What brings about the transformation in Julia's perception of nursing as her only option to seeing it as a calling?

Julia describes her deep wish to be a physician, but as a woman having no financial or emotional support from her family, nursing is her only option. Yet by the end of the book, pg. 249, she sees her career as a “calling” (p. 249). What brought about this transformation?

I think Julia comes to see the great importance of the nurse's role in providing medical care, and realizes that she is in a position to influence the developing profession of nursing. She thinks a great deal about how she interacts with her nurses, how to model for them, how to nurture them yet maintain high standards. She comes to appreciate the compassion nurses provide that seems beyond the focus on protocol and technical excellence of the physicians. Fortunately, today I have found both compassion and excellence in physicians and nurses.

As Julia said "All my life, I was told 'to whom much is given, much is expected.'" In her conversation with Emily Roebling, she learned that she "had the wherewithal and duty to do something important with my life." She is urged to become a nurse by the head of NY Training School for Nurses in order to apply her passion to become a physician in the actual hands on profession. Her leadership skills enabled her to excel in her career as a head nurse.

I think Julia realized the potential and value that her medical knowledge and contributions have made and will continue to make here and at home. She realizes and accepts her limitations. Yes, she wishes she could be a physician but sees that she can continue being a nurse adding value to the medical field and patient care and nurturing and supporting other nurses.

From the very outset of her journey to France to head the nursing effort for the American unit, Julia shows leadership, creativity and compassion in her interactions with other nurses, doctors and patients. As she moves out into the areas closer to the action, she is increasingly comfortable with her role and moves forward to solve problems with intelligence and boldness. She is not afraid to confront doctors who feel she has overstepped her authority. She pushes innovation and high standards which benefit all. She has shared her knowledge with her staff and now feels the Red Cross Director of Nursing position may be the best fit for her to ensure standards, supplies and continuing excellence in her field.

I think that Julia's desire to be a physician was a tough one for her to give up, but once she did, she could see the value in the profession she had. She was able to see (perhaps for the first time) how important nurses are in health care and ways in which she could make the profession even better. By embracing her career, she was free to pursue all its opportunities and grow.

Julia was good at patient care and even better at training nurses. I doubt that her love of wanting to be a Dr ever really diminished, but she was realistic, if nothing else. She knew she could continue to reach higher levels and achieve more satisfaction by staying in the nurse training arena, so that is where she excelled.