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.
Specializes in OR, Nursing Professional Development.
My understanding is, if a family said no, no means no. I think autonomy is very important when caring for patient's and their family. But, again, in the end the greater good comes into play, like someone else mentioned, feelings v. lives, and then, you'll find your answer.
But, bringing in someone else to ask the question, again, does make it questionable to say the least. I see it as, hoping that no changes to a yes, whether it being being more informed. And, that's grey area.
But why is the nurse or any other provider in the care team discussing organ donation with the patient's family? That is not their role and why the third party exists- to provide that separation from medical team and OPO.
Who cares about someone's feelings when LIVES are on the line? The pursuit of organ donation should be aggressive and persistent. We owe that much to those who are dying and to the families to know what their feelings may cost.
Organ donation is serious and should be treated as such, their tears will dry but dead is forever. Maybe their loved one's death will mean that others may live.
Feelings v. Life
Wow. They ought to use your words for endorsement. The line would be out the door.
But why is the nurse or any other provider in the care team discussing organ donation with the patient's family? That is not their role and why the third party exists- to provide that separation from medical team and OPO.
Hi Rose_Queen.
When we admit hospice patients, nursing and/or social work does ask these questions. Do you have a DNR? Have you filled out an Advanced Healthcare Directives? Have you designated a person to make your healthcare decisions should you become unable to do so? Are you an organ donor? Etc.
I'm reminded of a college age patient I had with irrecoverable anoxic brain injury. The patients mother, understandably in shock initially, said she didn't want his organs donated, which based on the arguments given here should have stopped any continuing assessment of donation, which would have been a huge failure on our part to advocate for and protect the patient's wishes, which is our primary ethical responsibility. A friend of the approached us to make sure we were aware he wanted to be a donor, and even supplied us with a paper the patient wrote how important that would be to him to have that chance to help others after having a relative who received a donor heart. Had we just gone with what the mother wanted we would have completely failed our ethical obligations to the patient, which comes first.
Specializes in OR, Nursing Professional Development.
Hi Rose_Queen.
When we admit hospice patients, nursing and/or social work does ask these questions. Do you have a DNR? Have you filled out an Advanced Healthcare Directives? Have you designated a person to make your healthcare decisions should you become unable to do so? Are you an organ donor? Etc.
But asking the patient those questions before it gets to the point of time to actually procure the organs is a whole different ball park than the healthcare team caring for a patient who is declared brain dead approaching the family about organ donation.
But asking the patient those questions before it gets to the point of time to actually procure the organs is a whole different ball park than the healthcare team caring for a patient who is declared brain dead approaching the family about organ donation.
True. Which is what we are going to focus on more for hospice patients admitted to SNF due to what happened last week.
(I was distracted in writing the above by having to drive Spidey to football practice - I meant to say we talked to the patient and the family about those things).
But why is the nurse or any other provider in the care team discussing organ donation with the patient's family? That is not their role and why the third party exists- to provide that separation from medical team and OPO.
When did I say I discussed organ donation with the family? You're arguing a point that wasn't made. Furthermore, no matter what, we are obligated to call organ procurement even if the family does say no or the patient does say no. Again, another grey area.
When did I say I discussed organ donation with the family? You're arguing a point that wasn't made. Furthermore, no matter what, we are obligated to call organ procurement even if the family does say no or the patient does say no. Again, another grey area.
Agreed - we have to call Donor Network regardless of Advanced Directives or a will or any statement the patient does not want to donate.
What I'm trying to say is, it's OK to question policies and procedures. Just don't do it within earshot of families who are watching a loved one who is actively dying. Your attitude toward organ donation may be the difference between a selfless, lifesaving decision or the death of, not just one, but multiple, patients.
I never debated organ procurement at work or discussed it with patients or their family members. I never once mentioned on this site I that I ever did. Why are you telling me something that I already don't do??
What I'm trying to say is maybe you should read what I'm saying before advising me.
I am CA ICU/Trauma nurse and I have to admit...I am extremely confused by your post.
First of all, when a patient meet a certain criteria, the hospital is required BY LAW to notify the organ procurement organization (it is not a hospital mandated policy). Second , the organ procurement organization ONLY approach family when the decision is made to withdrawal care, declared brain death, DNR status, or if the patient has an extremely poor prognosis. Nobody else is allowed to approach the topic (it is the law) .
I have been an ICU nurse for 16 years and I had never witness what you are referring to as a "sale pitch" or pushy behavior by the organ procurement coordinators. When the family is approached, it is usually done in a private setting (never at the bedside); once a family decline, that is the end of it...I am not sure what you are referring by "several meetings" (The only situation I can think of is when there is disagreement within the family).
Lastly, what do you mean by "3rd party companies" running organ donation?
In So. California, One Legacy, Golden State, Donor Network, and Lifesharing are the onlystaterun organ procurement agencies...there is no such a thing as "3rd party or private companies".
It seems to me like you had some bad experiences with the process. However,
I strongly encourage you to reach out to your hospital educator regarding this topic and do your own research about these organizations because as an ICU nurse managing this particular population, there is a knowledge gap.
I'm talking about when the family says no, these meetings are held. I'm only speaking of those family's that have already said no and the organization cannot take no for an answer.
I'm not misinformed. That remark is equivalent to me saying your misinformed. Does contribute anything, it's like a child's remark.
I live in a state where it's companies not state that run organ donations.
I think that asking a parent who has already said no twice "don't you want a piece of your daughter to live on in others ?" Is just beyond. I have also heard "why are you doing so much for an organ donor?" in the ER. After seeing an organ harvest there is nothing respectful about it. Being gutted into 6 coolers and getting a row of very crooked staples along your chest hardly qualifies. I understand that organs are wanted but preying on people losing a loved one is low. Perhaps that contributes to the high failure rate.
Rose_Queen, BSN, MSN, RN
6 Articles; 12,057 Posts
But why is the nurse or any other provider in the care team discussing organ donation with the patient's family? That is not their role and why the third party exists- to provide that separation from medical team and OPO.