Anne Cayley began her nursing career at UHN 40 years ago with one simple goal — helping people.
What she didn't expect was that the adrenaline-fueled days in the Emergency Department would mark the beginning of a career journey that would eventually see her help establish one of Canada's first specialized stroke units, advocate for advanced patient care, and graduate as a nurse practitioner at 50.
"I knew that I loved learning about the human body and how it worked," Anne says. "I wanted to care for the sick and help them be well.
"I quickly realized there was so much more to nursing than I imagined."
Now, after her four-decade long career at UHN, Anne is retiring on April 30, 2025.
Her story is one of determination, resilience, evolution, and never backing down from a challenge, especially when it meant better care for patients.
Anne graduated from Niagara College School of Nursing in 1985 and initially accepted a position at Toronto Western Hospital within General Internal Medicine.
When reflecting on her very first day, Anne remembers fussing with her uniform, hoping to make a good impression and to get everything right. Nervous, attentive and eager to help, she quickly began to love the action-packed days and new learning opportunities that each day would bring.
Her interest in Emergency nursing led her to transfer to the Emergency Department in 1987, where she worked in various roles, including trauma nurse, charge/triage nurse, educator and resource nurse coaching new hires. Anne worked through the peak of HIV and AIDS, SARS and MERS, and navigated the implementation of computer systems, merging hospitals and multiple construction developments.
"I loved the adrenaline rush. Working in Emergency gave me a great foundation for my nursing career," Anne says. "It helped develop my ability to relate to people in times of stress, build professional relationships and increased my knowledge and critical decision making skills."
Making a difference in patients' care journey
After 15 years in the Emergency Department, Anne wanted to learn more. She earned her Bachelor of Science in Nursing from Ryerson University in 2006.
That decision was the catalyst in her transition to working in Toronto Western's stroke care program where she was welcomed with open arms. Here Anne delivered care to admitted patients, coordinated acute clinical research trials, provided telephone triage for hyperacute stroke and led education initiatives and quality improvement.
Anne went on to graduate from the University of Toronto as a nurse practitioner in 2011, which coincided with the opening of Toronto Western Hospital's stroke unit.
She noted gaps in the care model for patients in the Emergency Department who were at a higher risk of a transient ischemic attack, or minor stroke, and created a new role proposal to identify ways to close these gaps in care.
In her expanded role as a registered nurse, Anne was able to provide comprehensive advanced level care making a difference in patients' care journey.
Bedside teaching rounds with Dr. Frank Silver, a stroke neurologist at UHN, inspired Anne to learn more about stroke.
Together with Dr. Silver, Anne played a pivotal role in establishing Canada's first Neurovascular Stroke Unit at Toronto Western in 2011 and the Transient Ischemic Attack and Minor Stroke Day Unit. The unit was established as a nurse-led model of care that changed how stroke patients are treated.
As part of the initiative, Anne expanded the stroke nurse practitioner role, recruited nurse practitioners and mentored many nurses and nurse practitioner students.
"There's been a lot of people that have been involved along the way to push the boundaries and lead the way in best practice care," Anne says. "It's really been nice to see that over the years.
"The growth, collaborative approach and specialization of our unit, helped to inform other sites and other professionals in stroke care."
Ensure 'no rocks are left unturned' for the recovery of patients
Anne's leadership in quality improvement initiatives and the Stroke Distinction program, through Accreditation Canada, undoubtedly leaves a lasting impact on UHN.
"Anne is one to make certain that no rocks are left unturned to ensure patients get the best possible recovery and management of their disease," says Rachel Boissonneault, Clinical Director, UHN's Krembil Brain Institute and Toronto Western Intensive Care Unit, and UHN's Donald K. Johnson Eye Institute.
"I was left in awe, not only of the extent and depth of knowledge Anne possesses, but her ability to comfort and support patients and their family members through minor and more extensive situations."
Now, after 40 years, Anne's career is winding down though her passion for helping people remains.
When considering the most memorable moments in her career, there were many. It's not just the clinical wins that stick with her, but the deeply human ones.
Like the young patient rescued from a house fire that no one expected would survive. Anne and her colleague cared for him around the clock. He cried tears of joy when Anne washed his hair for the first time in months.
"It's these little moments that get you in the gut and confirm why you are entrusted in a person's care," she says. "He provided me insight to never give up too soon on anybody."
Anne's career is filled with stories that remind us what patient care really means.
"I'm happy to be part of Team-UHN, part of this environment and working with good people," she says. "My colleagues and my patients have taught me so much."
What advice would she offer to those beginning their career at UHN?
"Don't take life so seriously," she says. "Be open to change, new challenges and growth. Work hard and you'll see the benefits of your work."
Now, as she looks ahead to mornings without a 6 a.m. alarm and afternoons of pickleball and cooking, Anne is leaving UHN in good hands: her daughter, an ICU nurse at UHN, has picked up the torch.
After all, when care is at the heart of what you do, the legacy and inspiration you give tends to carry itself forward.
