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When Marsha J. Casey was a nurse at St. Vincent Hospital 22 years ago, there was one part of her job that made her cringe. "I hate needles and the hardest part for me was giving people shots," laughs the effervescent redhead. Casey left St. V's to begin a professional odyssey that has come full circle. Now she is giving a "shot in the arm" to St. Vincent Hospitals and Health Services as the entity's first woman lay president.

At 44, the former nurse has made a triumphant return to her hometown. Her position as head of seven Indiana hospitals places her in the rarefied atmosphere of non-doctor females heading large health care systems. She oversees 4,500 fulltime employees at St. Vincent Indianapolis Hospital, St. Vincent Carmel Hospital, St. Vincent Mercy Hospital in Elwood, St. Vincent Williamsport Hospital, St. Vincent Jennings Hospital in North Vernon, St. Vincent Frankfort Hospital (formerly Clinton County Hospital) and St. Vincent Randolph (formerly Randolph County Hospital in Winchester).

Hoosier Upbringing

An Indianapolis native, Casey is the fourth of five daughters born to JoAnn and Robert A. Casey Jr. The family lived in a home at 44th Street and Central Avenue, and Casey attended St. Joan of Arc School through the fifth grade. The Caseys then moved farther north, and she went to Nora Elementary School where she wore her first uniforms as a Brownie and Girl Scout.

While a student at North Central High School, the natural athlete was involved in the student council, ran track, played volleyball and was a gymnast and diver at the Jordan YMCA. These days, the 1974 graduate who recently was named to the exclusive North Central High School Alumni Hall of Fame, is an avid golfer.

Considering a career in nursing "and the fact that my best friend was going there," she decided to attend Ball State University. "I chose Ball State because half of North Central graduates went to Indiana University. And I.U.'s nursing program required you to live on campus for two years and then complete training in Indianapolis. I didn't want to have to move back home with my parents," she laughs with hazel eyes flashing.

After taking a few tough courses, she got discouraged and contemplated changing her major to physical education with teaching in mind. "I called home and my dad told me to stick it out and then see if I wanted to change my mind. My mom said, ÔYou'll have more options as a nurse.' Mom had no idea how prophetic her words would become."

After College

She earned her bachelor of science degree in nursing in 1978, a fact not lost on Ball State, which recognized her accomplishments and leadership by awarding her an honorary doctor of science degree during May's commencement for the Class of 2000.

"We're so proud of her for that," boast longtime friends, Matt Brown and his wife Donna."She's only the 10th graduate from Ball State to get an honorary doctorate. Even David Letterman hasn't gotten one from there!"

During her commencement address, Casey advised graduates, "All choices are yours. We each are given gifts, talents and a spirit to follow our dreams. You become what you believe in and if you let others determine it, that is your choice; but I'd say follow your spirit."

Casey followed hers after a three-month cardiology nursing stint at St. Vincent's. Needles make her wince. But blood and guts don't faze her. "I moved to Texas to be near cardiac innovators Dr. Michael DeBakey and Dr. Denton Cooley. That's where it was happening and I wanted to be part of it," says Casey who spent a year as a cardiovascular services staff nurse at Methodist Hospital in Houston. She then became an operating room staff nurse at the Medical Center Hospital in Tyler, Texas.

While her spirit led her to Texas, so did her heart. "I wanted to be with Phil Nangle, a geologist who was my boyfriend at Ball State. We dated for six years and got married in 1980."

Climbing the Ladder

From 1981-83, she was a nurse in the Coronary Care Unit and the Cardiac Catheterization Lab at the University of Texas Health Science Center in Tyler. Recognizing her administrative skills, Mother Frances Hospital hired her away as an administrator in 1983. She directed its heart institute until 1989, three years after earning her master of arts in allied health degree from the University of Texas at Tyler.

St. Luke's Episcopal Hospital, a 950-bed facility with one of the top cardiovascular services in the country, lured her to Houston to be its administrative director of cardiology. She held that post two years before moving up the ladder to senior vice president of professional and clinical services in 1994.

