An important but less discussed area of health care is devoted to helping patients as they approach the end of their lives. It is just one of many areas that employ registered nurses, by far the most sought-after professionals in Maine.

Diane La Rochelle, a registered nurse with a bachelor’s degree in nursing, has spent the past three years as a home hospice nurse for Hospice of Southern Maine in Scarborough. She becomes a trusted house guest to terminally ill patients and their families.

“The patient defines how they want to live the rest of their life after getting a terminal diagnosis, and we help them achieve that,” La Rochelle said.

Some patients want to be as alert as possible even if it means dealing with added pain and discomfort, she said. Others want to be as comfortable as possible, even if it makes them feel more drowsy. Good hospice care is about honoring the patient’s wishes.

Some terminal patients’ health care needs are so intensive that they must be admitted to a facility such as Hospice of Southern Maine’s Gosnell Memorial Hospice House, but whenever possible, they receive their care at home.

“The majority of our patients, their goal is for end of life to occur at their home, surrounded by their loved ones,” La Rochelle said.

Being a hospice nurse can be difficult emotionally, La Rochelle said, but Hospice of Southern Maine uses a team-oriented system in which no care giver is required go it alone at any time. Teams include nurses, social workers, chaplains and home health aides, she said.

La Rochelle said she thinks every nurse should do a rotation in hospice, if for no other reason than to gain an understanding of its importance in the health care field. She said the experience has changed her life in a positive way.

“It has taught me to live in the moment, and to take care of myself, to not take life for granted,” La Rochelle said.

Nick Knowlton is the sort of person who regards a broken household appliance as an opportunity to troubleshoot. He’d rather figure it out himself than call in an expert.

It’s a characteristic that many computer systems analysts have in common, Knowlton said.

The analyst job description is a bit vague, even for a career field that embraces abstract language. Knowlton’s job is to act as an outsourced head of information technology for his clients. His title at managed services provider SymQuest Group in Lewiston is virtual chief information officer, or vCIO.

Knowlton’s job is to solve all of his clients’ technology challenges, whether it’s upgrading hardware, installing new software or moving IT infrastructure to the cloud.

A good computer systems analyst must embrace constant change and always keep abreast of the latest advancements in technology, he said.

“Training is probably the hardest thing,” because it never ends, Knowlton said. “It’s almost like something is invented every day.”

And forget the stereotypical notion of the tech support guy who has no patience for the technologically challenged. Knowlton said an important part of his job is explaining technology to clients in plain language that anyone can understand and answering even the most basic questions about it.

“You’ve got to have patience with the customer,” he said.

Knowlton said careers in computers appeal to young people because “you get to play with gadgets and write cool software.”

So if you enjoy solving problems and keeping up with the latest in technology, a career as a computer systems analyst may be just the thing for you.

“It can be very rewarding,” Knowlton said “You have to want to continue to learn.”

Driving around town, Laura Blanchette gets to play a game with her kids that few people can. It involves pointing out structures that she had a hand in bringing from concept to completion.

” ‘We built that, we built that,’ ” she said. “Now they do it, too.”

Blanchette is director of business development at PM Construction Co. Inc. in Saco. Her company has built grocery stores, drug stores, movie theaters, distribution centers, banks, schools, medical centers and just about every other type of establishment you can contemplate.

As communities in Maine and the rest of New England continue to become more heavily developed, construction managers have become a hot commodity.

The job of business development, just one of several management jobs in the construction industry, involves working closely with clients to ensure that their vision is ultimately manifested in bricks and mortar just as they imagined it.

It isn’t always easy, Blanchette said. It involves an extreme exercise in good communication that can sometimes resemble extracting ideas like teeth from a client’s head.

“My old boss used to say, ‘When you’re done with a conversation, always ask three more questions,'” she said. “It’s about finding out what the client wants.”

Construction management is an exciting profession that presents a different challenge every day and allows you to feel the pride of seeing a project through from beginning to end, Blanchette said.

It pulls you into the orbit of a wide variety of clients, from small-business entrepreneurs to leaders of giant corporations. Some walk in the door with carefully designed plans in hand, others with little more than a passion and vision for what they hope to build.

“You get to see a lot of professions and work with a lot of different people,” Blanchette said.

In the fast-paced world of hospitality, managing a business at the highest level requires the ability to step into the shoes of any employee.

“Your hands are really involved in everything,” said Erick Anderson, general manager of The Lord Camden Inn and Grand Harbor Inn in Camden. He will manage a third hotel, called 16 Bay View, when it opens later this year.

His areas of expertise include guest services, maintenance, housekeeping and every other aspect of running a hotel. It’s a demanding job, Anderson said, but the payoff comes when you see the smiles on customers’ faces.

