The role of the mechanical circulatory support (MCS) coordinator, also known as the ventricular assist device (VAD) coordinator, is a fluid position with changing roles and responsibilities based on the program and patient’s needs. Many programs will use nursing to fill these positions including Registered Nurses (RN) and Advanced Practice Registered Nurses (APRN). This role reaches into different areas of the healthcare setting, often requiring these Coordinators to be involved in the inpatient, outpatient, and procedural areas. As Coordinators, the job doesn’t stop there. MCS patients require an incredible amount of education and support, not just from the healthcare staff, but also from personal caregivers and members of the outside community. This may consist of emergency medical personnel, outpatient hemodialysis centers, group homes, skilled nursing facilities, and rehabilitation centers. All community members need continued education from the MCS coordinators to provide quality care to this patient population. Another integral part of the MCS coordinator role is to identify and prevent MCS-related adverse events. There are many complications associated with mechanical circulatory support devices, and the MCS coordinators play a key part in prevention and intervention. Adverse events may include driveline infections, gastrointestinal bleeding, stroke, equipment malfunction, device thrombus, and right heart failure. Depending on the MCS device, the risk of these complications may be increased or decreased. However, regardless of the device, effective patient education and early identification of signs and symptoms in all patient settings have been proven to extend the lifespan of patients in the MCS population. Mechanical circulatory support devices are utilized to prolong life and improve the quality of life. MCS is a treatment for advanced heart failure, not a cure making it even more important for close monitoring of the patients. End-of-life is unfortunately inevitable for the destination-therapy MCS patient. The MCS coordinators are heavily involved in this process and are expected to provide patient-centered care throughout all palliative and hospice processes. Due to the extensivity of the MCS coordinator role, burnout has become more prevalent, plaguing the ever-advancing discipline of MCS coordination.