Susan Bowler by 1992 had capped a 12-year career working with newborns at a California hospital and was ready to retire in Craig.
But a friendship at a local church set in motion events that now have her planning public health efforts in two counties while working next to a four-foot-high filing cabinet packed with facts on smallpox and bio-terrorism.
Bowler, public health nurse manager for Moffat and Routt counties at the Northwest Colorado Visiting Nurse Association, nearly saw a nursing career derailed before it started.
"I went into chemistry class and, at the end of day, walked out thinking, 'There's no way I'll be able to pass chemistry,'" Bowler laughed.
"But I was never satisfied because I knew I could do more."
A childhood spent on the move in an Air Force family shaped her interest in nursing. Bowler spent much of her youth in hospitals both stateside and at military posts from Japan to Thailand.
"I was an asthmatic," she said. "My mother talks about taking me to the hospital, handing me to the nurses and the doors shutting ... she wasn't allowed to see or touch me. I was kind of detached a lot when I was in the hospital and whether that was positive or negative I don't know."
In Thailand, Bowler also spent her early teens along with friends helping out where needed at orphanages with more babies than available cribs.
"We'd spend a day, pick them up and talk to them," she said. "(Thai nurses) were just grateful for someone to come and give the babies some attention."
Graduating high school in California in 1964, Bowler at one point interviewed for a flight attendant's position before taking a next step toward nursing at age 19 when she earned her licensed vocational nurse certification.
A single mother supporting two children in 1976, Bowler went back to school for a two-year registered nurse's degree.
That status secured a job in an intensive care nursery at a hospital in Sacramento, Calif.
"If I had the opportunity to go back to nursery ICU, that's really where my heart is," said Bowler, who met her future husband, Richard, while tending to his grandson at the California hospital.
Bowler pondered retirement when she and Richard moved to Craig in 1992. She didn't work up to a year afterward, but soon crossed paths with another medical professional at Craig's First Congregational Church -- Marilyn Bouldin.
The VNA's former director of community care made a lasting impression, Bowler said.
"She was very up, very positive and just kind of sucked me right in," Bowler laughed.
A few hours' work per week preparing VNA clients to see doctors expanded to other programs -- from child immunization to a three-year stint providing nursing services to inmates at the Moffat County Jail.
Bowler earned a four-year bachelor's degree in 2000 by taking on-line courses through the University of Northern Colorado.
"The whole reason was to get into management," she said. "If I didn't do it, they were going to hire someone else from outside the agency to boss me around."
Staff departures mixed with slashed budgets in recent years have resulted in several positions not being replaced, and pushed Bowler to the forefront last year when Bouldin left the VNA.
Bowler and VNA executive director Sue Birch split programs and management issues once shouldered by Bouldin.
"There are unbelievable amounts of paperwork with government programs, reports, and funding issues to look at," she said.
This as VNA is asked to serve more patients with less staff and funding, while maintaining programs. Bowler, under mandates laid down by the Bush Administration, has the added task of contributing to Moffat County's plan to vaccinate all residents within five to seven days of a smallpox outbreak anywhere in the United States.
"Our WIC (Women, Infants, Children nutritional program) numbers are 80 to 100 people over what the state is paying us to do," Bowler said.
Programs serving needs from prenatal care to family planning are now staffed by two individuals each -- splitting time between Moffat and Routt counties.
"All of us have learned not only to be more flexible, but to look at the most efficient way to do things," said Bowler. "But it's not just VNA."
In four years, she said she will likely try to retire once again.
But change happens fast in public health.
"I like to problem solve, accept challenges," Bowler said. "There's always something new here."
Paul Shockley can be reached at 824-7031 or at firstname.lastname@example.org.