Esther Conteh has enjoyed an extraordinary and varied healthcare and nursing career for over 25 years. She emigrated to New York City from Sierra Leone as a teenager and was inspired by her mother’s work as a midwife back home and decided to pursue a career in healthcare.
After working as a home health aide at VNS Health, she became an RN with the organization and moved quickly through the ranks, leading to her current leadership role, where she oversees a large and diverse team.
In everything she does, Esther works towards building a culture of inclusivity and family for her team. She is committed to providing top-notch care to the communities served by VNS Health Choice MAP and MLTC, many of whom come from vulnerable backgrounds.
Esther Conteh is an important nursing leader, and we’re pleased to profile her as part of the Champions of Nursing Diversity Series 2023.
The series highlights healthcare leaders who are prominent figures in their organizations and are making transformational impacts in nursing.
Meet Esther Conteh, BSN, MSN, Associate Vice President, Care Management at VNS Health, overseeing clinical care of VNS Health CHOICE Medicaid Advantage Plus (MAP), and Medicaid Managed Long-Term Care (MLTC) plans.
What is your title, and where do you work?
I’m an Advanced Practice Nurse (APRN) and Associate Vice President at VNS Health, one of the nation’s largest nonprofit home and community-based healthcare organizations. I manage care for members of our Medicare Advantage and Medicaid Long Term Care health plans, which were developed specially for people with complex, chronic health conditions.
Please discuss your career path and how you ascended to that role.
I have been at VNS Health for 25 years—I started here as a home health aide working in Manhattan. I knew from the beginning that caring for people in their homes was what I wanted to do, so I got in on the ground floor, and it was a great beginning. As a home health aide, I absorbed the experience of what it was like for people to recover. I got a chance to see what people needed and their concerns. I learned how to reassure and help people as they regained strength or coped with changing health conditions. The empathy I found in those days still guides me today.
After working as an aide, I went on to train and become a nurse and graduated as an Advanced Practice Nurse (APRN) from NYU. I was eager to build my skills in home health nursing. As I expanded my education, I focused on home health–a specialty I’ve always been drawn to because you can interact with people, and education is a big component. There is always the potential to help people understand what they need to stay healthy.
Throughout it all, I am grateful for the support of my mentors and those I work alongside. For example, when I was just about to enter the field as a nurse, I was also in the middle of my first pregnancy. As you might imagine, balancing so many life changes at once can be challenging! Thankfully, I had a lot of flexibility in home care, but the job could still be intense when I first started. I’m immensely grateful for the support I received from the team I worked with and my managers. Those early relationships helped me get where I am now.
After several years working in the field and many changes in the healthcare system, I’ve moved into a new role that’s been exciting. The work I do today as an AVP of Care Management for our VNS Health Health Plans is very much informed by my field experience. When talking with a client on the phone, I can visualize their home and ask questions about their environment, lifestyle, companions, or caregivers at home. Every day is different, but each structure is similar in many ways. That’s one thing I love about this work. Working with our MLTC (Managed Long Term Care) and Medicare members requires skill, empathy, and patience. Our plans serve some of the most vulnerable communities in the city. Disabilities, diabetes, heart disease, cancer, dementia, arthritis, and other chronic illnesses all come with fears and potential complications for our members. We try to simplify things and help them navigate complex systems, so they feel more in control of their health and well-being. Working in a management role, I still feel like I am a nurse first, but I’m also part of a care team that needs to be agile and deliver care quickly. My experience helps me support others on the team, too—especially younger clinicians.
Why did you become a nurse?
Growing up in Sierra Leone, my parents were healthcare workers and educators, helping all the locals. It sparked my desire to work in health care and to help others as my parents did. The care they provided others shaped my thinking, and I have never swayed from my passion for working in health and helping others. I moved to New York when I was sixteen, and as I finished school, I started moving into a career in health care, starting first as a home health aide. That experience still informs my work today and has given me a valuable perspective on best serving different patients.
What are the most important attributes of today’s nursing leaders, and why?
The first word that comes to mind for me is integrity. As a nurse, you’re often with people at their most vulnerable and truly depend on you, so integrity is critically important. Another core value that makes a good leader is empathy. Next, you have to understand where people are in their life journey. And lastly, you need to be agile and flexible and be able to pivot when needed. Especially working in people’s homes, our nurses are always mindful of where our patients come from. Every day has the potential to bring something entirely unexpected or new.
What does being a nursing leader mean to you, and how are you making a difference?
Experience is so important. Leading others, whether that is guiding someone who needs care or a team member that supports them, as is the case with our health plan care managers, that both the members and my colleagues know they can trust me. Leading requires clarity and honesty. I use those skills every day. There’s a lot of urgency in the work we do. Precision is essential, and you must make decisions quickly sometimes—it can be stressful. Everyone experiences that, both members and our experts on the phone. We lead by example and communicate one step at a time so we can hear what our members are saying—we try to “meet them where they are.”
