I've been a critical care nurse for 6 years, I'm employed at a Southern California hospital that mandates all nurses taking care of poor prognosis patients to report them to one organ donation company. If a nurse fails to comply or report it to that "none profit" organization, even if the family does not want to donate organs, we are written up. Essentially, we are forced to call them regardless and this organization sends a nurse to persuade the next of kin in their vulnerable state. I mean within hours of being declared brain dead.
If the deceased did not make their wishes known about organ donation, nurses should not force another third party to come in and try to sales pitch them. I asked one of the family's what they said, and they said all the good things that come from it, i.e. a tragedy. I think the organ donation organization plays on their vulnerability.
I've done research on this particular organ donation company and the CEO makes well above $500,000. I've seen invoices from other hospitals the amount of money that goes into harvesting an organ and clearly have been disenchanted by the thought of donation. Additionally, this organization threw a thank you party for our unit because we had 6 organ "harvesting" in a month.
I feel there are HIPAA violations of reporting something to a third party without the family's knowledge and mandating it by the hospital. Note, we do not get permission from the family to divulging information about the decease.
I'm in California as well and I work hospice. For our hospice patients in SNF, when they die, we have to call that 1-800 number. I've been doing it for years but recently it has gotten more difficult to deal with them. Even if you say the family has said no, they continue to ask you questions that take about 20 minutes to ascertain if the patient would be a candidate.
I had a patient die a couple of days ago. Uterine cancer with mets everywhere. She had a large open necrotic coccyx wound. When she died, I called her family and then started the paperwork as I called the Donor Network. I told the rep the family said no and again, had to answer all the questions. Very detailed, H&P, labs, X-rays, MRI, CT scans, etc.
The rep said the patient qualified for skin donation. I told her the family had already said no to donation - the legal rep of the family. I was told that another specially trained person would be calling back in an hour to talk with the family about donation and I should not talk to the family about the upcoming phone call or anything about donation.
I was appalled. So, OP . . . I totally get your point.
And I am in favor of donation.
But this new way to change people's minds reminds me of Mortuaries and how they prey on the grieving families in order to get them to purchase more expensive caskets.
"Predatory" and "unethical" indeed.
I'm still fuming about it . . .
I guess i don't understand what it so horrible that the actual organ network has to actually talk to the family and can't just "take your word for it"
I had to call the donor network when i was withdrawing care on a HIV, multi-system organ failure pt. I told them this and i KNEW she wouldn't be a candidate but they still had to look over her chart and not just take my word for it.
Specializes in Oncology; medical specialty website.
Is it not possible to grieve after a donation has been completed? I don't understand this "it's predatory to talk to people when they are grieving" argument. You can grieve your loved one at any time. Donating organs doesn't change that process.
Not everyone grieves the same way, and there are also cultural considerations that may need to be considered.
I've been a critical care nurse as well as an organ procurement nurse (organ donation) for nearly 12 years. There are certain federal guidelines as to who can approach a family regarding organ donation and how quickly after declaration of brain death this can be done.
As an organ procurement nurse we often have the reputation of "waiting in the wings" or being a "predator" for organs; this simply isn't true. Time is of the essence when REQUESTING a family's consent for organ donation. Once the brain dies the body quickly tries to follow. It is a balancing act to try and keep a body "alive" in order to procure their much needed organs. There are over 70,000 people on the list waiting for a chance at a life saving organ; of those, nearly 22 people per DAY will die waiting for their opportunity at receiving an organ(organdonor.gov). The organ procurement companies do not "get rich" from an organ donor. They are a non-profit company. It's illegal to sell organs for money.
Maybe you've had some bad experiences with organ donation, and I'm sorry if that's the case. The people who do this type of work are over worked and under paid. We do it for someone whose only opportunity at seeing tomorrow is the hope of receiving the gift of life.
I have always marked my driver's license as an organ donor, but I am now thinking I may change my mind. I do NOT want my organs sold on the black market (as is said can happen with for-profit procurement organizations in the first link of the articles.) I was always believing that my organs would go a person on the waiting list, not get sold to the "highest bidder."
It's illegal to sell organs. This doesn't happen. I've worked as an organ procurement nurse. Your organs go to the people who match your tissue type on the waiting list.
