Situated on a prime piece of real estate overlooking the San Francisco Bay—valued at upwards of half a billion dollars—is the San Quentin State Prison. Notorious for its death row, the largest in the country at 700-plus prisoners, the prison has been the subject of numerous books, movies and articles. The institution has also been at the center of controversy in California because of its age—it was built in 1852—and state of disrepair. Legislators have twice overturned approved funding to renovate the death row facilities.

It is here that Tonya Stepanek Church ’89 has spent the last 20 years, serving the prison population first as a nurse and more recently as a nursing consultant as part of a larger team focused on construction and activation of health care facilities.

“The orientation was really eery,” Church remembered of her initiation to the prison. “They showed us a clip from ‘America’s Most Wanted.’ I remember thinking, ‘I can’t believe I am really here. (The last time she had seen that exact clip was as a freshman at Calvin.) Is this really where I’m meant to be?’”

More than two decades later, that question has been answered for Church with a resounding “yes.” In fact, along her whole life journey, Church has seen the pieces fit together perfectly to lead her to where she is now.

A youngster's calling

“In second grade I had a dream that I was nurse,” she said. “It was strong enough that it stuck with me and made me think that maybe this is what I should do.”

A decade later, at Calvin, she entered into the nursing tract. “I struggled with anatomy and biochemistry,” she said. “I managed to get just high enough grades to stay eligible.” But when she applied to enter the program, she was one of four put on the waiting list. “I started to develop the attitude that if it was really meant to be it would happen.”

When Calvin hired an additional professor, she was allowed into the program. “It’s really amazing that I even made it through,” she said. “Three weeks before my junior year I had to have gall bladder surgery. I was still recovering when I came back to school. I was not going to allow a decision from the doctor’s office to influence starting school; I was afraid I might not get another chance.”

Once in the nursing program, Church loved it. “I knew God was calling me to be a different kind of nurse,” she said. For the community health component of her training, she was placed at Michigan Dunes Correctional Facility. “I thought it was kind of odd that out of all the places we were being sent, I had to go to a prison. I’ll never forget that as kind-of-naïve college students, we had to be told to lock up the alcohol wipes, because inmates would steal them. It was wild.”

This experience, though, prepared Church for her later career. “Almost every single thing I’ve done has culminated in something I needed to know in the future,” she said.

Making a difference

Early on, one specific instance of nursing care demonstrated to Church the power of personalized attention, a skill she would use often in her journey.

“My last week as a student, I was working with a lady who was really sick,” said Church. “The professor asked me if knew how to call a code. I said to myself, she’s not coding while I’m taking care of her. I went in her room, got her up in a chair and I remember thinking her hair is all messy. So I asked her, ‘Would you like me to fix your hair?’

“When my prof came back in she couldn’t believe the difference. She said, ‘She looks like an entirely different person.’ The nurses on the floor were also amazed at the difference in their patient.

“That was the first time I noticed that something very small can make a huge difference; I have seen that play out over and over again in my life. That’s what made being a nurse so cool for me.”

It turned out that working with people was the “easy” part of nursing for Church; the test-taking was the harder part.

“I had just started my job at [then-] Butterworth Hospital in Grand Rapids,” she said. “I was still in orientation when I walked in the house and saw this gigantic envelope on the table. I knew I had flunked; I didn’t even have to open it. Taking boards had been a very unpleasant experience. I had test anxiety.”

As it turned out, this, too, worked into Church’s journey. “After I told them at work, they moved me into what was the ‘float pool.’ I thought, ‘Great, I still have a job.’ I ended up getting familiar with all of the different areas in the hospital, which never would have happened otherwise.”

Still, Church needed to pass the Michigan Board of Nursing licensing exam to continue her career. That’s when then-Calvin nursing professor Mary Ann Gritter stepped in. “She told me that it wasn’t that I didn’t know the material; it’s that I didn’t know how to take a test. After her mentoring, the questions were not as ominous, and I had no problem passing the boards.”

At home in prison

After a few short nursing stints in Michigan, Church moved to California, and when she saw that the state prison system was offering guaranteed shifts, she decided to apply. It was the only job she was offered as there was not a nursing shortage back then, and nurses with 20 years of experience were being laid off, she said.

“I wasn’t afraid to work there,” she said. “There were always officers close by.”

In fact, Church began to relish it: “One of my first inmate patients couldn’t hear at all,” she said. “I got him some ear drops and told him to come back tomorrow. He came back and was so happy. I couldn’t believe how much of an impact that had on him. Whenever I saw him after that, he would say, ‘That’s the nurse that took care of me.’”

While the social and moral worth of a person weighs into many debates over the allocation of medical resources for inmates, for Church this has never been an issue.

“A lot of people struggle taking caring of inmates, but I’d rather not know what they did,” she said. “I would never want to read the case files; for many of them it would be horrific. I always knew I wanted to be a different kind of nurse, and I never wanted to be a mediocre nurse, so I’ve always done the best I could for them.”

As a nurse, Church served as the outside hospital liaison for inmates from San Quentin’s population including East Block, or death row, for five years. “There was a gentleman there that was getting really sick,” said Church. “We were getting ready to move him to a hospice bed, but he wanted to reconcile with his son before he died. His son had to fly in from Florida, and I was concerned that his son wouldn’t know where he was when he came out. I really wanted his son to be able to see him, so I did the best I could by facilitating visiting clearances through sutody connections at both prisons.

“I think people might have thought it’s a little late for that. It really is countercultural to do the best for an inmate,” said Church. “But it’s in situations like this that I’ve really felt that I was meant to be a different kind of nurse.”

Work in a prison requires a certain type of person. That’s why Church believes she and her husband, Les, are a good match. The pair met at San Quentin, where Les was a correctional officer, who transported prisoners to off-site medical appointments. “There’s a certain prison culture,” said Tonya. “Unless you work in a prison, you don’t understand prison.”

Designing prison health care

Tonya understands it pretty well after two decades. She became director of nursing for San Quentin in 2006, and later transition and activation liaison for building projects. In this position, she helped design and activate a new 116,000-square-foot prison health care facility that opened in 2009. “You have to know the operations side to design a good facility,” she said. “Form is supposed to follow function.

“That’s how I came to appreciate every step along the way. Here I am a nurse, but somehow God used all of my experiences to bring them together for this project. It’s one of the most fascinating things I’ve done as a nurse.”

Church has faced other challenges along her way, including a recent cancer diagnosis, for which she has received treatment. “I never knew how strong my faith was until then,” she said. “The roots of my faith are pretty deep; the top was shaken a bit and I had to shift some things in my life.”

She returned to work in April as was again assigned to work as a consultant for the statewide Health Care Facility Improvement Plan. In fact, a new $906 million prison health care facility she assisted the activation team with for six months was scheduled to open in Stockton, Calif., this summer. More plans are also in the works in California.

Church is also leaving open the door for another calling God may have for her; medical missions is one such opportunity.

“You have to have the faith to step out where God wants you to be,” said Church. “At Calvin I was taught that I was saved to serve, not saved to sit. God wants me to serve, and I feel uncomfortable when I don’t.”

Her car’s license plate reads RMNS828 for Romans 8:28. “And we know that in all things God works for the good of those who love Him, who have been called according to His purpose.”

“My entire life I have experienced the truth of that verse,” said Church. “I’m excited to see what God has designed next for me.”

Lynn Rosendale is managing editor of Spark.