My Specialty

Trauma Nursing, Gilda Cruz-Manglapus, Henry Mayo Newhall Hospital

Responding to severe injury and community crisis

Patient lying down in bed, while a nurse is standing in a white coat and holding paperwork for the patient to look at

Gilda Cruz-Manglapus RN, MSN, PHN, TCRN
Trauma Program Manager
Henry Mayo Newhall Hospital, Valencia

Please share the story of your nursing career.

I’ve been a nurse for 22 years. I started out working in a nursing home in Chicago and then moved to California and found a position at Henry Mayo Newhall Hospital. I earned my BSN and MSN while employed here.

I’ve served in a number of roles in different units at Henry Mayo: med-surg/telemetry, ICU, post-anesthesia care unit (PACU), quality department, and a brief stint doing home health nursing. I took my current position as trauma program manager in 2009.

What appeals to you about trauma nursing?

Trauma nursing sees patients through what could be the very scariest moment of their lives, whether it’s a car accident, a stabbing, a shooting or a skateboard accident.

Getting to watch patients move through the healing journey towards eventually going home, recovering from their injuries (to the extent that’s possible) and resuming their lives is incredibly gratifying and fulfilling.

In May 2009, about a month after I became interim trauma program manager, we underwent a verification survey by the American College of Surgeons Committee on Trauma. It went very well, and it was a total immersion that basically forced me to learn everything I needed to know about the trauma program in one month. It was eye-opening and paved the way for me to decide that this was what I truly wanted.

Tell us about Henry Mayo’s trauma services and what makes it a unique facility.

Henry Mayo is part of the L.A. County Trauma System, which includes 15 trauma centers throughout the county — one of the biggest trauma systems in the U.S. Henry Mayo is the only hospital in the Santa Clarita Valley, and extends its services to the counties of Ventura to the west and Kern to the north.

We’re designated as Level II, with a volume of approximately 1,000 patients per year. (A Level I trauma center needs to be affiliated with a teaching hospital, and we’re not an academic medical center.) Trauma centers are required to have the resources to provide the care for which we’re designated.

We have a trauma surgeon on site 24/7, and an OR available within 15 minutes around the clock. Specialty services such as neurosurgery and orthopedic surgery are readily available. We’re very proud of our patient outcomes.

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If you’re not familiar with a trauma center, a trauma resuscitation room can look from the outside like utter chaos, but it’s actually organized chaos. Everyone knows their roles, from the lab techs and blood bank techs to the surgeons, ED physicians, nurses, ED techs, respiratory therapists, chaplains and social workers. Of course, we also often require security if a trauma case involves a suspected crime.

What characteristics do the best trauma nurses share?

Aside from clinical knowledge, trauma nurses need to be able to work in a fast-paced environment and also have a lot of compassion and judgment — these are circumstances you can’t just take at face value.

Let’s say a woman shows up badly beaten. You need to remain detached enough so that you can deal with the situation objectively. You don’t know what’s behind the woman’s circumstances, so you must withhold judgment, deal with the trauma at hand and communicate compassionately.

In 2019, there was a school shooting at Saugus High School in Santa Clarita. These types of events are very emotional for everyone, as many of us both live and work in the community — many of our ER nurses had kids who went to that school.

Those nurses needed to be able to remain present and take care of pediatric gunshot victims who could very well have been their kids or their kids’ friends. It takes a special kind of nurse to be able to do that.

How do you help staff members process difficult situations?

If a nurse needs to step away, they can talk to someone immediately. Chaplains and social workers are also there for support.

We talk openly with our staff members and offer whatever support they need. If we lose a patient — a baby o child, for instance — it can be very difficult, whether the cause is gun violence, a car accident, SIDS or something else.

Many of our nurses have worked in the facility for 20 or more years, so we know one another well. Everyone supports each other. Being able to talk openly with your leaders also helps a lot when things are tough. Our nursing director has an open-door policy and is always available.

Do you see a lot of burnout in trauma nursing?

In the last two years, burnout has been more related to COVID-19 than to trauma nursing per se. When the streets were empty back in early 2020, our census was down, since people were staying at home more, but it’s starting to escalate again.

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Tell us about your community outreach activities.

One community education program we teach is called Stop the Bleed. It’s an American College of Surgeons national program where we teach bystanders to be able to assist a bleeding patient before EMS arrives.

In mass casualty events such as the Sandy Hook Elementary School shooting in 2012 and the Boston Marathon bombing in 2013, lives can be saved if there is bystander intervention like this.

We’ve focused our educational initiative on elementary, middle and high schools. A local nonprofit provided Stop the Bleed kits for middle and high school classrooms. Sadly, those kits needed to be used during the Saugus shooting.

In collaboration with the community court and the Superior Court, we have programs for teens who’ve been cited for things like reckless driving or driving while intoxicated. The court mandates that they take our classes, which teach them to be more responsible drivers. Another community program centers on fall prevention for seniors.

What is the value of the TCRN certification? Do all trauma nurses have it?

The TCRN (trauma certified registered nurse) certification is fairly new. Not all trauma nurses have the certification, and we do not require our nurses to earn it, although we encourage it. We do require that our ED nurses take the ENA Trauma Nursing Core Course (TNCC) every four years.

I earned the TCRN certification to make sure I had comprehensive knowledge. I’m not actually a bedside trauma nurse, but I take part in cases when I am able to and round with the trauma surgeons on the units. The TCRN certification helps me understand what’s happening and how our nurses are involved. Being certified, I can also serve as a role model.

We maintain a staff education program in which we teach TNCC. I’m an instructor, and we train our nurses to be instructors themselves. Our goal is to also have 100 percent of our ICU nurses complete the Trauma Care After Resuscitation (TCAR) program.

I see you’re certified as a public health nurse — tell us about that.

Part of my BSN training was geared towards public health. Trauma nursing also involves partnering with the community through initiatives such as injury prevention programs, so my BSN allowed me to fulfill the requirements to be a PHN.

Please share anything else that you love about your work.

Working at Henry Mayo allows me to highlight my greatest potential as a nurse and as a leader. The support of administration for the trauma program, the confidence that my leaders have in me, and the dedicated staff all make me want to do my best work all the time. The collaboration of our team members shows in the way we care for our community and our patients.


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


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