General and operations managers are needed in a wide variety of industries, which places them among the professionals in highest demand among employers in Maine. It isn’t the sort of job you can just walk in off the street and take on. It involves experience in all areas of the business.

And you must be ready to take on new challenges each day, Anderson said.

“Every day is completely unlike the other,” he said. “Every guest is completely different, as well.”

But that’s part of what makes the job of general manager exciting, Anderson said. It can be all-consuming at times, but it is rarely boring.

Like many general managers, Anderson made his way to running a string of boutique hotels not by planning, but by doing. His original plan was to be an engineer, but he decided to work one season at a resort in Florida to save up money for school. By the time the season was over, he was pretty much hooked.

Anderson worked in various areas of hospitality from housekeeping to food preparation and service. His willingness to learn and grow ultimately led him to the general manager position in Camden.

“The captain of the ship, if you will,” he said.

Not every high-paying, highly sought-after job in Maine requires being chained to a desk all day.

That’s good news for Todd Lamoreau, physical therapy coordinator at InterMed, whose job is to get patients safely and comfortably back on their feet.

Lamoreau said he became interested in physical therapy after spending years as an athlete and suffering various injuries himself. Now he leads a team of 13 therapists who treat everything from sports injuries to occupational hazards afflicting warehouse and office workers.

“The biggest thing is helping people get back to being able to do things after an injury,” he said.

Lamoreau and his team have become specialists in industrial ergonomics, the science of promoting worker comfort and preventing injuries on the job. They spend two days a week consulting with workers at L. L. Bean in Freeport at the retailer’s employee health center.

The team’s responsibilities range from treating on-the-job injuries to recommending equipment to reduce the potential for future employee pain and discomfort.

Sometimes it’s as simple as teaching warehouse employees the proper way to lift heavy items, or recommending that shelves be lowered to make inventory easier to reach, Lamoreau said.

One of the reasons physical therapists are in such high demand in Maine is that they are needed in a variety of organizations including health care providers, private companies, college athletic programs and K-12 schools, he said.

The job does have its challenges, such as dealing with the reluctance of some health insurance providers to cover adequate therapy sessions, but Lamoreau said it’s a great way to avoid the pitfalls of an overly sedentary lifestyle.

“If you don’t like sitting behind a desk or in a cubicle, physical therapy is a good profession,” he said.

For infectious disease specialist Dr. Emily Wood, every patient who walks through the door represents a mystery waiting to be solved.

“A lot of it is like doing detective work,” said Wood, who splits her time between InterMed, Maine Medical Center and other hospitals.

Infectious diseases are caused by pathogens such as viruses, bacteria and various other germs. There are hundreds, spanning the entire alphabet from AIDS to Zygomycosis (fungal infections that can target a range of bodily regions).

The pathogens themselves are often invisible to the naked eye, so the key to proper diagnosis is identifying the associated symptoms and prescribing the right tests and treatment.

Working in Portland offers the perfect mix of being in a community that is small enough that most colleagues know each other, but still big enough that it attracts a variety of patients from throughout the region, including those with the occasional exotic disease, Wood said.

“From a nerdy standpoint, I enjoy interesting cases,” she said.

Regardless of how rare or mundane the disease, Wood believes an important part of her job is helping patients understand clearly what they are dealing with. No patient should walk away from a consultation confused about their diagnosis or prognosis, she said.

“I put it to them in plain terms they actually understand,” Wood said.

As intriguing as it can be, a physician’s life presents challenges, she said. It can take years to earn enough money to comfortably pay down medical school loans, and the medical profession’s heavy demands can make it difficult to maintain a healthy balance between work and private life.

Still, Wood, who has two young children, said it can be done, and that the work of a medical detective is often rewarding.

“I like working with patients,” she said.

Celeste Rouleau sees herself as the mayonnaise in the tuna salad – the component that holds everything together.

“I’m behind the scenes, really working with the team to make the team successful,” she said.

Rouleau, pediatrics practice manager at InterMed, works in a high-demand profession that marries medical expertise with management skills. It takes a special kind of person to do it well.

“You wear many hats,” she said. “You have to be authoritative but tactful.”

That’s in large part because the people she manages are accomplished medical professionals in their own right. Rouleau oversees a staff of 45 doctors, nurses, nurse practitioners, physician assistants and clerical staff members.

Like most managers in the health care field, Rouleau worked her way up through the system as a practitioner herself. She began as a registered nurse, working many years in a hospital. During that time, she always seemed to gravitate toward leadership roles.

Rouleau said that while taking care of sick people remains her passion, she discovered along the way that she has a knack for leading a team.

