Let's call it "organ support," not life support

[nurseprnRN]

This is an idea that originated in a legal nursing group discussion about the brain-dead teen at Children's in Oakland. While I completely understand the family's pain and that a lot of it is due to misunderstandings (e.g., the mother is reported to have said, "She's not dead, her heart is still beating and she breathes,"), I think the language we use in these situations contributes to this, and would like to spread the idea that better language would be more descriptive.

What would it be like if the health care people involved in this didn't say that a brain-dead person was on "life support," but instead called it "organ support"? In these cases, the life is over.

[Ruas61, BSN, RN]

I agree with you on this one - the body is still human. Even remains unearthed are called "human remains".

Does not change the fact that it is a dead body. But I also would not feel right calling her a cadaver... Just out of respect.

But she is not on Life support, she's not alive.

Sent from my iPhone using allnurses.com

I am not arguing about the dead or alive part.

But dead on any level it was still a person's shell.

That should be afforded some dignity and respect as people and professionals.

I am just saying calling someone's loved one a cadaver or speaking about 'maintaining a cadaver' to s/he's face or where there can hear you is in poor taste.

[LadyFree28, BSN, LPN, RN]

Those are the reasons I vote for mechanical support over organ support. Organ support makes it sound as though the facility just wants the organs.

To me, mechanical support sounds like a machine, not human.

[Esme12, ASN, BSN, RN]

To me, mechanical support sounds like a machine, not human.

The vent isn't human....It is a machine supporting the human organs.

[edmia, BSN, RN]

I am not arguing about the dead or alive part.

But dead on any level it was still a person's shell.

That should be afforded some dignity and respect as people and professionals.

I am just saying calling someone's loved one a cadaver or speaking about 'maintaining a cadaver' to s/he's face or where there can hear you is in poor taste.

Yup. We completely agree.

[LadyFree28, BSN, LPN, RN]

The vent isn't human....It is a machine supporting the human organs.

I know that, lol...vent aficionado here.

Maybe it's me, but organ support, is just what it is; it keeps the human body supported; the skin is an organ, so it keeps the skin from becoming an ashen gray, for example.

Just picking a skin color....I'm sure another skin color can be more exact, but it was the first I could think of.

My point is organ support is more direct...it is used regardless of whether organ donation is going to occur or not.

Mechanical, if I was a lay person, would depersonalize it for me; I'm trying to think in terms of a lay person; if that came out of my mouth, I can see family members saying "mechanical support-like a robot?!?!"

I feel I can rationale organ support better than mechanical support, I guess...not saying these terms will come I to vogue-but who knows?

[Esme12, ASN, BSN, RN]

I know that, lol. To me, organ sounds more direct; mechanical soud like circumventing the obvious.

I wish there were ways around this stuff but there just isn't.....we as nurses have the hardest jobs....the doc listens until they are done and move on. It the nurses at the bedside that are the true caregivers....we deal with the family on moment to moment questions, information and changes.

Sometimes our jobs just suck

[TopazLover, BSN, RN]

Mechanical support is what family members see. When they are told it is a temporary measure to mechanically support breathing, and they see a machine, it sinks in. Having dealt with my family members who are not medical in any sense of the word, they understood the explanation. When ventilation is explained to family as life support, it really means without ventilation there is no life. Most people anticipate some form of recovery when they see a vent. Unless you are a nurse, then you may see it as the kiss of death.

When initiated would you call it organ support, if the expectation was recovery? As a lay person it would be easy to confuse, and they will ask which organ.

I pray I never have to deal with this again in my life time. If I do I do not wish to hear organ support. I don't want my loved one to be considered cadaver, and I do want them respected in every way. Modesty needs to be maintained. Appropriate conversation at the bedside, etc.

Being on the other side of the blanket, as it were, being the family member, I saw these things. While they were minor in the whole situation, I knew my loved one would be mortified to have people see him striped naked. Care is needed, and that includes caring about the person who did inhabit that body.

[SL2014]

It's amazing how changing a word can change the way people see things. I agree with whoever said "mechanical support" that is a good term too. Organ support certainly does get the point across also.

