Trying to understand the death of an Organ Donor

scg08rn · Dec 11, 2009

1. Can you be a DNR and an organ donor?
2. Do you have to be on ventilaters and such equiptment?
3. Even though im in my mid twenties.. I feel now more then ever I should make a living will out.. Is that weird?
4. Am I over thinking this?

Hello.

First, I'd like to share 2 stories of organ donation with you.

- When I was in nursing school, during my O.R. rotation, a few of us stayed after clinicals to watch an "organ" harvest. The team came, set up, and harvested skin and a few bones. This was on an already deceased patient. It was awkward to watch, but very educational.

- The other story is recent, had to deal with my boyfriend's uncle. He recently had a stroke, he was immediatel intubated upon arrival to the hospital and the damage was already done and there was no way to "bring him back." His license had "organ donor" written on it-which his sons never knew about. The sons received the education regarding the organ donation process and was able to make the final decision if they wanted to donate his organs. They did. He was on a vent for a few days prior to becoming brain dead, and the surgery was done side by side.

As for being a DNR and donating organs, I think the family decides if nothing is indicated by the living will/drivers license.

I've never dealt with presenting that option for donating organs to my patients where I work.

http://www.organdonor.gov/

If you want to make a living will so your wishes are carried out, go do it.

Organ donating is something to think about, not over think about.

Dalzac, LPN, LVN, RN · Dec 11, 2009

Hello. So I want to start by saying when I renewed my license when I was 21, I marked the "check" to become an organ donor. I felt i was doing a positive thing.. and after all if its my time to go then so be it.. and i hope i can help someone along the way. Since then I havent honestly thought much about it.. never really learned about the procedure and such. Well, today in my Nursing Fundamentals course we had a guest speaker who works with families and teaches about organ donating.
I must say, I was floored.. unsure.. and kind of confused by the end of the class. I guess what Im mainly confused about is the process of organ donation.. the speaker kept saying.. how the best teaching is done when your in the actual process. Im wondering if anyone can steer me in the right direction of understanding...
1. Can you be a DNR and an organ donor?
2. Do you have to be on ventilaters and such equiptment?
3. Even though im in my mid twenties.. I feel now more then ever I should make a living will out.. Is that weird?
4. Am I over thinking this?
I realize that this conversation can be a heated one.. filled with ethical issues and such.. My intentions are to just seek answers & not push the issue of whether its "right, wrong, good, bad, or other wise to donate".
Thanks for reading.
1# you can be a DNR and an organ donor. But you need to get busy if he is an organ donor. Before patient is declared brain dead, the organ procurement team are called and they can go over the patients current condition to see if they meet the requirements to donate. If yes,someone will come in and take over all of the patient care. They are no longer your patient. They will always need help with this though. It is a very busy time and sometimes becomes a 2 to 1 ratio.
2# They are most always on a vent, and probably on many drips as well The procurment team looks at how long the patient has been on them. It has to be avery short time bcause your vital organs start losing their viability after a while.
3# Since I am an old ICU nurse I think everybody needs living wills and have easy access to them If you are going to be in the hospital bring it with you if you are admitted without it make sure your family knows tobring it you.Make the hospital staff know you have one or want one.
4# You are not overthinking it it is a subject that always needs a great deal of thought behind it. This process is one of the hardest things to talk about At the time it can be very emotional on everybody's part.
I have been on both ends of this> I have had to helpwith procurement and I have had to be the family that gets the organ. My husband has a donated liver He has had his liver for 11 years.

Home Health Columnist / Guide · Dec 11, 2009

united network for organ sharing has wonderful resources.

myths about organ & tissue donation

understanding donation

publications:

critical pathway for the organ donor -free

the critical pathway for the organ donor is a clinical blueprint designed to help critical care staff and procurement coordinators understand and follow the steps required for effective donor management of a patient after brain death.

organ donation guide for faith leaders and healthcare professionals cost $20.00

this 200 page resource contains descriptions on the referral and donation process, theological perspectives, cultural issues, ethical issues, dcd, additional resources and extensive appendices.

article: end-of-life decision making, organ donation, and critical care nurses

BluegrassRN · Dec 11, 2009

I work on a regular medical floor--none of our pts who die are on vents, etc. Most are DNRs. Most still qualify for eye donation.

In our hospital, every death must be reported to the regional transplant office within I think one hour of death. They then determine if the pt is a candidate. If they are, our designated requester talks to the family, and then we contact midwest transplant again.

I think everyone should have a living will. I made one before I birthed my second daughter, in part because I wanted one of my friends (who had also just had a baby) to breastfeed her in the event that I couldn't (as in, if I had to have surgery or if I were for some reason incapacitated after the birth). The doc said to have that wish respected in the hospital setting I would need a living will specifying that. So at the age of 25, I made a living will. Although the breastfeeding part doesn't apply any longer (as that was 12 years ago), the other aspects of the document do.

