As Diane Hartwell settles more deeply into Navy life, the people who helped make Pensacola home begin moving on-and Diane realizes she is changing, too.

With friends receiving new orders and careers moving forward, Diane steps into greater responsibility as a Navy nurse. On the oncology unit, leadership becomes more than rank or authority. It means developing young corpsmen, recognizing potential others overlook, supporting families through devastating losses, and finding a way forward when even experienced caregivers begin to lose hope.

Diane's instincts continue to challenge the boundaries of what she has been taught. She notices what others miss, questions what no longer works, and discovers that some of the lessons shaping her as a nurse come from far beyond the hospital.

As one chapter of her Navy career draws to a close, Diane must decide where she wants to go next. An overseas assignment promises a new culture, new challenges, and an entirely different kind of nursing-but first she must prove she is ready to leave the familiar behind.

Vital Signs: Underway is the third novel in the Vital Signs series-a story of nursing, military service, leadership, intuition, friendship, loss, and the courage to keep moving toward what comes next.