DONATION BEST PRACTICES: Q&A – Advice from the Frontline, Three Area Hospitals
Your hospital is ready: staff has been trained and policies are in place. It is always best practice for hospitals, big or small, to be prepared in the event that a patient they are caring for could become an organ donor and help to save others through the gift of life.
Equipping hospitals and staff with the tools and knowledge on organ donation is an on-going service provided by Finger Lakes Donor Recovery Network. While taking these steps is effective, nothing compares to hands-on experience, especially if your hospital does not see many donation cases.
Staff from Unity Hospital, Geneva General Hospital and Thompson Health share their experiences and advice with colleagues around the region to prepare them for what to expect when taking part in an organ recovery.
Based on your role, what part of organ donation was the easiest to manage?
Cindy Ross, ICU Nurse Manager and Respiratory Therapy, Geneva General Hospital: “The easiest part was working with the (FLDRN) team. Many of us had not had that experience before and they provided constant support and guided us through the whole process.”
Josh Smith, Clinical Nurse Leader, Unity Hospital ICU: “The easiest parts of the process, I find, is the referral and discussion regarding the appropriateness of the patient with FLDRN staff.”
Yasmin Ayyub, RN, Unity Hospital ICU: “As a bedside nurse in the ICU we often are task oriented so managing of drips and labs is the easy part of the job.”
What do you find most difficult when working on donor cases?
Peg Hurst, Clinical Manager, Unity Hospital ICU: “The most difficult, overwhelmingly, is the emotional toll that this process takes – not only on the family but on the staff as well. A couple of our recent donors were very young with sudden onset illnesses, giving families little time to assimilate what was happening. A number of nursing and physician staff have kids or family members of similar ages and that makes it much harder as you project on to yourself what these folks are enduring.”
Josh Smith, Clinical Nurse Leader, Unity Hospital ICU: “It can be challenging to keep the Providers in tuned with what is occurring with the donation process in concurrence with actual clinical progression. For example, if the family wants to proceed with withdrawal of care.”
Cindy Ross, ICU Nurse Manager and Respiratory Therapy, Geneva General Hospital: “Helping the family and staff to understand she was (brain) dead was difficult. But once we were able to show them the flow study, they understood. After that, moving to recovery mode was also difficult because of allocating the staff and resources needed. It became ten times harder because we were medically managing the patient and optimizing organ function for several days.”
In one word, how would you describe your experience(s) with organ donation?
Peg Hurst, Clinical Manager, Unity Hospital ICU: “Powerful”
Josh Smith, Clinical Nurse Leader, Unity Hospital ICU: “Hopeful”
Yasmin Ayyub, RN, Unity Hospital ICU: “Humbling”
Cindy Ross, ICU Nurse Manager and Respiratory Therapy, Geneva General Hospital: “Sacred. It was a very spiritual kind of event for me because 28 years ago my own daughter died and became a donor. Who better to hold the hand of a mom than one that had experienced the same journey?”
What advice would you like to share with nurses, providers or hospital administrators about your experiences with organ donation?
Cindy Ross, ICU Nurse Manager and Respiratory Therapy, Geneva General Hospital: “Follow-through and closure is important. A few of us went to the funeral and (by doing so) not only were we then able to move through the process of healing, but we could see the family begin to move through it too.”
OR staff, Thompson Health: “Make sure you have your ducks in a row and manpower available, especially (if recovery takes place) after 3 p.m. or on the weekend. Have a plan and review it periodically.”
Peg Hurst, Clinical Manager, Unity Hospital ICU: “I see many of the nurses on their first recovery case become extremely involved – staying overtime, coming in on days off, and ‘over-identifying’ with families. My best piece of advice would be to never abandon that part of themselves that makes them react that way. Part two of that advice is to take care of yourself and try to let it go when you leave. Part three is to remember that, while the (brain dead) patient you are caring for is legally dead, the (transplant) recipient is every bit as much your patient, though you have never met.”
Yasmin Ayyub, RN, Unity Hospital ICU: “The best advice I can give is to keep asking questions. There is so much to learn and the FLDRN staff does a fantastic job of walking you through the process and answering questions.”
Is there anything else you’d like to share with your counterparts at other hospitals?
Yasmin Ayyub, RN, Unity Hospital ICU: “I can honestly say that prior to this experience I probably would not have considered being an organ donor due to my cultural and religious background. Having gone through the experience from having the patient being declared brain dead though to the OR (organ recovery) experience, my outlook has completely changed. I have a new appreciation for donation after seeing the OR process and the level of respect and teamwork that was exhibited. This experience was a journey that touched on a variety of emotions (and was) exhausting at times. In the end, her gift of donation saved three lives.”
Peg Hurst, Clinical Manager, Unity Hospital ICU: “I have found these (donation) cases to be some of the most memorable of my very long career. To know that you have not only helped the patient and family in front of you but also a whole host of people whom you will never meet is extremely powerful.”
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