Bream has held key administrative positions at Kaiser Permanente for 20 years, the last 14 of them as administrator of clinical services for the Regional Office of the Southern California Permanente Medical Group in Pasadena. Prior to her work at Kaiser, she was vice president of nursing at Daniel Freeman Memorial Hospital. Other highlights of Bream’s 42-year nursing career include being elected president of the Hospital Council of Southern California Nursing Board, in 1990; and president of the Association of California Nurse Leaders, in 1996. Her book Caring: Making a Difference One Story at a Time was published this year. Bream’s most cherished professional highlight was also a personal one: As an associate faculty member at the UCLA School of Nursing, she handed her daughter Lauren her M.S.N. degree at the school’s 1998 Commencement.