Transplant Nursing

[really]

Background: I have worked as a neuro nurse for the last 4.5 years (with a little N(eonatal)ICU stint thrown in the middle). I have been spit, hit, kicked, nearly bitten, scratched, etc. by poor, scared souls who aren't in their right minds and I've had enough. :angryfire Additionally, there are management issues where I am currently that leave many of us nervous about our future livelihood. Being the soul breadwinner in my family, I can't stand the stress of the threat to my employment. Not to mention, the stress is negatively impacting our nursing care, but I don't see a change in site.

So, I recently started talking with a friend about a Transplant Coordinator position, which I really think I would be interested in. There is one available, but they require experience with transplant, which I do not have. Miraculously, a transplant nursing position just opened up at a facility much closer to my home. I'm wondering what the work is like. How heavy are the patients (I'm used to total care - trach, peg, flaccid, incontinent, etc.)? How challenging are the patients (I'm used to people being totally disoriented requiring frequent contact to help them feel secure)? Can you actually communicate with your patients and can they do things for themselves?

Any information would be appreciated. Thank you in advance!!

[RNperdiem, RN]

The patients you generally work with are at least candidates for surgery.

I work with a lot of liver transplant patients in the SICU.

The patients can be heavy post-op and start out in the ICU.

Many will recover quickly, and a lot of patients amaze me with how little pain control is needed for this big surgery with its big incision.

Others never really recover and can linger on a long time never regaining their health. It depends on how healthy they were before the surgery sometimes.

[highlandlass1592, BSN, RN]

I'm not really sure what kind of transplant position opened up for you. Our unit takes hearts and lungs...then ships them out to our step-down unit once the initial recovery is done. ICU phase you're talking intubated, chest tubes, multiple IV abx's and transplant rejection meds. They can be labor intensive. Once they are extubated, if they are stable they can hit the floor as early as POD#3. Then we are ambulating, titrating anti-rejection meds, sometimes titrating down low dose meds (for hearts, isuprel and low dose dopa). Then we start much of the teaching on the floor: meds, diet, follow-up care and in case of hearts getting ready for right heart caths and biopsies. Sure, some do poorly and need extended intereventions in ICU: vent,trach peg,CRRT but that is VERY rare. Not sure if that's what you're looking for but hope it helps. We are a VAD center so our nurses deal with VAD's and then get the privilege of dealing with them when they get transplanted, which is such a joy for us.

[GOMER42]

At times those liver patients have been known to hit, kick, spit, scratch, and bite!

[RNperdiem, RN]

Yes GOMER42, I have had that happen. Those high post-op doses of steroids makes some folks crazy for a while.

[Student2Registered]

Liver transplant patients can be very labor intensive patients. They are typically confused, weak and unsteady, lots of electrolyte replacements, plus the antirejection meds, and the abx too...oh yeah and a lot of adult liver transplants are secondary to ETOH/drug abuse so there is usually a dysfunctional/codependent family dynamic thrown in the mix.

[really]

Thanks to all who replied. Believe it or not, I was floated to our transplant unit (livers/kidneys) just a few nights after I posted this. It's definitely a very different discipline...the labs, meds, etc. are all very specialized, just as neuro has it specialized areas of knowledge, I guess. I'm sure I would find it interesting.

Never got a call back on the job I applied for. Seems to be the case...jobs are scarce. I'll continue to ride it out, pray I don't get too abused and keep my eyes open for something different!