Kidney transplant coordinator helps patients navigate the process

A nurse since 1984, Juanita Conner practiced in pediatrics for 12 years before transitioning into case management.

“I really liked helping patients coordinate their care and get the services they needed, so I became a case manager,” said Conner, RN, BSN, MPH, CNN, CCTC, CPHQ.

Working in hospitals, clinics and independently, Conner earned certifications in case management, health care quality, clinical transplant coordination and nephrology nursing along the way. In 2008, everything came together when she took a position at Emory University Hospital as a kidney transplant coordinator in the outpatient transplant clinic.

“This work allows me to use all my nursing background and skills. I have found my niche,” Conner said.

Conner chose to work with chronic kidney disease patients because they have options and she believes she can help them the most.

“It’s a population I’m passionate about, and kidney disease is an epidemic in this country, especially in the South,” she said.

An estimated 26 million adults in the United States have chronic kidney disease, according to the Centers for Disease Control and Prevention, and many of them don’t even know they have it.

“The good news is that the body of research about this disease is growing and things are changing very quickly,” she said.

Conner keeps abreast of the latest findings as an active member of the Dogwood Chapter of the American Nephrology Nurses Association and the North American Transplant Coordinators Organization. She’s seen many clinical trials and advances in treatment since 2002, when the National Kidney Foundation came out with its Kidney Disease Outcomes Quality Initiative, which featured evidence-based clinical guidelines for treatment and prevention.

“Post-transplant patients have to take fewer medications now and we’ve decreased the rejection rate and made organs last longer,” she said.

Conner evaluates and educates patients about their disease, and helps guide them through the process of being officially placed on the Georgia kidney transplant list.

“There are about 3,000 people on the list and the average wait time for a new kidney is four years,” she said.

At any given time, Conner carries a caseload of 150 to 200 patients who are in various stages of the evaluation process.

“Patients are surprised by how much is involved in transplant evaluation. It’s a lot of work, especially for patients who are already receiving dialysis three times a week,” Conner said.

Nurses take a complete health history and perform a full physical assessment, scheduling tests of the heart, lungs, blood, liver, abdomen and pelvic area. Social workers and others conduct a psycho/social evaluation to make sure the patient has the mental, financial and family support to successfully undergo a transplant.

“Our entire team looks at the final assessment to make sure that nothing is missed and that there are no contraindicators that would make a transplant more risky,” she said.
Some of Conner’s patients come to her in the early stages of kidney disease, when education about diet and other factors can help prolong and strengthen kidney function.

“I’m an educator and a facilitator, and I love seeing patients take charge of the information and make informed decisions,” she said. “You have to be really committed to make it through a transplant. I love to see a patient fight and make changes.”

Conner has watched patients lose weight and address other lifestyle issues in order to make the transplant list. Other patients have multiple comorbidities and need greater attention.

Her patients come from all over the country. Not all of them will prove to be good candidates for the transplant list. Some who make the list will die while waiting for a kidney. But there are positive results as well, and those inspire Conner.

“We get to know our patients very well and it’s exciting to see them make their first goal of making the list. It’s even more exciting to see them doing well after a transplant,” she said.

Some months Conner may help place 15 to 17 people on the waiting list, but other months it’s a smaller number. “I don’t measure my progress by the numbers, but by how much progress my patients are making in the process,” she said.

The job takes organization, clinical knowledge and plenty of compassion. Some days she might help a diabetes patient find cheaper medications or discover ways for a dialysis patient to extend his or her benefits.

“One of my biggest roles is to tell patients that they have the option of waiting for a deceased donor or finding a living donor who will give them a kidney,” Conner said. “A living donor is going to shorten their wait time and it also frees up an organ for others on the list. We’re seeing an increase in living donors and that’s great.”

Conner plays the role of nurse, scheduler, cheerleader, advocate and resource-finder.

“Some days I’m tired, but I never wake up not wanting to come to work,” she said. “I love what I do and this is a good place to be.”

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