Emergency Nursing Manager: Interview with Vetta Mankarios, RN

My Specialty

Emergency Nursing Manager: Interview with Vetta Mankarios, RN

Learning to listen, manage stress and react quickly when every second counts

By Keith Carlson, RN, BSN, CPC, NC-BC
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Tell us about your nursing career.  

I’ve been a nurse for almost 35 years, with almost 32 of those years here at Glendale Adventist Medical Center. I began my career in med-surg. I then progressed to the ICU and soon thereafter realized my ultimate career goal by transferring to the ED.

The best advice I ever received in nursing school was that I shouldn’t be afraid to start in med-surg and build the skills that I needed to be a great nurse. I’ve learned so much and not a day goes by when I don’t learn something new — either about myself, my colleagues, our patients or the practice of nursing.

What have you learned?

I’ve learned the value of patience, far and above what I thought I was capable of. When you have a Type A personality, patience isn’t necessarily one’s forte. Most of all, I’ve learned the value of listening — to both the verbal and nonverbal. Taking the time to listen has great value in the work we do as nurses.

What made emergency nursing your career goal?

All nurses do clinical rotations in nursing school, working in different departments and areas. You learn and see so much, but it doesn’t always click in terms of what type of nursing you’d like to do.

During school, I was sent for a clinical rotation in the ER at Fairfax County Hospital in Fairfax, Va. When those ER doors opened, it was mayhem: people everywhere — on gurneys, running back and forth — alarms and noise.

I stood there observing the scene for a moment and realized that I wasn’t afraid. At that moment, I felt like I was home and that this was the world that I wanted to be part of as a nurse. If you had depicted that moment in a picture, it would be the big, bright, white light shining out of the ED doors.

Realizing that the ED was my calling, I never second-guessed myself. In order to get there, I had to be good at what I did. In the ED, you have to know so much about everything. It’s not just pediatrics, critical care or med-surg — it’s a never-ending process of learning. The more you know, the better the care you can provide. You can never sit back and say that you know it all. Every shift is different with something new to learn. Each day is like 50 First Dates — how can you not love that?

How did you make your way into nursing management?

I was a charge nurse and I always worked the night shift. Night shift is still my favorite. When I came to the ED, I was blessed to have great preceptors and managers who mentored me. I always took a great interest in the hows and whys of everything. My director and managers took the time to teach me and expose me to the other side of nursing.

I started out doing the schedules for the ED and gradually began assuming more and more responsibility. At a certain point, our director left and I was asked to step in, which I did for about a year. Having small children at the time, I eventually stepped down in order to be there for my family and went back to a charge nurse role.

Over the years, I would intermittently help in the office; eventually, it turned into an assistant nurse manager position. I got to wear a lot of hats while we searched for a new ED director. Now, we have a great director in place and I serve as the ED nurse manager.

What do you find most fulfilling about your work?

You never know what will happen and you’re always surprised at least once every day. I also serve with an amazing group of EMTs, RNs and M.D.s. It also has to do with managing the highs and lows of the work. We go through our days being a patient’s mother, father, sister or brother. It’s the practice of both the art and science of nursing.

I believe it is the art of nursing that most connects us with our patients. It is the heart of caring, beyond the presentation. It’s like when a homeless person left the ED after being treated and one of our EMTs gave him his jacket because it was cold outside. Or the times when a new mother brings her ill baby to the ED and one of the nurses carries the child for a while to allow the mom a little time to rest.  

We have great equipment, technology and skills in the ED, but it still comes down to the human side, the art of nursing. We never get cards from patients thanking us for the technology; the thank yous are for the kindness, compassion and skill with which the patient’s care was provided.

What is it like to witness so much human suffering?

One never gets used to seeing pain and suffering. Working on those critical patients where every second counts, you’re so in tune with your clinical side along with the rest of the team of nurses and doctors. However, the outcomes are not always what we would like. One never gets used to losing somebody — it doesn’t matter how old or young they are. Every one of us grieves in our own way. Working so closely together in the ED, we understand each other. Often, words aren’t needed. We learn to take some comfort in knowing that we’ve given our very best.

How do you support your new nurses?

We want our new grads to be successful in transitioning into the ED RN role. We have a new grad program that was developed by our phenomenal ED educator that uses didactic and clinical instruction over a period of six months.

The new grads are each assigned to a preceptor RN who teaches, coaches and mentors them. Our preceptors are the best. We all remember that each one of us was in that “new nurse” place at one time in our careers. We need to remember that someone cared enough about giving back to the profession in order to mentor us and sometimes it’s our turn to do the same.

How do you help your nurses recover from the stress and trauma of their work?

Again, each of us has our own way of handling stress. We recently offered debriefing get-togethers after the tragic loss of a child. Our office doors are always open and our home and cell numbers are available to everyone 24/7. Our hospital chaplains always make themselves available to us and there is an Employee Wellbeing Team that provides crisis support wherever there is a need.

Each day, we have huddles in the morning, noon and evening — unless things are “all-hands-on-deck” busy. We do quick updates of important information and then share thank-you letters, comments and kudos for work well done. It is so important to hear the thank yous from our patients for the amazing work that gets done in this ED.

Before breaking to the floor, we share something for which we are all thankful. Then, someone will offer a prayer or blessing and we begin our work. It is wonderful to work in a system like Adventist Health where the spiritual aspect is encouraged.

I believe everyone has a spiritual side; it’s not about religion, but what connects us to a higher power, something or someone greater than ourselves. It is part of our healing mission that our work encompasses the physical, mental and spiritual.

What qualities do you look for in your colleagues?

We look for experience, the ability to adapt quickly to change, solid critical thinking and judgment, and being open to learning. We can teach nursing skills, but we can’t teach compassion, kindness and caring.

During interviews, we ask for stories that demonstrate teamwork and how the applicant handled stressful situations with patients or coworkers. Skills are evaluated with clinical scenario presentations.

We look for traits that reflect our core values and mission. We not only want applicants to be a good fit for our department, we want the job to be a good fit for the individual applicant.

You really love what you do, don’t you?

I love what I do because I am passionate about the people I work with every day. I am blessed to be part of this department. We have such a great culture here; we share the good and the bad.

Every day, I see courage, forgiveness, resilience, humor, gentleness and people who truly care — not only for the patients, but for each other as well. It is family like no other.

What are your professional aspirations?

There will come a time for me to seek out a new adventure — I’m not sure where or what — but it will include some type of nursing, perhaps on a volunteer basis. You just don’t stop being a nurse.  


Keith Carlson, RN, BSN, CPC, NC-BC, has worked as a nurse since 1996 and has maintained the popular nursing blog Digital Doorway since 2005. He offers expert professional coaching for nurses and nursing students at www.nursekeith.com.

This article is from workingnurse.com.

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