Prior to accepting this position she served the state of West Virginia in the WVU School of Nursing and in a variety of nursing positions in the DHHS and WVU Hospitals for 30 years. She was appointed to the West Virginia State Guardianship Commission in 1989 and to the Catastrophic Illness Commission in 1999. The Commissions were instrumental in the development and passage of legislation on advance directives, guardianship, and other issues related to end-of-life care. Her role as primary recorder and drafter was essential to enactment of initial bills by the WV legislature.