. In a soft voice, he describes the treatment he is receiving as “stunning, just stunning,” praising the compassion he has found. “You’re in the dark tunnel now, “ Jakel tells him. “We’re going to get you through it.” She listens intently as Marra shares his views on life and death, which have been influenced by his interest in Eastern philosophies. “What is life? Life is something beautiful that you experience, and then it’s gone. There’s nothing strange about it.”

Their conversation turns to issues of quality of life and mercy. Jakel tells him that she has worked with elderly patients who, in the advanced stages of illness, are ready to die, but whose families influence them to do everything possible to prolong their lives. “We don’t let people die anymore. I struggle everyday with people well into their 80’s.” Marra shakes his head sadly. “It’s a natural process,” he says quietly.

Jakel estimates she has seen “hundreds of deaths in 27 years” on the job. “It doesn’t get easier; it gets different,” she says. “I have other areas where I can put my emotions now. I still cry. When Ashley died, I cried for days.” She shares stories about work with her children, believing it will help make them more compassionate. At the hospital, this open expression of feeling for her patients is not lost on her young mentees, who quickly discover that in the life-and-death world of oncology, tempering one’s compassion with the steely resolve to persevere is perhaps the greatest skill they can develop.

Pattie Jakel

See Pattie Jakel’s anything but typical day in our photo gallery.

Yet it took a near-death experience for Walsh to gain a full appreciation of the true nature of her calling. In 1998, she was diagnosed with polycystic liver disease, and found herself wearing the same beeper she had seen on patients in the ICU. Her experiences as a patient and the treatment she received post-op allowed her to see nursing “from the other side of the bed rail,” as she puts it. “That gave me a greater sensitivity toward anybody who’s in a vulnerable health condition.” In a voice tinged with emotion, she recalls one particular night in 1999. “They were transporting a patient who had just suffered brain death to the operating room to procure the organs.” At that moment, the enormity of the situation hit home, and she remembers “going off to a private place and crying my eyes out.”

Doctors had difficulty finding a suitable liver for Walsh, and she ended up hospitalized at the University of California, Los Angeles, where she waited three excruciating weeks until an eleventh-hour transplant was arranged. It was during her post-operational convalescence that Walsh really got a taste of how patients view their own healthcare. Simple things, which she admits she herself did as a nurse, became aggravations as she lay in recovery. “One thing that really made me furious was the way hospital employees would walk by, pop their head in my room and toss old gloves or empty coffee cups into my trash can. I still get pissed when I think about it…my whole world had shrunk to that little cubicle, and I felt like that was my trash can! To this day, I respect the patients’ space.”

Other transgressions were more serious. She recalls the intense pain she felt when having a drain removed, and the dread she felt when the time came to remove another one. The bedside manner of the doctor and nurse left her cold. “They basically ignored me, talking about his weekend and other trivial stuff,” recalling that even as she cried in pain, they never once looked at her or asked if there was anything they could do to make her more comfortable. “I had fallen into that mindset where ‘you have to be a good patient,’ so I didn’t say anything. It was extremely impersonal and rude. I thought about how many times I had been in a patient’s room involved in personal chatter—so that experience really brought that home to me.”

It has been more than eight years since the transplant, and other than having to closely monitor her immune system, there is little outward sign of what Walsh went through. Today she is more physically active than ever, an avid hiker and jogger who participates in long-distance runs. Like all good teachers, she is able to synthesize her own life lessons into her work. “I’ve shared these personal examples as a staff developer, during training sessions,” she explains with a smile. “It really seems to raise the level of interest. I guess no matter how long you’ve been involved in this kind of work, you can never, ever overestimate the importance of compassion.”