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 asking you, someone who doesn't know "my truth" to tell me the process. Immature, no, I'm asking you to prove your statement.
It's not "my truth" if it's a objective surgical procedure, repeated again and again, you know, like science. It' can't be "my truth" if it's not subjective.
I have actually, 1-2 million, quick google is very taxing. But, let's not digress.
Bringing in a third party after the family already made their wishes known regarding organ donation and during the grieving process seems predatory and unethical.
In California, the same license practice of being an organ donor is done. I was wondering about the people that didn't respond yes or no on their license.
I understand the role of the third party to show no impropriety. But, is it really ethical to persuade someone during the vulnerable state of grieving?
And, thank you for the good read. It was an intelligent and thoughtful reply.
@dangerous1: I understand how you feel. We had a similar policy when I worked in the ED, and it didn't sit well with me either. I remember watching a video where they showed the representative from the organ donation center approaching a grieving family shortly after they'd gotten the news about their loved one being brain dead. It was supposed to be a positive representation, but it really put me off.
I don't think you're unintelligent for questioning these procedures. Better to question than to blindly follow.
Wow, the timing of this thread is shocking!
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.
I'm asking you, someone who doesn't know "my truth" to tell me the process. Immature, no, I'm asking you to prove your statement.
.
Not my statement, but no problem. I saw surgeries and procurements, both more than I ever cared for. Both do not look good. Nobody told anyone, neither before surgery nor before procurement, that the sternum will be sawed through, ribs are broken and insides pulled out. But that's the nature of surgery. I once asked why most knees were done under minimal sedation, and most hips under much deeper sleep or general, while we have excellent regional techniques for both. The answer was to take me in to see a hip replacement done. When I heard THOSE sounds and saw pieces of bloody bone flying around, I got the message.
In fact, for procurements the skin was, in my opinion, stitched much more accurately since there was no more rush, no ICU sitting on the neck and no chances to have to get the poor guy opened all the way back in a few hours. In my opinion, the final result, if you like, is way more human and respectful after procurement.
And I do not even come to mention how many, many folks describe labor and delivery, for others' $$$. "Some cramps", "some pressure" and "the beautiful view" of crowning baby's head
You forgot to answer that post. Do you think questioning someone's intelligence during an argument isn't childish?
You were the one who stated that only one person was giving you an intelligent response. No one else said your argument wasn't intelligent. We just don't agree with you. And that's okay.
You were the one who stated that only one person was giving you an intelligent response. No one else said your argument wasn't intelligent. We just don't agree with you. And that's okay.
Well, a few of us think she has a pretty good point.
You were the one who stated that only one person was giving you an intelligent response. No one else said your argument wasn't intelligent. We just don't agree with you. And that's okay.
Do the ends justify the means? Persistently persuade one family to save a lot more. At what point should the grieving family's wishes be respected?
I never said my argument wasn't intelligent. People were passively questioning my intelligence throughout the thread. i.e. But surely you know that if you've been an ICU nurse for six years?" and "You were misinformed."
I'm not against organ donation just because I disagree with some practices. You completely assumed I was against it and never experienced it, personally. When organ donation hits close to home, maybe you'll change your opinion.†That statement there is ignorant. And, shows you're not okay with my opinion. And, that's okay.
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 . . .
Thank you for posting this. Apparently, a few people thought it doesn't happen. I really appreciate it.
"Thar be vultures afoot" is a normal feeling when the organ donation people are on site, although from a more rational point of view I don't find anything unethical about the overall process when the rules are followed, and there are comprehensive and strict rules that guide the process.
One important thing to remember is that it doesn't matter what the family of a patient wants, it's what the patient would have wanted that determines the most ethical course. When this is first brought up (which is only after the patient has been declared futile or the decision has been made to withdraw care) the immediate responses are usually in terms what the family members want, not what the patient wanted, which often requires recurrent discussions with those who knew the patient.
the practices in CA given by OP & a few others are pretty ridiculous, speaking to family despite staff reiterating family refuses, numerous meetings, etc. However, as reiterated close to the OP, time is very crucial and obviously, some families DO change their minds. Whether somewhat forcefully, or they just want to be rid of the donor folks & their harassment, if you will. The company has to wonder at what point the family has absolutely ZERO chance of being swayed. Just playing devils advocate here. And, the company/organization throwing a party for a particularly high-procurement month; I'm not sure I believe that as the rationale given that is so extreme. I think maybe we're only being presented your side/interpretation of the event.
To the procurement process being brutal and not nice, in my experience (granted, NO OR time, just observation in school, CABG when moving to cardiac ICU and now observing a dialysis graft inserted via video) the body is tough. Unfortunately, the body is a beautiful, strong & resilient 'machine' and in order to break it, even to fix it, is not a pretty process. I think if most non-medical folks knew how nasty procedures are, they would avoid any procedure unless life-threatening. I was just discussing C-sections with a friend recently & how brutal the team is with ripping the abdomen open & getting that baby out. It is not pretty, but it IS usually effective in the end.
