We are UHB: Roisin Gaffey, Heart & Lung Recipient Transplant Coordinator

University Hospitals Birmingham NHS Foundation Trust runs Good Hope, Heartlands, Queen Elizabeth and Solihull hospitals and Solihull community services.

Heart and Lung Transplant was something I'd always had an interest in when I joined the team. In my first clinical role I looked after cardiothoracic transplant patients regularly, both pre and post transplantation, so I got quite a lot of exposure to the post-op clinical care required, and to patients who were experiencing life on the waiting list. After joining in a training role in 2015, I'm now coming up to eight years in the team.

My day will typically be based in our assessment clinic, with patients who are coming to transplant for the first time. We talk them through the journey that they are about to embark on. This includes giving an introduction to our service, explaining and rationalising the investigations that will be carried out that day, as well as giving them a summary of potential outcomes that could come from that clinic visit.

In the same clinic, we also see patients who have been assessed by us before, but have certain targets to reach or barriers to overcome before they can be considered for transplant. So, it's sometimes faces that we've seen before and sometimes it’s brand new faces. Lastly, we also see patients who are on the waiting list for transplant. It’s a really good opportunity for us to keep in touch with our patients, to build rapport and, of course, to answer their questions or address concerns. Our assessment multi-disciplinary team meeting precedes this. This meeting includes our transplant cardiologists, respiratory physicians, surgeons, radiologists, transplant coordinators and sometimes physiotherapists. It is designated time dedicated to discussing many different patients’ cases in order to provide a suitable pathway for them. During this meeting the transplant coordinator will present psycho social assessments that have been carried out on our inpatient assessments. Our counselling talk is an integral part of the assessment process; an essential tool in deciding their outcome.

This is insight into only one area of our service. As well as assessing patients for transplant, we also provide lifelong aftercare for those who undergo transplantation. This includes two further clinics and multidisciplinary team meetings per week, as well as daily education and organisation to carefully plan their discharge and aftercare. Furthermore, we look after patients who undergo implantation of a left ventricular assist device (LVAD). We counsel and care for LVAD patients’ pre-op, post-op and for the duration of time they live with the pump. This includes intensive education and the provision of all aftercare necessary. We are currently in the process of beginning an exciting new venture into nurse lead clinics, led by our experienced LVAD coordinator colleagues.

We also go on the daily ward round, a further chance to provide education, to educate ourselves and most importantly to be a friendly face and pillar of support to our inpatients. We regularly visit our patients who are urgently listed for a transplant. They are in hospital away from their family for prolonged periods of time waiting for their organ or organs to become available. Therefore it is also our responsibility to support their psychological needs, with the guidance of our transplant psychologist if necessary.

We spend our administrative time in the office maintaining and adding to the NHS blood and transplant (NHSBT) waiting list, handing over patients’ care to one another to ensure there are no gaps, triaging patients on our emergency phone line, dealing with donor offers, responding to emails in order to indirectly continue to provide patient care. This is also our opportunity to plan teaching sessions, both internal and external in order to spread the word about our service and its aims.

I think the most satisfying part of my job is being one of the people that introduce patients to our service then continuing to support them and their families over time. We go through quite a lot with them so naturally build relationships with patients who so desperately need our help. The most fulfilling feeling is when you bring someone to their transplant operation that you have supported for sometimes months and years - seeing them on the ITU post-op and being able to say, “You did it!”

The biggest challenge with this role is the on-call requirements; it’s really variable. You might not get many offers of available organs or patient calls, but then again you may work a full 12 hours in hospital, sometimes after a long day. However, I still see it as one of the most rewarding parts of the role because you get the opportunity to go through so many of the patient’s experiences with them.

It’s important to mention that the acceptance of a donor offer leads to a transplant set-up. This is the most autonomous element of our role! With good organisation, you tend to not have that moment of urgency when an organ becomes available and you can plan the process in a controlled, calm fashion. That's the goal with a transplant set-up. You want to negotiate and communicate with all external teams effectively so to avoid any logistical or timing issues that could potentially cause difficulties.

In the early days before an on-call, I used to finish my shift and think, “tonight could be the night that we are changing someone's life!” I would go home and have a bit of a nervous feeling in my stomach, like a bit of a flutter, thinking of what could lie ahead. That's the thing with transplant: the unpredictability of the whole process for both us and our recipients. It’s a privilege to be the person that makes that phone call to the recipient, to inform them that their life could potentially be changing. It’s like a nervous excitement because of how much is at stake and it’s a privilege to be at the centre of that navigating and coordinating it all.

I think one of the biggest advantages of our role is how dynamic it is and the variety that you're exposed to as a qualified nurse. You’re exposed to three exciting, varied areas of a specialty. They are all combined and linked together in a really special way.

We currently have an opportunity for a Heart and Lung Transplant Recipient Coordinator to join the team. You need to be dynamic, keen to learn and enjoy working as part of a team, but also able to demonstrate you can work autonomously as well. It would suit somebody who has a specialist interest in cardiothoracic, cardiology or respiratory nursing.

Within the team there are brilliant opportunities for funded further education. You’re supported and encouraged to improve your skills and knowledge as a practitioner. We support our nurses undergoing the advanced health assessment course, as well as non-medical prescribing course. We also travel nationally and internationally for conferences and study days. So whilst exploring the world, you’re getting to build your skills and knowledge.?

I’ve already said what a privilege it is to be a transplant coordinator, but it needs to be reinforced. You really are involved in changing someone's life and I never take that for granted.

If the role of Heart and Lung Recipient Transplant Coordinator is something you’re interested in, you can find all current vacancies on our jobs website:

Please contact us on 0121 371 8824 or 07920530026 if you would like to discuss the role in more detail, or to plan a visit to shadow us for a day.?