click to enlarge
Kelly Garner, RN, A-Fib program coordinator in her office in Cardiac Ultrasound
Kelly Garner, RN, does not like to be the center of attention. As the UNC Hospitals atrial fibrillation (A-Fib) program coordinator, she prefers to be in the background, using her compassion and considerable nursing skills to deftly guide patients with atrial fibrillation through the complex set of testing needed before an A-Fib treatment procedure can begin. You won’t see her in the procedure room, but much of what led to that moment started with her.
Garner came to UNC in December 2010 as a consultant to teach the hospital how to manage the new convergent heart procedure, pioneered by cardiothoracic surgeon Andy Kiser, MD. Dr. Kiser had arrived at UNC just one month prior from FirstHealth Moore Regional Hospital in Pinehurst, and Garner had served as the cardiothoracic OR manager for FirstHealth.
At that time, she was the surgical educator and manager for the Advanced Cardiac Arrhythmia Training Institute (ACATI), created by Dr. Kiser to train physicians and their staff on how to do the convergent procedure.
“When Dr. Kiser came to UNC, he asked me to come as a consultant to teach the staff how to do the convergent procedure,” explains Garner.
By June 2011, Garner’s skill was evident and the patient load for atrial fibrillation was growing rapidly, as well as growth in patients needing the convergent procedure. Garner was brought on full-time as the A-Fib program coordinator, a new position at UNC. As a matter of fact, UNC is the only hospital in the Triangle to have a full-time A-Fib coordinator.
Catherine Rege, Director of UNC Hospitals Cardiac Services, says, “Kelly has helped organize our A-Fib program, making for a much better experience for the patient. Her work has had a tremendous impact on the efficiency and quality of the care we provide.”
As the A-Fib coordinator, her responsibilities include managing patient care for people having procedures for atrial fibrillation. Whether it means they are having an endocardial ablation, the convergent procedure, or any other medical procedure to treat their A-Fib, she is the person who coordinates their care.
Her background, however, did not start with program management. For five years, she was an in-the-trenches cardiac operating room traveling nurse, contracted to work in Alaska, Hawaii, the Virgin Islands, and various other places in mainland America.
“I love the cardiac OR,” says Garner. “It is task-oriented, and you get the adrenaline rush that you find in the ER, but it’s in a controlled setting. You hope for the best but anticipate the worst because you know at any time, the case can dramatically change.”
Garner has spent 18 years working in cardiothoracic surgery, in one role or another. She settled in Pinehurst for 11 years, working with Dr. Kiser, meeting her husband, marrying, and starting a family.
“When I was asked to come to UNC, I noted the extremely high volume of A-Fib cases, and I saw a really great need to coordinate the schedules for those patients,” explains Garner. “Many A-Fib patients are treated with drug therapy, but I only handle the patients who are coming to UNC to have a procedural intervention.”
Throughout February and March 2013, she has seen an increase in patient volume for both cardiac ablations and the convergent procedure.
When asked what a normal day at UNC is like, Garner laughs and says, “There is no normal day!” However, there is a certain rhythm she finds in each case, though she admits that they can vary widely.
When the Open Access Referral Center receives a call from a physician about a patient needing an A-Fib procedure, the Referral Center begins the process of scheduling the necessary tests. Parallel to that process is Garner, who receives the patient information from the Referral Center, and then contacts the patients to learn more about them and the medical management that failed to resolve their A-Fib (one of the requirements before receiving A-Fib procedural intervention is medical/drug management of the symptoms).
[See this month’s article about the Open Access Referral Center for more information on the behind-the-scenes of an A-Fib procedure, and then read about it from the perspective of one of our A-Fib patients.]
“Each patient’s case is so varied, and as a nurse, I need to know as much as I can about the patient – medically and personally – so I can assist with their treatment.”
Garner knows that patient education is vital to the success of any A-Fib procedure. “There are multiple tests that occur before any procedure is performed, as well as a lot of follow-up after the procedures,” states Garner. “The more I can teach the patient about the procedure and what they’ll need to do afterwards, the less likely it is that they will have complications. The patient is more comfortable, confident, and educated.”
Even though Garner likes to stay “behind-the-scenes”, her ability to interact with her patients and their physicians is unparalleled. “Kelly never likes to be recognized for her extraordinary clinical expertise and her unique personality,” Dr. Kiser says. “But she is one of the best nurses I know, and a wonderful friend to me and to the patients and staff.”
She often finds herself in conferences with physicians to discuss treatment options, with patients on the hospital recovery floor following a procedure, guiding patients to various hospital clinics as they prepare for their procedure, and she even interacts with the billing department to ensure that everything goes smoothly for the patient and the hospital.
“I do enjoy the personal contact that I have with physicians and patients,” she says with a smile. “It keeps it interesting. I really enjoy what I do.”
Garner lives in Sanford with her husband, Tommy, and her seven-year-old son, Sawyer.