[LadyFree28, BSN, LPN, RN]

Mechanical support is what family members see. When they are told it is a temporary measure to mechanically support breathing and they see a machine, it sinks in. Having dealt with my family members who are not medical in any sense of the word, they understood the explanation. When ventilation is explained to family as life support, it really means without ventilation there is no life. Most people anticipate some form of recovery when they see a vent. Unless you are a nurse, then you may see it as the kiss of death. When initiated would you call it organ support, if the expectation was recovery? [/quote']

Yes...because I have worked with patients who are "vent dependent"; in particular, SCI patients, many who have very full lives with the technology that has helped them continue to maintain life.

I have also worked with patients who were "wait and see cases", and the inevitable as well.

As a lay person it would be easy to confuse, and they will ask which organ.

As I stated in my rationale, I could explain how the vent takes care of all the organs and how; I've given the rationale for many years; I am more comfortable with "organ support"

[Spidey's mom, ADN, BSN, RN]

Yes but . . . we are trying to find terminology that laypeople, the public, would hear.

There is a huge disagreement with organ donation in this country. Any time you simply use "organ support" with the public, you should prepare yourself for the feedback. Let's be kind to the public.

aky - I appreciate your point of view.

[LadyFree28, BSN, LPN, RN]

Yes but . . . we are trying to find terminology that laypeople the public, would hear. There is a huge disagreement with organ donation in this country. Any time you simply use "organ support" with the public, you should prepare yourself for the feedback. [/quote']

See, that's the issue...I explain what a vent does to lay people; I have done so for eight years. Explaining that your organs are benefiting from the vent is not difficult; it has helped understand the human body, it's complexities in times of health and fragility.

Let's be kind to the public. .

Um, who says we are not when explaining organ or mechanical support???

"Life support", IMHO, has not been "kind" to families either.

Being "kind" is helping laypeople understand health and the human body more. It is very empowering, as nurses to give them support and education during a difficult process...it helps give them rationale; I have also seen families go through the process of grieving in a more healthy way, ask for support, as well as become more informed and open about many options.

As I stated before, there are people who are "vent dependent" that have full lives in communities; the biggest challenge AND reward is explaining to a family when their family member, when indicated, can live with one. I have had the experience and ability to do his.

Sometimes its seems nursing needs to be kind enough to enlighten people for the betterment of their patients and family, not be hesitant to do so.

Vent doesn't always equal "death" in nursing, we need to be more mindful of that as well.

[la_chica_suerte85, BSN, RN]

I think using the term "organ" does reduce the person to individual organs being supported and would be confusing to family, too. I do like mechanical support as it directs the focus to the machines involved in maintaining respiration and also implies that anything about the patient's situation is not natural. I think in the case of Jahi McMath, there is a lot of confluence with the family and their lawyer (who does not seem to be helping the situation one bit) along with severe guilt on the part of the mother. I mean, her statement that (to paraphrase) Jahi is still breathing and her body is still warm so she cannot possibly be dead shows that she is either refusing to understand her daughter's situation or really is not of the mindset to comprehend it.

I think life support may imply, for some, the possibility of the patient reviving on their own but there are some factors in play in this situation that are some serious obstacles to a rational conclusion. Perhaps when this happens under more "normal" circumstances (i.e. not as an outcome of a "routine" tonsilectomy) families are more prepared to accept brain death as a final state and that their family member's natural death is being impeded by a machine. I think if I were told that my family member was being maintained by "organ support" that sounds like some organs are functioning fine on their own so why not wait until the damaged organs heal and begin function as part of the system. Organ support denies that, even on a ventilator, the body continues to function as a system (hence, Jahi continuing to breathe and metabolism resulting in her body remaining warm). I think mechanical support really drives the point home that the patient is maintained by "unnatural" means that will NOT improve their condition and that withdrawing this support would lead to natural death that would otherwise occur.

Maybe, too, people could be encouraged to volunteer with in hospital settings where they may come into contact more with death and people dying and see it from a perspective not skewed by their emotional attachment to the patient. The culture's propensity to avoid the realities of death and dying really needs to change and exposure and personal experience are good places to start.