Looking back on the life she’s led so far, NICU nurse Lisa Warren has one valuable piece of insight to offer her younger self: “I’d tell her,” she says, “that whatever path she takes is going to be the right one… I’ve learned that my biggest joy in life is serving others.”

In Sacramento, California, Lisa was born to a family with a solid work ethic. Her parents and grandparents taught her the value of being in service to other people, and of “finding the joy in that service.” She grew up with a strong sense of community. Her mother spent much of her time volunteering at Lisa’s school. Her father worked for Volkswagen. Both parents instilled a love of nature in their four children–of which Lisa was the eldest; Lisa’s childhood was filled with camping trips, hiking, and canoeing. Hers was “the typical 80’s childhood.” Her days were spent playing and exploring outdoors. “You fended for yourself,” she says. “You stayed outside until the lights came on.”

The carefree liberty of Lisa’s youth was perhaps contrasted by a sudden awareness of what was going on in the world around her when she was in high school. Incredibly bright, she boasted a place in her school district’s prestigious honor society. Her experiences in this program marked the beginning of her ambitious career path. Honors students occupied themselves with community service, and Lisa spent a lot of time tutoring younger students. As a tutor, she realized that she loved working with children, and for some time she considered becoming a teacher. She had always loved reading and had always excelled in math and science. Science was the subject that fascinated her the most. “I could spend all day looking under a microscope,” she says, speaking with awe even now of the wonders of biology. During her junior year, Lisa took anatomy and physiology classes and became fascinated by genetics. “How miraculous it is,” she says, “that everything is so perfectly put together!” Lisa realized that she wanted to pursue a career in medicine, and initially, she saw herself as a future pediatric cardiologist–a career that would marry her joy in working with children with her fascination with the human heart.

Lisa had always known that she must attend college. “It was a non-negotiable,” she says, noting that her parents, who had not finished college themselves because they had married and had children at a young age, regarded higher education with great importance. As Lisa grew, her mother had always wanted to go back to college; unfortunately, this was an impossible dream with four children to look after. Lisa applied to five schools–four of which were in California–, but she chose a small, Christian liberal arts college in Chicago. “I really wanted to spread my wings,” she says. “This was the farthest away I could get from home on a scholarship.”

Her decision was a brave one. Lisa remembers her college years fondly, though she admits that moving to the midwest–and experiencing snow and humidity for the first time–was “very eye-opening.” She recalls one blizzard that kept her locked inside her dorm building, unable to traverse even to the dining hall (only several hundred feet away). She admits that she was ill-prepared for the elements as a “California girl from the Central Valley.” Still, Lisa’s four years at her small college far from home were a cherished time of growth and opportunity. It was here that her future began to take shape. But it also played a very instrumental role in developing her faith. Lisa was raised in the Covenant Church, but she considers herself spiritual rather than religious. She believes in God, and her faith has been strengthened by the scientific wonders she’s witnessed. “There are too many things that happen,” she says, “to say it’s purely coincidence.” Lisa appreciated that her small Christian college culture brought forth the social justice piece of Christianity, unlike the attitudes she had experienced from many churchgoers. “I have a hard time with the church and people who profess a faith but do not show evidence of that faith.”

As a member of TriBeta, the National Biological Honor Society, Lisa served her community–just as she had as a high school student. She tutored at a local elementary school in a low-income neighborhood. “It was the first time I was really aware of my privilege,” she says, remembering the small–yet significant–acts of kindness she performed for the young students. “These kids didn’t have anything, and they were excited even about a cheeseburger Happy Meal… It was earth-shattering for an 18-year-old.” Though, as a college student, Lisa herself did not have a lot of spending money, she resolved to perform one act of kindness every day during her freshman year. Often, on her way to her job at the local Disney store, she purchased a sandwich and a coffee and brought it to the first unhoused person she saw. “This is when I discovered,” says Lisa, “that my greatest joy was being able to give something to other people, no strings attached.” It was the beginning of a lifelong commitment to selfless compassion.

During her senior year of college, Lisa was surprised to discover a new passion–one which would change the trajectory of her life. Pre-med majors who were about to graduate were required to spend one day shadowing a physician and one day shadowing a nurse. During the 12-hour shift during which she shadowed a nurse, Lisa learned about the “many different hats” that nurses wear–including that of a social worker. “A doctor might say to a patient, ‘You aren’t taking your medication,’ whereas a nurse will know that the patient isn’t taking their medication because they can’t afford the prescription.” Lisa was drawn to nursing because she knew that it would allow her to serve and care for others in the most meaningful way possible. She realized, too, that she did not want to endure another four years of school, followed by a six-year residency or fellowship. After much deliberation over a pros-and-cons list, Lisa told her parents that she did not want to go to medical school. They were confused, wondering why they had spent so much money on their daughter’s undergraduate education only for her to change her plans for her future. They told her that she would need to pay for it herself if she wanted to pursue a nursing degree. But Lisa was determined to become a nurse.

