My Specialty
Emergency Nursing, Sally Mascarena, MLK Community Health
Staying centered in a wide array of emergency situations
Sally Mascarena, RN, BSN
Assistant Nurse Manager, Emergency Department & Clinical Observation Area
MLK Community Health Los Angeles
What is your nursing origin story?
Two of my younger siblings were medically fragile, so I took my first CPR class in 4th grade, and learned to help my parents with G-tube feedings and medication administration.
In my 20s, I worked as an EMT and paramedic. Unfortunately, I suffered a fairly serious shoulder injury and couldn’t continue.
My mom is a nurse, and she had been telling me for years to go to nursing school, but it took me until I was 40 to do it. The year I graduated was her 50th year in the profession.
How and when did you get started in emergency nursing?
In my final semester of nursing school, I was at a hospital that offered a six-week preceptorship that I was able to spend in the emergency department. They hired me right out of school, so I’ve always worked in the ED. I became assistant nurse manager in the past six months.
Do you have a story that illustrates the best of what the ED has to offer?
About a year ago, a mom arrived in the ED carrying a little girl who was in full cardiac arrest. Every single area of our department collaborated in the effort to revive that child — it was a textbook example of optimum teamwork.
In the process, we recognized ways to help staff feel more confident treating pediatric cases, which is not really our specialty. We began brainstorming how to improve our pediatric care on every level and make sure every child receives the care they need.
What qualities do you look for in a new ED nurse?
An ED nurse needs a sense of calm, because you have to stay centered in emergent situations. You don’t want patients and their families to see that you’re nervous because they’re looking to you for reassurance.
When I was a new grad, my preceptor, who had 45 years of emergency experience, asked me if I was anxious. I said I was, and she told me, “Good — you should feel anxious, because the moment you no longer feel anxious is the moment that mistakes will happen.”
Honestly, being slightly on edge keeps you focused.
What are some of the unique challenges of emergency nursing?
The sheer volume is the greatest challenge. We have constant turnover of beds. It’s altogether different from a med-surg/tele floor, where a nurse will usually have the same four patients all day.
After a while, it can catch up with you. In our department, we rotate assignments and offer specialty roles, like call-back nurse, triage, flow coordinator, preceptor, or medical screening. By having these various roles, we give people a break, so they can come back to the ED floor with fresh perspective and renewed energy.
Is there truth to the common belief that ER nurses are adrenaline junkies?
I think many emergency nurses like the fast pace, as well as the sense of novelty and adventure. You never know what you’re going to face: One day could be multiple gunshot wounds, stabbings, or overdoses. Another day might be anything from an MI or stroke to a psychiatric emergency or acute appendicitis.
What’s changed since you started?
COVID really changed the number of people coming to emergency rooms. The acuity might not be as high, but the numbers haven’t really subsided. During the second week of February 2026, we had four days with more than 400 patients per day. Our hospital wasn’t built for that, so we’ve had to be very creative.
We’ve seen a big jump in behavioral health patients. We were just licensed to open our new Emergency Psychiatric Assessment, Treatment, and Healing (EmPath) Unit. EmPath patients have some freedoms they wouldn’t have in the regular ED, but with 24-hour treatment and counseling. It’s a more dignified way to receive emergent psychiatric treatment.
What do you like about being a leader?
Being able to make a difference in the lives of our staff. It’s fulfilling to help colleagues by offering a day off, empathic listening, or simply the opportunity to vent. If you lead with compassion and empathy, you’re going to be successful. When you have leaders you believe in who encourage growth from within, anything is possible.
KEITH CARLSON, RN, BSN, NC-BC, has worked as a nurse since 1996 and offers expert professional coaching at www.nursekeith.com.
In this Article: Career Advice, Emergency
