By Matt Skoufalos
In 2002, Fitzgerald and his spouse moved to the West Valley of the Phoenix metropolitan area, as he started working in adult cardiac care at Boswell Memorial Hospital. Shortly thereafter, a phone call from Banner Health presented an opportunity to join the start-up team at a hospital scheduled to be constructed nearby. Fitzgerald was invited to focus especially on guiding plans for the operating room. He spent two years consulting with designers and five years managing the OR after the hospital was built. Then, St. Joseph’s Hospital and Medical Center in Phoenix invited Fitzgerald to help with its start-up cardiothoracic program, and it was time for another change.
“At St. Joe’s, we did adult and pediatric hearts, and had a thoracic program that today is number one in lung transplants,” Fitzgerald said. “I did charge nursing there for a little bit, and then did the whole gamut of surgeries.”
After another five years in the program, the hospital decided to maintain its focus on adult patients exclusively, and Phoenix Children’s Hospital moved to adopt its pediatric program. Fitzgerald joined a team that consisted of “a single surgeon and a handful of staff,” but because that surgeon was Dr. John Nigro, whom Fitzgerald described as “probably one of the best surgeons on the west coast,” it was an opportunity he couldn’t pass up.
“I knew what the program was and I knew what Dr. Nigro’s vision was for this program,” he said. “He wanted to be ranked nationally, he wanted our outcomes to be the best it could possibly be, and he wanted an efficient program, because all those things come out in numbers.”
For someone who describes himself as driven to the point of needing a challenge for motivation, there was no other choice.
“This was the obvious progression for me,” Fitzgerald said. “I was at Joe’s doing the lung transplants and pediatric hearts, which were by far the most challenging, and then when they moved this program over, and asked if I would move with the program and start it up. It was a no-brainer [but] it wasn’t easy.”
The cardiovascular services unit at Phoenix Children’s Hospital specializes in complex care for children with congenital heart conditions. The program proceeds according to a grueling schedule, seeing the sickest of patients through surgeries that last eight hours or more. Its goal is to perform 15 transplants a year, and there are 10 children on its latest waiting list. Any time a heart becomes available, one of two standby teams is sent to procure it, 24/7. Fitzgerald described it as difficult work that can attract glory-seekers; however, the folks who last the longest on the job are committed to the integrity of the process and making connections with families in need of lots of support.
“I have trained people for a year, and out the door they go because now, on their resume, they can put they’ve done congenital hearts,” Fitzgerald said. “These children and their parents don’t know where to turn. You’re seeing a kid who comes to us with a very sick heart, and the prognosis isn’t very good, and they’re put on a transplant list.”
When Fitzgerald joined the department, it was transitioning from one or two congenital cardiac cases a week to eight to 10 cases a week; today, it’s become a service line for three full-time and one part-time surgeons.
“For the first three years, I ran this program with a couple of techs and a handful of nurses,” he said. “My team works extremely hard. It’s a very skilled profession, and we go on bypass for the better majority of our cases. It’s very stressful but very rewarding.”
Finding the right nursing staff to support the unit required a nationwide candidate search. As the patient volume kept growing and the staff stayed the same, however, “the obvious thing was to train them ourselves,” Fitzgerald said, adding, “it was a stressful process.”
“These cases are very complex cases,” he said. “What I instill in my team is the idea that we’re all one, and we’re only as strong as each other. I’ll look at the cases for the week and pick and choose who’s going to do what. I’ll team them up so that everybody is at their top level.”
Designing that team is a critical part of Fitzgerald’s role at Phoenix Children’s Hospital, but so is elevating their individual skills. He said he’s provided – and been provided with – a good amount of educational resources through the years, but what makes him able to do the job he does is working as part of a team.
“There’s no individual that can achieve this goal on his or her own,” he said. “This program is fast-growing, and we are doing hearts with outcomes that are right up there with these other hospitals. Just to be an active part of that is very rewarding.”