By Suzi Birz, principal, HiQ Analytics, LLC, NurseZone editorial board member
April 9, 2010 - Next week, we will celebrate and honor transplant nurses. There are many roles for nurses in the field of transplantation, including transplant coordinators, staff nurses, clinical nurse specialists, charge nurses and organ procurement coordinators. Each role contributes to the rising survival rates for organ transplantation.
According to the U.S. Department of Health and Human Services, between January 1, 1988 and December 31, 2009, 478,348 transplants were performed in the United States.
“Transplantation allows many patients to trade an illness that will shorten life for a manageable condition,” explained Julie Hudson, RN, MSN, CCTC, liver transplant coordinator at Duke University Hospital in Durham, N.C. Hudson has been working in transplantation for more than 20 years and has treated more than 800 patients.
“For some transplant patients, like those receiving lungs, it is not always about longevity, but rather it is about improving quality of life,” added Tracie Holland, RN, BSN, CCTC, lung transplant coordinator at Duke University Hospital. Holland has been working in transplant for more than 12 years and has seen all sides of the specialty, having worked as a staff nurse, an organ procurement coordinator and now a transplant coordinator.
Clinical transplant coordinators have responsibility for the patient's evaluation, treatment and follow-up care.
“The transplant coordinator mantle of responsibility includes clinic hours, reviewing lab results, coordinating medications, patient triage, and organ offering communication,” said Hudson. “This workload is carried for the nurse’s entire patient case load.”
“Transplant coordinators’ work crosses care delivery sites, inpatient, outpatient and local doctors’ offices,” added Hudson.
The work begins when a patient is referred for a transplant. “Pre-transplant activities include evaluations, testing, decisions to transplant, and listing the patient for an organ,” explained Holland. “The surgeon and transplant coordinator work to offer the organ to the patient and accept the organ for transplant.”
“Once the decision to transplant is made and an organ procured, the coordinator begins a series of ‘go calls’ including the operating room, anesthesiology, respiratory therapy, perfusion, blood bank and pharmacy,” detailed Holland.
Unlike other specialties, a transplant coordinator’s relationship with patients does not end when the transplant is complete and the patient is discharged. “There are no hand-offs in transplant,” explained Hudson. “We continue our work with recipients to monitor rejection, medication compliance, and complications for the rest of the patient’s life.”
The scope of activities spreads beyond medical issues. “We are teachers and coaches, we coordinate insurance, complete FMLA and patient assistance forms, file drug prior authorizations, write letters of medical necessity, and we assist patients in finding local resources,” said Hudson.
“We treat patients of all ages,” she noted. “Some programs treat pediatric patients, and for some programs there is no upper age limit for the recipient,” added Holland.
Transplant coordinators work with the living related donors as well as the recipients. “The donor will have a different coordinator than the recipient,” said Holland. “This allows the donor to ask any questions and make the decision that is right for them regarding donation and to have an advocate that is separate from the recipient.”
Hudson finds the work rewarding, “There are far more miracles than misery in transplant.”
Since the first successful organ transplant in 1954, thousands of organs have been transplanted. Organs that can be transplanted include liver, kidney, pancreas, heart, lung, and intestine.
Thank you to nurses around the nation making transplantation possible and improving the experience and health of recipients, donors and families.
April is designated as National Organ and Tissue Donor Awareness Month.
International Transplant Nurses Society (ITNS)
Donate Life America
© 2010. AMN Healthcare, Inc. All Rights Reserved.