Depression amoung OR nurses after organ harvesting

akor · Feb 28, 2005

I am not finding any information on depression amoung OR nurses who have assisted with organ harvesting. A few articles actually mention the existence of OR nurses finding the experience difficult to deal with, but I wonder if anyone has done a study or workup on the subject. I am an OR nurse and am attempting to do a CE on the circulators duties in the organ harvesting process. My CE will be targeted at OR nurses and so I thought the objective of the effect the process has on the OR nurse would be interesting. Maybe this is a topic for someone to do a paper on. If you know of any article, study, or someplace where one can be found, could you post it? Otherwise, anyone out there assisted with organ procurement and found it depressing.
Thanks, Kathy

Hi Kathy, I am recently back to O.R. nursing after 11 years of being out of nursing. I worked in N.Y. for five years and only have done kidney transplants. It is a good feeling helping the kidney receiver. Yet, now I am working in Italy in one of the major hospitals where organ procurement is done. I was recently at an inservice because all the nurses were up in arms for the organ procurement that most of the times happens at night and they are called in. It is an interesting question about depression. I don't know but it would be an interesting study. One time a nurse had to scrub on an organ procurement of a girl that she used to baby sit....that is depressing . The doctor who gave us the inservice had us try to focus on the hope for the other person who is to receive the organ....

I have only been working for 6 months now and am not on call yet but when I do have to work on an organ procurement....I will be sure to let you know my feelings.

Alyce

redding6 · Mar 1, 2005

Thanks Alyce for replying, I am really surprised no one has done a study on the topic for their masters degree, or some other reason. AORN for OR nurses has touched on the topic in their article in 1999, but really, no one has done a study. Oh well, I would say I look forward to your input except that would mean you had to do an organ harvesting procedure and it may mean you in fact are finding yourself depressed about it. So, maybe I don't want that to happen after all! Thanks either way. Kathy

Hi Kathy, I am recently back to O.R. nursing after 11 years of being out of nursing. I worked in N.Y. for five years and only have done kidney transplants. It is a good feeling helping the kidney receiver. Yet, now I am working in Italy in one of the major hospitals where organ procurement is done. I was recently at an inservice because all the nurses were up in arms for the organ procurement that most of the times happens at night and they are called in. It is an interesting question about depression. I don't know but it would be an interesting study. One time a nurse had to scrub on an organ procurement of a girl that she used to baby sit....that is depressing . The doctor who gave us the inservice had us try to focus on the hope for the other person who is to receive the organ....
I have only been working for 6 months now and am not on call yet but when I do have to work on an organ procurement....I will be sure to let you know my feelings.
Alyce

akor · Mar 1, 2005

It will be a few more months before I go on call but I will let you know what I experience....don't think I will get depressed...think I will look at the other side of the coin....the way I usually look at things.....

smarkley · Mar 2, 2005

I recently worked in a large trauma center and I was able to go on donor runs...where I went and helped the surgeon harvest the organs. I have also participated in some at our hospital where I was the circulator in the situation. As far as harvesting the organs as a scrub, that part wasn't so depressing. The depressing part for me was after the procedure was over and we were cleaning the patient up. By that time all the chaos of the procurement is over and anesthesia has long since left the room. It is very quiet in the ORs and even if there are several staff members helping to clean everyone is pretty somber. Everyone seems to take that time to reflect and I know that some of the ppl I used to work with were angry at how they felt the patient was treated. It is kind of brutal, they don't take any care to make it "pretty". It's a very gruesome incision. I don't know if there are any more studies done on the topic. It is very rewarding, on a happier note, to know that the organs are saving a life. Our hospital does a lot of heart and lung transplants so we see more of the organs going in patients than being harvested. Most organs come from other hospitals.

redding6 · Mar 2, 2005

thanks for replying! I pictured myself in that room that you described. Very somber indeed. Reminded me of the Parkland ER (Dallas) when a trauma victim died. A lot of "could that be me". I haven't seen an organ harvest, but I have heard from those that have....very brutal, as you described. Thanks again. Kathy

I recently worked in a large trauma center and I was able to go on donor runs...where I went and helped the surgeon harvest the organs. I have also participated in some at our hospital where I was the circulator in the situation. As far as harvesting the organs as a scrub, that part wasn't so depressing. The depressing part for me was after the procedure was over and we were cleaning the patient up. By that time all the chaos of the procurement is over and anesthesia has long since left the room. It is very quiet in the ORs and even if there are several staff members helping to clean everyone is pretty somber. Everyone seems to take that time to reflect and I know that some of the ppl I used to work with were angry at how they felt the patient was treated. It is kind of brutal, they don't take any care to make it "pretty". It's a very gruesome incision. I don't know if there are any more studies done on the topic. It is very rewarding, on a happier note, to know that the organs are saving a life. Our hospital does a lot of heart and lung transplants so we see more of the organs going in patients than being harvested. Most organs come from other hospitals.

Peach10 · Mar 2, 2005

Hi, I'm a OR nurse from Singapore. :chuckle Over here in my facility, we do have multiple organ procurement but not often. This is my experience with organ procurement.

