Lauren Astorino
July 2018
Lauren
Astorino
,
RN, MSN(c), CPTC, CCTC
Transplant
Yale New Haven Hospital
New Haven
,
CT
United States

 

 

 

Yale New Haven Transplant Center (YNHTC) cares for pediatric patients in need of lifesaving liver transplantation. Patients often have a lengthy wait inclusive of multiple outpatient visits and inpatient admissions. Lauren is a Transplant Coordinator who works with the pediatric population, managing patient flow across the care continuum. Lauren is particularly protective of patients whose families have additional stressors in their lives that preclude their active involvement in the patient's medical care. Lauren serves as a passionate advocate for these patients whose social circumstances put them at increased risk of "getting lost" in the transplantation process with resulting morbidity and mortality.
Lauren's specialty is dealing with the difficult long-term complicated patient. It is her knowledge of the YNHTC system that has helped her support JB, a 9-year-old patient with a congenital liver disorder whose second deceased donor liver transplant is starting to fail. It is most probable he will require a third transplant; which will require a tremendous amount of care and support by the family. Unfortunately, JB has been removed from his home and separated from two older siblings by the Department of Children and Families (DCF). Lauren has spent a significant amount of time with two potential foster families, both of whom declined to care for JB when they learned how difficult it would be to care for him. Now having taught a third family, Lauren communicates with his foster parents who live an hour away from his sibling's foster home. This was done to be closer to YNHTC as he has required regular outpatient appointments and hospital admissions. Without a designated pediatric Social Worker, Lauren has taken on the role of JB's champion, arranging visits with his siblings. She also coordinates care between DCF, JB's lawyer, the Institute of professional practice, his foster parents and YNHTC. In addition, she has coordinated social work supervised visits for JB's parents. Lastly, she even took part in legal proceedings with JB's lawyer when these visits needed to be terminated.
Special connections with patients and families can lead to a change for both nurse and patient. As JB has required a significant amount of time during the day, Lauren has coordinated this advocacy with her fellow pediatric Transplant Coordinator, Lindsay Arnott. This was done to ensure both were able to coordinate the significant number of people required to be involved in JB's case when the other was absent. This teamwork has strengthened an already strong working relationship. This collaboration is well recognized and appreciated by interdisciplinary colleagues in YNHTC. It is due to this advocacy and coordination that JB continues to receive high-quality medical care, supporting him to his next transplant. Without her care, compassion and diligence, it is likely JB would not receive this care. Her work is truly life-saving for this child.