“A good manager has that certain skill set,” she said. “You have to love people, and you have to love communicating with teams.”

It is challenging work, she said. Being a health care manager requires constant education as various changes are spurred by government, technology and the insurance industry. And managers in the medical field spend much of their time dealing with more mundane issues such as paperwork, billing and reimbursement from insurance providers.

“Sometimes it’s not, unfortunately, all about medicine and seeing patients,” Rouleau said.

Still, it is a satisfying career for anyone who chooses to take on the challenge.

“It’s really fulfilling,” she said.

Most people think of an auditor as some sort of human calculator, but that’s completely wrong.

An auditor is a role-player who, armed with a deep understanding of accounting principles, places herself in the mind of a regulator or investor to ensure that a company’s public disclosures reflect its financial situation accurately, warts and all.

Melinda Irish, senior manager of the audit division of the Baker Newman Noyes accounting firm in Portland, said she even had misconceptions about the job before she started doing it.

“I did not know what an auditor was until I really got here,” Irish said.

The auditor’s credo is total independence – her only obligation is to provide an unbiased, critical perspective.

Did the client fail to disclose a financial risk such as the loss of a major account? Is the risk explained in clear and simple language that anyone can understand? They protect their clients by asking the tough questions before anyone else can.

The auditor’s responsibilities extend beyond review of financial disclosures, Irish said. They also look at a client’s internal controls. Are checks and balances in place? Are there multiple eyes on every transaction?

“Part of confirming that financial information is accurate is also making sure controls are in place,” she said.

Irish, who originally planned to become a photojournalist, said she took an accounting class in college and loved it but worried that she might not be able to forge a career in her home state of Maine.

That turned out to be a misconception, as she quickly discovered there is ample demand for quality accountants and auditors in the state. In fact, it is one of the most sought-after professions in Maine, between public accounting firms, private companies and government.

“There are a lot of opportunities with the regional firms right here in Maine,” Irish said.

After more than 25 years in the industry, Cynthia O’Rourke now manages the finances of multiple generations of clients as a certified financial planner at Spinnaker Trust in Portland.

It’s a profession that emphasizes long-term relationships. As young clients age, get married, have children and ultimately head toward retirement, their financial needs and goals evolve. A financial planner’s job is to be a trusted adviser every step of the way.

“I feel like part of the family with a lot of people,” O’Rourke said.

Financial management, a career field that is growing in Maine as the state’s population continues to age, is focused heavily on ethics. Financial planners have a legal obligation to act only in the best interests of their clients.

O’Rourke works strictly on salary. She does not receive any incentives or commissions for advising clients to choose a particular investment vehicle or financial service.

“That would be a no-go for a certified financial planner,” she said.

A large part of the business revolves around planning for retirement, but O’Rourke said there are many other issues on which she advises clients: power of attorney, wills, trusts, life insurance, college funds and more.

“It encompasses everything that is important in your financial world,” she said.

The trick is to figure out what a particular client’s financial goals are, and then find the right instruments to achieve those goals. Another challenge is to master the art of talking clients down off the ledge when the major exchanges take a big hit as they did earlier this month.

“Probably the hardest part is keeping clients calm when the stock market is volatile,” O’Rourke said.

But financial planners help their clients understand that retirement planning is a marathon, not a sprint. If they stay the course, they will get to enjoy prosperity in their later years and help their children build their own nest eggs.

“It’s an extremely gratifying career in the sense that you are helping people,” she said.

Cory McKenna said educators spotted his potential to succeed in the field of law when he was still young.

“I was always talking to my classmates and trying to answer every question, basically being a know-it-all,” he said. “And my teacher said I would make a great lawyer.”

McKenna is now an attorney with Fairfield & Associates in Portland who specializes in criminal defense. His work brings him face to face with clients who have been accused of crimes and may have no one else to turn to for help.

“I do a lot of court-appointed criminal defense,” he said, adding that many cases involve defendants who are poverty-stricken, mentally ill or have serious substance-abuse problems. “Not all criminal defense is arguing legal issues. A lot of it is about getting people connected to the services they need, and about having someone on their side.”

McKenna believes strongly that every American accused of a crime has the right to legal representation. He said being a defense lawyer is rewarding because it involves defending the principles of the Constitution on a regular basis.

However, the job can be stressful, he said. Some cases drag on for years. It’s important not to lose faith in the legal system.

“I don’t know how you would do this if you didn’t believe in the system,” he said.

McKenna said one of the big advantages to being an attorney is the ability to find work in any community that suits your lifestyle.

“I picked my law school (University of Maine) because of Portland and the state of Maine,” the Boston native said.