After graduating, Lisa moved to the Bay Area, found a roommate, and started working retail. For the next four years, she struggled to support herself on her retail salary, but she spent her time looking to the future, researching nursing programs in the area. Eventually, she began taking classes at the College of San Mateo and applied to the nursing program. Much time had elapsed since she had graduated from college, and at first, she was waitlisted. One day, however, while Lisa and her now-husband–whom she had met in her church’s youth group–were preparing to set out for a hike on a trail several hours away, she received a phone call. There was a last-minute opening in CSM’s nursing program, and she had one hour to get to the college and participate in orientation in order to be accepted. The phone call’s timing could not have been better.

At first, Lisa was convinced she wanted to be an emergency room nurse, though she now understands and admits that George Clooney’s television performances had given her a “skewed idea of the ER.” The nursing students completed 12-week rotations through different nursing concentrations; during her first year in the program, she cycled through stints in long-term care (which she found too sad), maternity, and pediatric nursing. Her experiences in the maternity ward made her realize that, more than anything, she “wanted to be at the beginning of life.” She felt honored to be present for one patient throughout the entire process of labor and delivery. Though it was an unpaid shift, Lisa remembers it as “the coolest experience.” And though she still loved working with children, she now “felt destined” for labor and delivery. However, when it came time to apply for jobs, Lisa learned that “no one wanted a new grad in labor and delivery.” She was disappointed, but she discovered a great need for nurses–even new graduates–in Stanford’s newborn intensive care unit. It looked as though her path led her to work with young people–very young people–after all.

In 2004, Lisa graduated from nursing school and began working as a NICU nurse. “Nothing in nursing school,” says Lisa, “prepares you for the NICU… I’ll never forget my first day walking into the unit.” Her confidence was dashed when she was confronted with the challenge of turning over a baby who had rolled onto her stomach. “Never… in any of the situations in the didactic… did they have a baby laying on their stomach.” She stared confusedly at the mess of wires, completely stumped. “I now very well know how to turn over a baby when they’re laying on their tummy and they’re all wired-up…” Lisa laughs, “so I’ve learned something in these last 18 years.”

“As a nurse,” says Lisa, “you learn how to advocate for your patient, and you learn how to be strong. You learn how to talk back in a way that people will listen… It’s a muscle you develop.” She has confronted more than her fair share of physicians with dismissive attitudes towards nurses, and she has never regretted sticking up for herself and the people in her care. “Nursing is like a sisterhood,” says Lisa of her close bonds with her fellow nurses. They look out for and support each other. But she remembers the first time she “did battle” independently. About five years into her career, an infant for whom she was the primary nurse became very sick. The little girl had been born at only 22 weeks. The attending physicians had begun to feed her, but Lisa noticed that the baby’s belly grew very large every time they did. She saw the risk of necrotizing enterocolitis–a deadly condition in which premature infants’ intestinal tissue dies–long before the physicians did. She spoke up, but no one listened to her. She was even written up for insubordination. Sure enough, the baby was diagnosed with “NEC”, and circumstances looked dire. Once again, Lisa spoke out. She insisted that the baby should undergo surgery. Fortunately, because of her close relationship with the infant and her family as the infant’s primary nurse, a newer fellow on the team took her suggestion seriously. The surgery was performed successfully, and the baby lived–perfectly healthy. “It was the first time someone had listened to me,” Lisa says of this harrowing–yet, in the end, rewarding–experience. Her resolve to stand by her convictions in the face of doubt and dismissal helped her to grow as a person and as a nurse.

After this heroic episode–though humble, Lisa would never presume to call herself a hero–she became a team leader. Soon she was running an entire 40-bed unit as a charge nurse, and she began treating infants with more and more serious conditions. Over the years she has faced many challenges–and many heartbreaks–but she has never stopped being a fierce champion for the beings in her care. At times that has meant advocating for the quality of life over the length of life. Lisa describes one such occasion, three years after her determination, saved the life of an infant with necrotizing enterocolitis. It was clear that the life of a patient with whom Lisa had bonded was going to be short, and Lisa had to learn how to shift from advocating for life to advocating for compassionate death. She was present for the child’s family until the end–even buying the patient’s only-ever Halloween costume. As heartbreaking as this experience was, it prepared Lisa for her career. “Stanford’s NICU is a Level IV NICU,” says Lisa, “meaning we get the worst of the worst.” She notes sorrowfully that she’s had to help many families through end-of-life this past year.

These days, Lisa is content as a bedside nurse rather than a charge nurse. But this shift has not saved her from burnout amid the Covid-19 pandemic. She notes that most nurses have dealt with burnout in recent years. The question on the minds of Lisa and other nurses has been, “How can our employers help us with this moral distress so we can continue giving care?” The answer remains to be seen, but Lisa’s story–and her relentless selflessness and compassion–is a great credit to her and reminds us to be grateful for nurses, who have always given so much, but who face unprecedented challenges in this time of great upheaval.

Lisa’s life reflects her spiritual values. She believes that her passion for serving others began when she was very young, serving her community as a tutor. Since then, she has grown immensely–and accomplished so much. But she has never lost sight of her greatest ambition: service. “It’s the most rewarding thing for me,” she says. “It’s what makes my life worth living.”