Nina was looking for a way out of rural south-central Indiana. As the ninth child growing up in a one-room household, she knew she needed to carve out a path for herself. The path she found — nursing — served not only her but generations to come.

Nina was the first among three generations of nurses with her daughter and granddaughter following her footsteps. The granddaughter, Jen Rykovich, M.S.N., R.N., CCRN, CHPPN, proudly displays a photo of the three generations in her office at Johns Hopkins All Children’s Hospital in St. Petersburg, Florida.

“It’s in our blood,” says Rykovich, RN clinical manager for the Center for Congenital Diaphragmatic Hernia (CDH) at the hospital.

The Big City

Nina embarked on her nursing career at the end of World War II. Women had limited career options, but many were encouraged to become nurses.

Nina moved to Indianapolis, living and studying at a hospital to become a “diploma nurse.”

“It was an opportunity for her to leave poverty,” Rykovich says.

Nina started her career caring for polio patients, walking up and down rows to crank their iron lungs by hand. Perhaps it foreshadowed Rykovich’s eventual move to a hospital initially founded in 1926 to care for polio patients.

“They didn't have the same manner of electricity that we do now, so she'd spend her whole shift just up and down, cranking patient after patient after patient, and then go back to the beginning of the line and start all over again,” Rykovich says.

The Next Generation

Rykovich’s mother, Cyndi, got the nursing bug early.

“It seemed like an interesting career to her,” Rykovich says.

Cyndi studied nursing at Indiana University and worked on many hospital campuses in the Indianapolis area. She became a neonatal nurse practitioner, retiring last year.

When she walked across the stage to accept her master’s degree in nursing, she was pregnant with Rykovich.

Break in Tradition?

Despite literally being exposed to nursing in the womb, Rykovich initially was reluctant to follow the path of her mother and grandmother. Counting aunts and cousins, many women in the family were nurses. She remembers one aunt who was studying for her master’s practicing pediatric assessments on her when she was a young girl.

Rykovich liked to write. She liked to investigate. She had a grandfather who had been general manager of a newspaper in Lebanon, Indiana. Maybe she would follow his path and go into journalism.

But after studying for about two years, the shine of journalism wore off and the tug of nursing pulled her in.

“I realized it really is my calling,” says Rykovich, who like her mother, studied nursing at Indiana University. “It’s a vocation for me.”

Cyndi was thrilled with the choice.

“She was elated,” Rykovich says. “She never wanted me to go into journalism in the first place. She knew that this was a better fit for me.”

Upon graduation, Rykovich started out working as an adult nurse in the St. Petersburg area, but she always knew she would like to be a pediatric nurse. In 2013, she got an opportunity to join the cardiovascular intensive care unit (CVICU) at Johns Hopkins All Children’s.

“There's an entirely different energy working in a pediatric hospital,” she says. “Everyone is really here for the kids. The attitude among team members who work in pediatrics is just full of light and positive energy.”

David Kays, M.D., joined the hospital in 2016 and brought an innovative approach to CDH care that produced positive results well above the norm. Rykovich worked with the CDH team in the CVICU and when the team formed the nation’s first hospital unit solely dedicated to CDH care, she joined them.

“Seeing the extraordinary patient outcomes that we have in this unit was impressive,” she says. “Some of our strategies and care have shifted the paradigm of care for CDH patients.

“The team we have grown is just extraordinary.”

All Together

Before Rykovich moved to Florida and her mother joined her, Nina was nearing death in 2011 in Indianapolis.

She couldn’t have asked for better caregivers.

“When my grandmother was at the end of her life, my mom and I were actually able to take care of her in my mom's home during her very last days,” Rykovich says. “She raised us as nurses, and we were able to share that nursing with her at the end of her life. That was really special.”