By 1996, her entire life suddenly needed emotional emergency room treatment. After 15 years, her marriage was terminal. It was a bitter pill to swallow.

But a call from Vanderbilt University Hospital helped make the medicine go down. Rebounding, she accepted the offer from the prestigious Nashville, Tenn., teaching hospital, which named her director and chief operating officer.

"I went to Vanderbilt just six months after getting divorced," she says. Vanderbilt became her recovery room. Therapeutically throwing herself into her work, she became CEO two years later.

Long Hours

Since assuming her St. Vincent's post, she has been putting in killer days, which start at 4:30 a.m. "I begin exercising at 5 a.m." says the woman who ran the 26.2-mile Houston Marathon. "Then I usually have a 7 a.m. meeting, meetings all day long, followed by fund-raising dinner functions which usually don't get me home until 10 o'clock at night.

" What shows does a hospital president watch on television? ER, whenever she can! "It's pretty close to what happens in a hospital," she grins.

A Fresh Approach

"I think I bring fresh eyes to St. Vincent's. A woman's eyes," says the vivacious president.

While you would expect such a high-powered executive to emanate intense vibrations, the easy-going Casey brings to her executive office the same traits that made her a great bedside nurse Ñ warmth, compassion and a listening ear. She has a reputation for being an accessible executive with an "open door" policy. From those on the admitting staff to others at higher levels, most everyone takes his or her concerns to her. But the ever-modest Casey gives all the credit to others. "The 10 teams who are in charge of ÔExtraordinary Patient Care' came up with the idea of ÔPhone-the-President,' which employees do, sharing with me their complaints and compliments."

High Marks for the Hospital

Her management style obviously is working. U.S. News & World Report's "11th Annual Guide to America's Best Hospitals" recently recognized St. Vincent's heart program as one of the top 50 programs in the nation for the third year in a row. In 1999, St. Vincent's heart program was ranked 42nd in the nation. This year, it moved up to 27th in the nation. And St. Vincent also was recognized as having the top heart program in Indiana Ñ an obvious source of pride to the former cardiac nurse.

"We're open 24 hours a day and we currently have 400 job openings that are hard to fill in this tough labor market," Casey bemoans. She credits the hospitals' 450 dedicated volunteers for picking up some of the slack. "When you tally up the number of hours that they work, we would have to hire 42 people to replace them," she says about the caring and energetic people who are a friendly and calming influence on anxiety-ridden patients and visitors alike.

Guided by Faith

Casey, a member of St. Joan of Arc Catholic Church, does thoughtful, caring outreach of her own, according to 14-year-old Julia Brown. "Marsha is like my second mom and I want to be just like her," exudes the Carmel Junior High School eighth grader. "She is my confirmation sponsor and she is so supportive of all my activities. I'm big into women's rights and she is my role model."

It's not all work, long days and no play for the fun-loving Casey, who is a member of the high-spirited Lambs Club. She also is a member of the Young Presidents' Organization and Legatus, which is an international organization comprised of Catholic CEOs. The mission of Legatus is "to study, live and spread the faith in our business, professional and personal lives."

The organization is the brainchild of former Domino's Pizza and Detroit Tigers owner Tom Monaghan. Explains Monaghan, "As corporate executives, most of us know what we have to do, and economic conditions may leave us no choices. The question then becomes how to do it the best way, and the moral guidance Legatus offers helps make the tough calls a little easier."

Casey makes those tough calls every day. And she receives effusive praise for her executive decisions from Vincent Caponi, CEO of the St. Vincent-anchored network, Central Indiana Health System. "Marsha brings a sense of integrity and competency to her work that is outstanding. Her commitment to our ministry and her demonstrated values serve as an inspiration to all those with whom she works," he says.

Downplaying those accolades, Casey says, "At St. Vincent's, we treat the body, mind and spirit. To be part of this ministry is a lovely thing." Marsha Casey always has followed her spirit. It finally led her back home. The woman who traded in bedpans and needles for a boardroom is just what the St. Vincent doctors ordered.