Read the article linked, "Abusing the gift of tissue donation" on page 7 of this thread, where the person from the Funeral Director's Alliance states that the for-profit trade in donated tissues is a legal gray area. Apparently donated organs (technically tissue) can be sold for profit, at least in some states. I am not in favor of this. Apparently it depends on whether the organ and tissue procurement person is for profit or non-profit. Apparently yours is a non-profit.
The OP brings a curious point to light in that communicating PHI to this third party organ-procurement organization (Univ. of Miami Tissue Bank or Lifelink here in my locale) there may be HIPAA violations.
If I am ordered to request medical records from another facility, a patient or their representative must sign a release of information form.
Why is this not true when I share information with these organ procurement-related third parties, as I have done so many times in the past? I have never once stopped to think that I am sharing PHI without the knowledge of the patient or their representative, but now it seems I have done so quite a few times.
The OP brings a curious point to light in that communicating PHI to this third party organ-procurement organization (Univ. of Miami Tissue Bank or Lifelink here in my locale) there may be HIPAA violations....
That is a really good point. It is probably addressed in the state or federal law pertaining to organ procurement organizations.
But, I don't know . . . I never even thought about that.
Specializes in Pedi; Geriatrics; office; Pedi home care..
I agree that HIPPA violations are being done.
Being written up for not reporting poor prognosis patients is violating (to me) the following :
1 - Family's right to choose;without being forced into making a choice at a time when they are under stress
(poor prognosis reporting = the organ procurement company can; and, probably does; send in a representative to talk to family and "convince" them to donate)
2 - It is a violation of your rights as a nurse for being ethical (HIPPA).
3 - Reporting poor prognosis patients is just plain wrong.
Most states have their own laws regarding this. If I was put in this position I would be reporting this to the state medical board; nurses union (if allowed in your state); and, any applicable agencies.
Sadly, I have personal experience with organ donation from the donor's side. My beautiful, precious 5-year-old son passed away six years ago in a drowning accident. We have nothing but good things to say about the wonderful, compassionate, empathetic people who worked for the donation organization. My family and I were in a horrible situation and trying to find some way not to allow our son's death to be in vain. Given the choice, we would never have put ourselves in such a position. That these people chose this as their life's work amazes me. I'm communicating all of this in order to qualify my next statement. The idea of a party for six "harvested" organs is outragous to me. ...............Can anyone else tell me if this is common?
((((dbabz)))) I wish I could give you a real hug. I am so very sorry for your loss...I truly cannot imagine losing a child.
The organ procurement organization that is a family regular presence on my unit (level 1 trauma SICU, so we get lots of non-survivable injuries) treats our donor patients and their families with the utmost care. We have a beautiful tribute mosaic honoring them in our hospital. They have a non-RN staff member whose sole job is to support the family, as the OPO RN is busy enough on the clinical side that s/he can't drop everything to provide emotional support. Once, at the mother's request, staff sang the 18-yr-old's babyhood lullaby as they brought him to the OR.
I want to say twice in my career, they have purchased food for the unit staff. It was in no way a party to celebrate the gift; it was a token of thanks for our work. A few months back we had some incredibly sick MICU patients on our unit (M=medical, if you're not familiar with unit abbreviations), and one of the critical medicine MDs brought us a big box of bagels and K-cups. Likewise, it wasn't a celebration of the sick people; it was a thank-you for caring for his patients.
Many of us are parents, and all of us have loved ones. We are very cognizant of what pain the family is in, and the strength it takes to think of another person in the midst of that pain.
Being written up for not reporting poor prognosis patients is violating (to me) the following :
1 - Family's right to choose;without being forced into making a choice at a time when they are under stress
(poor prognosis reporting = the organ procurement company can; and, probably does; send in a representative to talk to family and "convince" them to donate)
2 - It is a violation of your rights as a nurse for being ethical (HIPPA).
3 - Reporting poor prognosis patients is just plain wrong.
Most states have their own laws regarding this. If I was put in this position I would be reporting this to the state medical board; nurses union (if allowed in your state); and, any applicable agencies.
LOL.
I would advise you to read or at least familiarize yourself with HIPAA before proclaiming it is being violated. HIPAA is not the uber super patient privacy law that most people think it is, only certain entities are covered and there are many exceptions for covered entities to divulge information such as organ procurement entities.
Feelings v. Life That is what is at stake here.
It is not a perfect system but if feelings have to be hurt to save other lives then that is what has to be done.
NurseGirl525, ASN, RN
3,663 Posts
And we should, without name calling.