I remember scrubbing for one such procedure where almost every organ was donated even the skin. During the hours long procedure (it was in the late nights) due to the nature of the procedure I have no time to think until the very last part when the major organs are out and we were left to clean patient up wiht all the tubes still sticking out. Being physically tired out by the procedure, I began to think how much this one donor has helped save lifes. The heart, the liver, both kidneys, even cornea and skin were donated. It's an awesome feeling. I just felt sad for the family but didn't dwell in it. SO I didn't get into depression. Then again maybe it's because I didn't see the family members.

cwazycwissyRN, RN · Mar 3, 2005

Hi,

The first time I was a part of the harvest it was kinda tough. The thought of it was worse than the accual procedure of me. The organ donation team was very helpful. Waiting the approximate 6 hours....before the official start was a little overwelming. It takes about that long for the team to set up all the recipiants and run all of the tests involved. In the mean time a few hours before the case we start to set up the slushy........for the organs to go into. The donation team brings some people but we still suppy a scrub and circulator. They can bring as many surgeons as there are organs to retrive at times. I felt the surgeons were very good a keeping people focused on where the organs were going .........even during the case. It is extreamily overwelming when anesthesia shuts off their machine and walks out of the room.....before the case is over. It is soooo quiet. It is also overwelming at the end of the case since you do not take the patient to the recovery room...it is just so out of norm to deal with toe IDs and body bags in the OR. The donor team send out thank you letters to each team member that helps with the surgery. The letter tells a discription of each recipiant and how well they are doing. This helps give a sence of closure and appriciation to what we are able to do. I do believe it is key to keep in mind , that the person is already dead....when we take them into the OR. Some times that can play with ones head a little when there is the normal sounds of the heart beat ect. coming from the anesthesia machine. All in all I have found that keeping my eyes focused one the good this whole process can bring into so many different peoples lives.......well ....it makes me feel proud to be a part of the process.

Sorry so lengthy here....just hard to summerize this process of life and death.

rcsc · Mar 4, 2005

I too man developing a CE article regarding organ procurment, but depression, in my experience is only part of the picture. I did have some articles too, but they were not very helpful. I have participated in both harvesting and transplants, I can tell you that I have observed varied reactions. Good luck - I hope you get more responses - though I think they will be similar. Perhaps it is the kind of experience that raises lots of existential questions - confronting one's own mortality - questions about how we live life and how we are going to die someday. The same kind of questions come up when dealing with the subject of DNR.

daisee · Mar 7, 2005

Dear Kathy,

we do 'brain death' harvesting in the twilight zone of the wee small hours with surgeons who swoop in from their various specialties in different institutions in the nearby major city and depart clutching their booty (We are a major regional center on the main highway about two hours away) Besides the fact that harvesting takes up the emergency theatre, with the likelyhood of on call staff get dragged in - leaving holes in the following shifts - and you know you're entrusting precious organs to an ice bucket on a notorious freeway, I, as scrub RN, was 'priveleged' to witness the liver dr fighting with the cardiac drs over clamping times and seniorority, not unlike vultures fighting over carrion. Scissors were waved, voices were raised, people stormed out and back, all while I thought it probably inappropriate to call them to order, although if it happened again I probably would. All I did was report to my nurse manager, as did my scout, and we got debriefed by the transplant co ordinator strssing the wonderful nature of the gift of donation etc etc... After the bunfight departed (and continued elsewhere) I was left with the gutted carcass of someone's 30 year old daughter who had gone to sleep one night and never woken up (?cerebral bleed I recall). I've done harvesting previously prior to brain death legislation when the race was on to get the kidneys ASAP, and saw the skin incisions made as the ECG began to waver, I must have been younger and more resilient. I know I won't be leaving my body to the contemptuous ministrations of disrespectful and ungrateful people.

redding6 · Mar 12, 2005

Thanks to those who replied to my question about participating in an organ harvesting, very insightful responses you gave. I will use the responses in my CE (not verbatim, but generalized). The situation in the OR at the time of the harvesting process seems very much to be decisive on whether the nurse (and team) is left with a positive or negative impression. Thank you all again for your reply(s).

redding6

Pray · Mar 13, 2005

Thanks to those who replied to my question about participating in an organ harvesting, very insightful responses you gave. I will use the responses in my CE (not verbatim, but generalized). The situation in the OR at the time of the harvesting process seems very much to be decisive on whether the nurse (and team) is left with a positive or negative impression. Thank you all again for your reply(s).
redding6

years ago I helped harvest eyes for the corneas. This was actually done in the morgue, while another autopsy was going on. I was 23 at the time (now 41) and the experience at the time was not so terrible as the experience I had at home that night. The bodies were set up so that my patient (a dad of one of my friends) was at a T to the other body. In other words, behind my back, the autopsy patient was cross wise to me, and laid open pretty good. I was pregnant and had little to no room to move between the instruments and the ophthalmologist at the head of the bed. Anyway, that night I had HORRIBLE dreams about bodies cut up in my house-really wierd and frightening.