Leading from the Background: The ECLS Coordinator Role, Redefined.

In the world of Extracorporeal Life Support (ECLS, aka ECMO), there are many heroes, bedside clinicians, surgeons, perfusionists, and critical care teams. But one role often goes unnoticed, under-recognized, and misunderstood: the ECLS Coordinator.

Though rarely in the spotlight, ECLS Coordinators are the quiet force that keeps programs and people moving forward. Their work is complex, emotionally taxing, and essential. And while it can often feel like a thankless job, it remains one of the most rewarding roles in healthcare today.

Wearing Many Hats, Every Day.

An ECLS Coordinator can be many things at once:

• The Educator who designs and delivers comprehensive education to units and teams, ensuring every clinician at the bedside is competent, confident, and prepared.
• The Positive Pusher who uplifts and encourages the team during long, high-stakes cases.
• The Researcher who collects data, leads quality improvement efforts, writes abstracts and manuscripts, and ensures the program advances with evidence-based practice.
• The Listener who provides emotional support for overwhelmed staff during challenging cases.
• The Organizer who oversees equipment, staffing matrices, protocol revisions, audits, and readiness for site surveys.
• The Advocate who collaborates with leadership and multidisciplinary teams to secure needed resources and promote best practices.

They also possibly take on the heavy lift of drafting and submitting Center of Excellence applications, a process requiring rigorous attention to clinical metrics, outcomes, and operational quality. These achievements are often celebrated publicly, yet the foundational work is frequently led quietly and skillfully by the Coordinator.

Despite their many roles, Coordinators are still sometimes met with the question:
“What exactly do they do?”

The truth? They do everything that keeps an ECLS program functioning safely, efficiently, and progressively.

Who They Are: Multidisciplinary Experts.

ECLS Coordinators come from a variety of clinical backgrounds:

• Registered Nurses (RNs)
• Respiratory Therapists (RTs)
• Perfusionists (CCPs)

Each brings a unique and valuable perspective to the role. What unites them is a deep passion for patient care, system-level thinking, and collaborative leadership.

However, in some settings, team members, including operating room-based Perfusion staff or upper-level leadership, may not always have full visibility into the scope and complexity of the Coordinator role. This can lead to misunderstandings about the Coordinator’s responsibilities or value to the program.

Often, what isn’t seen are the late-night phone calls, the weekend education builds, or the pre-dawn simulations that the Coordinator led to prepare the team. What looks like a coordinator leaving early might be someone who’s been actively supporting the team from behind the scenes all night and will be again after hours.

Always On: The 24/7 Reality.

ECLS Coordinators are effectively on call 24/7. They are the central point of contact for questions, support, and escalation from specialists, perfusionists, fellows, nurses, RTs, physicians, and more. Whether it’s a question about circuit management, documentation, cannulation planning, or education gaps… the Coordinator is there.

While it may seem enviable to see a Coordinator leave mid-afternoon, it’s often because they’ve been fielding urgent messages well before sunrise or are preparing for a full evening of follow-up and program work. Their schedule doesn’t always follow traditional hours because the role demands flexibility, responsiveness, and stamina.

Their work doesn’t stop when they leave the building. It just continues differently.

The Challenges Few See.

ECLS Coordinators face a wide range of ongoing challenges that often go unnoticed by those outside the role. Their schedules are frequently unpredictable, as clinical and administrative demands extend well beyond standard working hours. Emotionally, they are deeply immersed in high-stakes care and often serve as anchors for teams navigating stress, uncertainty, and grief. Much of their work is invisible, from policy development and compliance tracking to simulation coordination and audit preparation, yet each task is critical to a program’s success.

Despite their expertise, even well-meaning colleagues may not fully grasp the complexity and breadth of the Coordinator role, leading to frequent role clarification and occasional misinterpretation of their efforts. Coordinators also shoulder the responsibility of continuous advocacy, championing patient safety, supporting team education, and pushing for sustainable staffing practices. As cross-functional leaders, they are regularly pulled in multiple directions, balancing clinical realities with administrative expectations, all while striving to ensure the program runs safely and smoothly.

The Connector at the Center.

An ECLS program doesn’t function in silos, it requires seamless collaboration across disciplines. At the center of this coordination stands the ECLS Coordinator, who is not observing from a distance but actively guiding, supporting, and aligning every part of the system.

They understand the perspectives and pressures of each discipline they work with, from bedside nurses and RTs to Perfusionists and physicians. Coordinators are translators between roles, advocates for shared goals, and champions of communication. They don’t just enable teamwork, they embody it.

Often, it is the Coordinator who quietly prevents miscommunication, catches small details before they become big problems, and brings the team back to center during critical moments. Their leadership is relational, not positional, and their ability to unify people behind a common mission is what ultimately drives patient success.

The Voice That Deserves to Be Heard.

As leaders and educators, ECLS Coordinators should also be more visible in professional spaces, including conferences and research presentations. Too often, the story of a program is told by a fellow fulfilling an academic requirement, while the individual who built the education, submitted the quality metrics, and sustained the team day in and day out remains unseen.

That perspective, the one that livens the program every day, matters. Coordinators bring not only technical insight but lived experience, cross-disciplinary knowledge, and a pulse on what makes ECLS work at the ground level. Let’s make room for those voices.

Why They Stay.

Despite all of this… the long hours, the unseen efforts, the misunderstood role, they stay.

They stay because they care.

They stay because they believe in the people they support.

They stay because they know patients’ lives depend on every piece of the system functioning at its best.

It is the Coordinator who may not always hear “thank you”, who continues to show up, lead quietly, and give their all. They do it for their team. They do it for the strength of the program. And most of all, they do it for the patients.

Though not always visible, ECLS Coordinators are the pulse that keeps the program and the team functioning, connected, and constantly evolving.

A Final Word of Thanks.

As ECLS programs continue to evolve, grow, and innovate, let us not overlook the people who hold it all together. The ones who teach, support, manage, encourage, and rebuild behind the scenes.

To every ECLS Coordinator:
You are the silent strength, the advocate, the educator, and the constant behind the chaos. You may not always hear “thank you,” but your impact is felt every single day – in every life saved, in every team supported, and in every standard you helped elevate.