With the deck seemingly stacked against her, Debbie Manning, RN, beat the odds and is on a roll to a new role in medicine: ob/gyn physician from obstetrics nurse.

Her fortune, however, has nothing to do with luck. Persistence and the quest for an education have carried her through 12 years of nursing to the brink of medical school at the University of South Florida. She plans to enroll in the fall, all the while maintaining her career at Heart of Florida Regional Medical Center in Davenport, and rearing a daughter, 10, and sons, 4 and 3, with her husband, Virgil, at their home in Winterhaven, Fla.

"I come from a very rural, very poor family," Manning said of her upbringing in Demopolis, Ala. "I was the first one to graduate high school, let alone college, on both sides of my family. Education is the key to breaking that cycle of poverty."

Working a Baylor shift, 7 p.m. to 7 a.m. Saturdays and Sundays, allows a weekday routine that goes like this:

Up before 7 a.m. to get the kids breakfast and off to school, then errands and housework. She tries to cram in homework for a medical school prerequisite before picking up the kids at 3 p.m., giving them snacks, starting supper and getting them to bed around 9 p.m. "I try to spend time in the evenings with them and my husband," Manning said. Then, it's more homework.

She said her best advice to RNs is to get as much education as you can, as young as you can, because it creates career opportunities.

At 31, Manning said she sometimes doesn't feel too young, but being a physician has always been her goal. "Being a nurse was supposed to be a steppingstone. I didn't think it would take me 12 years," she said.

The source of her inspiration was a grandmother who mostly raised her. "She had chronic lung disease which developed into heart disease," Manning said. "She was sick basically her entire life. I just wanted to take care of her, I think, which I did my best to do," until she passed away three years ago at age 63.

The decision to specialize in obstetrics is a reflection of Manning's experience as a dialysis nurse, in open-heart and medical intensive care, med/surg and now as a charge nurse in labor and delivery.

"I like obstetrics because, typically, it's a happy time that you're in the hospital. It's not a death and dying time," Manning said. "I did my share of that. A new life coming into the world is a miracle every time no matter how many times I've seen it."

From the perspective of an RN who one day will have an "MD" behind her name, Manning said that physicians generally don't appreciate the sense of responsibility that nurses have.

"They give us orders, but what they don't understand is that we're just as responsible, even more so, that the order is correct and that we don't do any harm to our patients," she said.

On the other hand, nurses tend not to understand how much time physicians put in away from their families and that "they really never get to leave their job. They're always on call," she said.

Manning said that despite scholarships, employer reimbursement for job-related education and some federal funding, "There have been terms that I've sat out because I didn't have the money." Her determination, though, has not gone unnoticed.

A couple of people at work have followed her example and gone back to school, she said. "They said if I can do it, they can, because they don't have three kids and the responsibilities that I have. I like thinking that I inspired someone to go on with their education."

Contact Phil McPeck at getpjm@aol.com.