Those we serve are often facing multiple comorbidities and life challenges. So you must ask yourself, what can I do right now to ease some of the issues this person has to deal with? It’s about considering all their needs, not just nursing care, but do they have access to food? Are they safe? If not, we must prioritize those crucial basics for our members.
What is the most significant challenge facing nursing today?
As the aging adult population grows, so will the need for skilled home care nurses and caregivers. It’s an exciting time to be in this specialty, but it also means more nurses with skills in home health care will be needed.
I don’t think the solution is simply hiring more people. Instead, we must think carefully about where nursing is going and how to improve. It is about what we learn from those we care for and how that can transform nursing. It is about working smarter, not harder. Because we can all agree burnout is a prevalent issue across the industry, and it’s important to support both veteran and novice nurses that put their all into the work.
As a nursing leader, how are you working to overcome this challenge?
Technology has become a valuable tool and resource for our team. Throughout the pandemic, it’s been amazing to see how telemedicine has transformed how we communicate and deliver care. The pandemic brought people together through technology and made it easier to trust and feel a face-to-face connection, even if that was on a phone or computer screen. For many of us in nursing, I think it opened our eyes to new possibilities.
For example, with remote patient monitoring, you can recognize a problem before you are even there in person, enabling us to respond faster. From afar, we can manage our patient’s heart rates, blood pressure, blood sugar levels, and much more. With this data, we can spot emergencies and react immediately. At VNS Health, we created a sort of dashboard where we could track and monitor incidents with patients. This lets us monitor risk and work with different teams to determine which services or interventions are likely needed.
Technology encourages even the most seasoned nurses to think out of the box. Our world is changing, and that’s not necessarily a bad thing! Especially if it can help nurses excel, feel supported, and better serve their patients.
What nursing leader inspires you the most and why?
That’s a tricky question because there are so many who have been an inspiration to me! Someone who comes to my mind first is Susan Underwood, Director of Compliance Operations with VNS Health. I first met her in an entirely different capacity from the one I am now, as I had just graduated from another part of the organization, so it felt like I was starting somewhere new. However, she was incredibly supportive and recognized my potential, encouraging me to grow.
She approached me one day and said, “I think you are ready to take the next step. So let’s work together to find a role where you can grow your skillset and mature.” And she was right. Moving into a leadership/managerial role was daunting, but I’m glad I did it.
Looking back even further, I think the founder of our organization, America’s first public health nurse, Lillian Wald, was such a visionary figure. Her work 130 years ago still holds so much in common with what we do today. She looked around at the communities she worked in and saw significant issues that needed to be addressed. So, she took action. And that way of seeing the world, of instilling change, is very much a part of the culture here at VNS Health today.
In home health, as a nurse, you have the privilege and the challenge of being aware of so much. We watch family dynamics firsthand; we see the ins and outs of a patient’s life and understand the many unspoken things behind the scenes. Home health nurses must ask ourselves, “What help do I need to bring? Do they trust me in this relationship?” Home health nurses must consider all the factors that impact a patient when planning care.
What message would you like to share with the next generation of nurses?
It is so important to have a passion for this field, knowing that it can be tough sometimes. But nurses will find that sticking with this career is worth it if it is their passion. In nursing, as in every other career, there will always be challenges, and many of us face added hurdles because of race or ethnicity. However, one advantage I’ve seen is a better understanding of some health disparities because of my lived experience. That alone can play a powerful part in healing.
I would tell future nurses you have a significant role, especially when serving people who look like you and might share the same experience. Remind yourself that it’s important to implement a certain amount of selflessness, be there for them, and show up for them because you can make a real difference in their lives.
As you advance in your career, don’t let your fears hinder your growth. You are never truly alone in the journey; don’t be afraid to reach out to others for support. You will have so many people–to inspire you, encourage you, help you grow, and share their experiences with you. I have been so blessed to have people, all my leaders, all my bosses, and all the people I’ve encountered in this job, and I learn from them. So have a toolkit in place, be ready to be a sponge, and soak up new experiences. Education never ends when you’re a clinician; there’s always something new to learn.
As a Black woman, I want to tell other nurses that your contribution will speak for itself. Sometimes, you may feel like people don’t always tell you they appreciate you. But trust me; you will be rewarded. You may not see it immediately, and it may not be tangible, but there is a reward for all you do.
Is there anything else you’d like to share with our readers?
Nursing has always felt so natural to me. It could be because it brings me joy every day, and I chose a career that keeps me happy and smiling. As nurses, we may not have all the answers all the time, but if we do what we can at the moment to change somebody’s life and positively impact them, then we’ve done our job.
The real beauty of nursing is that there are so many ways to be a part of it, and you can find an outlet for your strengths. You could work in different environments or specialties like home health, hospice, or behavioral health. You can lead teams as a care manager or become an expert in analytics and data …you have so many options and choices. The sky’s the limit when you have a nursing career!
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