What does it take to be a peds transplant nurse?

[KayRN910]

I've looked at a lot of threads, but this specialty hasn't came up much.

I am currently in the early interview stages at a local children's hospital. We were going over the positions open, and one in their transplant department is open. I was basically like, well, I've never been around that or known of anybody who has done that, but I would be open to giving it a shot.

I've always had jobs working with kids, mostly special needs children. But, I (like so many) could not be picky about where I worked after graduation, so I took a job in an ER, which sees almost zero children. I really, REALLY miss kids. I miss getting to know the kids and parents, and being part of a team to help them. Building that trusting relationship with both the kid and parent.

I like ER a LOT. But it misses that key element that makes my soul happy. :-/

So I thought maybe transplant would be a good choice for me? Anybody here ever done it?

[NotReady4PrimeTime, RN]

At our hospital there isn't a specific "transplant unit" for peds, although there is one for adults. We average about 35 peds transplants a year, mostly hearts but a good mix of livers, lungs, kidneys and multi-viscerals as well. The hearts and lungs go to one of our inpatient units out of PICU and the rest go to another. As a nurse caring primarily for transplant patients, you'd be getting a lot of practice with wound care - they all have long, often gnarly incisions, multiple drains and poor wound healing. You'd also get lots of experience with central lines since many of them will be on TPN for a long time and will need daily blood draws for weeks to months. You'll get good at handling cytotoxic agents like mycophenolate mofetil, ganciclovir, borteximib, rituximab, ATGAM and an assortment of others, plus boatloads of antibiotics and other antimicrobials. You'll have lots of opportunities to become expert at fluid and electrolyte management and blood product administration. And time management! (All of them will have scheduled blood draws for drug levels, and all of them will be getting their immunosuppressants and anticoagulants at the same time... ish!)

The other part, the part you're looking for, will definitely be there. These children are chronically ill and have been hospitalized frequently for long periods of time. It can be very challenging to establish a strong, trusting relationship with the parents of these kids, who are the ultimate experts in their children and who have developed methods of getting through life with them that don't always mesh with hospital routines, rules and attitudes. It really pays to listen to them, and to stuff our own feelings and opinions down into a deep pocket. I find that I can't allow myself to "be the RN in the room" and to ignore what a mom is telling me about her transplant-recipient child's behaviour or symptoms. She knows what she's talking about and even though the delivery of this important information might create some animosity, I know we're all in this together. I've seen too many moms and dads pick up on some seemingly insignificant little thing that has been the beginning of something much larger and potentially serious to pretend I know it all anymore!

[KayRN910]

Thank you so much for your reply. I always enjoy reading what you say whenever you comment on anything regarding pediatrics. I can tell you must really care about what you do, and for that I thank you again. :)

I actually scored an in person interview with the transplant unit. I'm very excited. I can only hope my heart is big enough to love them all. :) (and that my brain is big enough to take good care of them!)

[NotReady4PrimeTime, RN]

Thank you for your kind words. I just finished one of those shifts that the foregoing derives from... the dad arrived just as I was preparing to give report, walked over to the chart and checked out the new orders then pulled the lab reports.

Congratulations on your interview. I'll hold good thoughts for you. I don't think you need worry about the heart part, and the brain part is something that can be developed with the right amount of interest. You'll do fine.

[KayRN910]

I GOT THE JOB!!!!! AHHHHH!!! I AM SO TICKLED!!!! :) Thanks for your kind word!!! :)

[NotReady4PrimeTime, RN]

Congratulations! I really hope you love it. There's a lot to learn... get ready!

[KayRN910]

Any suggestions on study material between now and then?! Any good books or pocket guides you would suggest?!