vi Essentials in Hospice and Palliative Care: A Practical Resource for Every Nurse About the Cover The arbutus tree shown on the cover of this book is na- tive to southeastern Vancouver Island, the nearby Gulf Islands, the adjacent coast of mainland British Colum- bia, and some areas along the west coast of the United States. Often rooted in the crevices of rock faces along the shore, this tree, with its gnarled and twisted branches, hangs over the edge and is blown about by the wind. The smooth, papery bark peels off as new bark grows. Each arbutus is unique. The arbutus inspires me with its ability to grow, survive, and even thrive in such rough and rocky areas. This tree graces the cover of my book because to me the arbutus symbolizes the strength of the human spirit, the amazing ability of human beings to survive, grow, and even thrive in difficult, harsh, and even traumatic situations. Like the tree, we too get gnarled as we age. And like the tree, we are all unique. The arbutus reminds me of those I care for, those who grew in the midst of dying, who grew as they cared for their loved ones or in the years following. The arbutus reminds me of you, the many nurses I have worked with over the years. You also struggle with per- sonal and work challenges, you provide excellent care, and you inspire me with your stories. I wish you well as you continue on your path of caring for others. I hope that you will find great satisfaction and growth in doing this work.