Finally, as stated prior, ethics are not right or wrong. There is a huge grey area. It does seem as though the company/organization is not one with the best practices (in my opinion, given the examples presented here, if they are factual and accurate representations).
OP, you have responded quite defensively to some folks and especially being a new member, maybe it might be a better personal practice to take criticism/others' opinions with a grain of salt and let it roll off your shoulders? I think maybe if you had posted the other examples & details in your initial post some of the first replies may not have been as insulting, to your perspective. Without more data, your first post seemed to be based on more the subjective, than objective data.
It seems you came looking to argue & be condescending/rude to others who responded. This is an internet forum and you will find many opinions different from your own. And you've kindly thanked those who aren't presenting an opposing viewpoint. And either feed into or ask a million more ethical/unanswerable questions to those who raise questions of their own. I'm sure you'll come after me now, and that's quite ok. Just wanted to give my 2 cents.
Honestly, my first thought is you're a troll & LOVING the drama!!! (which I just fed into, oh well...)
I do hope you receive more thought-provoking & less 'passive-aggressive' replies.
It seems you came looking to argue & be condescending/rude to others who responded. This is an internet forum and you will find many opinions different from your own. And you've kindly thanked those who aren't presenting an opposing viewpoint. And either feed into or ask a million more ethical/unanswerable questions to those who raise questions of their own. I'm sure you'll come after me now, and that's quite ok. Just wanted to give my 2 cents.
Honestly, my first thought is you're a troll & LOVING the drama!!! (which I just fed into, oh well...)
I do hope you receive more thought-provoking & less 'passive-aggressive' replies.
Wow, I didn't interpret the OP's original post the same at all. Amazing how we all see things differently.
I was surprised by the timing of the post because I had a recent negative experience with the donor network here in California.
The OP has some good points and a scattered few posters have agreed that some of the donor networks' tactics are troubling.
And either feed into or ask a million more ethical/unanswerable questions to those who raise questions of their own. I'm sure you'll come after me now, and that's quite ok. Just wanted to give my 2 cents.
Honestly, my first thought is you're a troll & LOVING the drama!!! (which I just fed into, oh well...)
I do hope you receive more thought-provoking & less 'passive-aggressive' replies.
Although the beginning of your post, superficially playing both sides, I actually appreciated it, but the truth of purpose seems to be towards the end.
The closing was rather demeaning and rude. Calling someone "Troll" is rather provoking and is a perfect example of what you just criticize me about. I'm sure I never called anyone names, but, I'm glad you've resorted to that. It shows your true motive.
Like I mentioned before, I was never outright rude or demeaning to anyone, it's only after someone was rude/demeaning to me.
Although, I enjoyed reading you psycho-analyzing myself, let me make a correction to your false statement of ONLY thanking people who shared my views.
I've thanked 3 people. I suggest you read the first page. LOL!! I also thanked someone who held opposing opinion than mine and who was not rude. Even offered a link. Unfortunately, I couldn't read the link because I don't have a medscape account, but, why did I click it? Right?
I'm glad you left that out. Doesn't really fit your narrative, huh? LOL!!
I've mentioned this before, I wanted to know people's opinion, not on organ donation, but certain practices. But, people like arguing things that weren't really pertaining point.
But, I'll leave without psuedo impartiality, psycho analyzing, unsolicited advice, and calling names. I respect your opinion . Clearly.
Wow, I didn't interpret the OP's original post the same at all. Amazing how we all see things differently.
I was surprised by the timing of the post because I had a recent negative experience with the donor network here in California.
The OP has some good points and a scattered few posters have agreed that some of the donor networks' tactics are troubling.
Again, I am in favor of donation.
This is not about if organ donation is right or wrong, it's about the certain practices.
I've seen it. I didn't see all organ reps do it. But, the times I did see, I felt the family was being rushed.
I had a overdose young girl in her early 20's. I know, pristine organs for donating, right? And, she was, didn't require vasopressors, just brain dead and vent. Her parents lived over seas, 15 hour flight to come to California.
The parents came 3 days later after the event. The day the parents arrived, the organ donation people were already on them. I think they only talk to her 3 times, this time. Twice in conference and once at bedside.
The mom didn't even have a day with her daughter without organ procurement asking for them and taking her. I think she only had 4 hours before they assumed care.
As nurse's sometimes you can tell people's emotions, when we were getting her daughter ready to go to OR. I don't think the death settled in yet with the mom. She had a dazed look on her face.
I felt sorry the mom, I felt this time, when things didn't need to happen fast, they could've thought of the patient's family. No one seems to ever think of the the donor's family during the process of them agreeing to donate.
. Clearly.
dangerous1
50 Posts
I'm asking you, someone who doesn't know "my truth" to tell me the process. Immature, no, I'm asking you to prove your statement.
It's not "my truth" if it's a objective surgical procedure, repeated again and again, you know, like science. It' can't be "my truth" if it's not subjective.