Lacie, BSN, RN · Dec 11, 2009

My husband was only 34 when he said he was going to bed early one night due to a headache. When I woke the next morning to get the kids off to school I found him nonresponsive and cheyne stokes. I knew soon as I heard the breathing! Long story short I did cpr, got him to Mercy in Pittsburgh where they said he had a brain stem aneurysm. Within a matter of hours of waking up for the morning my husband became an organ donor. He didnt have a living will therefore they asked us as the family of which we agreed. We had to wait 3 days for all the brain scans etc to prove brain death. He was on the vent and coded twice therefore couldnt use his heart. Everything else from his kidneys, corneas, skin, liver, bones, lungs were given to another in various states. Weeks later I recieved letters from CORE giving me the ages, state locations and the # of persons his donation helped. I was astounded at the number of over 100!! Muscles, bone etc. His mother even had the CORE put on his grave stone. The donations is what got myself, my 2 boys and his family through the loss. They even allowed me to walk all the way to the OR with him and spend that time until the very last minute. My 9year old son was never once asked to leave his dad's room in the ICU and in fact the staff encouraged and explained every tube and machine in the room. Picking him up and helping him to set in the bed and read to his dad for those 3 days. Too this day and that was 13 years ago I think of the staff at Mercy and am so very grateful to the way they treated my husband and my family with the utmost respect and dignity during our grief. We couldnt have survived it as well as we did without thier support!

Everyone should have a living will. You never know when and if something will happen. My husband was health, an ex marine and young. He wasnt invincible. We returned to Kentucky, his home state and had a huge celebration of life rather than a funeral. I encourange anyone and everyone to think ahead and consider organ donation. Its not just the receipants that are helped by it.

Neveranurseagain, RN · Dec 11, 2009

Five years ago, my husband ended up coding due to a medical incident on what should have been a 20 min procedure. He was 47 years old, and our children were 9 and 10. I watched as he struggled to wake up, but by day 5, he was nonresponsive and had blown blown his pupils. He was not brain dead, as he was breathing 1 times a min. I knew what was in store for him if he was kept alive-pegged, bed ridden, nursing home, decubs and finally death from pnemonia as he had no gag reflex. By keeping him alive, I was only prolonging death, and his organs would probably be nonviable. I did the kindest thing I could do, and asked that the vent be dc'd. He was a healthy man, and by donating his organs, they would bring a chance for life to other people. My husband was kept alive on the vent for 24 hours while organ donation teams were assembled from across the country. He had not signed up to be an organ donor. It was up to me to decide, and I did what I knew he would have wanted done.He became the first DCD (Donor after Cardiac Death) in our county. Five years later, everyone that received his tissue and organs are doing well.

It was the hardest decision to make, taking him off life support, but it was the kindest. I hope if I end up under these conditions, that someone will be as kind to me. Organ donation is such a difficult subject to discuss and understand for families, as it is presented in times of crisis. Personally, I think everyone should automatically be considered an organ donor, with the option to sign up to opt out, rather than opt in, for organ donation. It would not only increase the availability of organs, but help America confront and understand an issue that has been far removed from mainstream life. That issue is that we all die someday.

tewdles, RN · Dec 11, 2009

The vast majority of my experience with organ donation comes from my many years in the Peds ICU...so the donors were all very young, none older than 16yrs. Clearly, these patients did not have living wills or advanced directives and their families were devastated by the situations. It was surprising to me how many parents were able to listen to those discussions and make the decision to move forward with donation while in the midst of intense grief.

I was sitting in the ICU waiting area at the University of Michigan Mott Children's hospital...waiting for word on my daughter following her open heart surgery...she was 2 at the time. There was a family there, crazy excited but crying and upset too. Their 2 year old was getting prepped for a new heart! The family was literally celebrating their renewed hope while simultaneously grieving the loss of another child. The heart was coming from a 5 yr old struck by a car across the state...the donor was a patient in my PICU. I shared my experience with my staff (I was the nursing super of the unit) and I know that it touched them all in ways that they did not expect. Organ donation is a courageous choice.

debi49 · Dec 11, 2009

I just want to thank you for sharing the stories of your beloved husbands,awsmfun and lacie, and the selfless decision you made infavor of organ donation. :heartbeat

LilRedRN1973 · Dec 11, 2009

Lacie, I would like to thank you for your story. I lost my mother in August from a massive bleed (an aneurysm that most likely had been there for years). She was on a vent until family could get to the ICU to say their goodbyes (5 days). My mother wanted to be an organ donor but due to her history of an MI, high BP, high cholesterol, and years of smoking, she was disqualified for major organs. We did have her skin donated and designated it to help burn victims in the military returning from war. It's what she would have wanted. I've felt like I was the only who ever lost a loved one so early in life (she was in her mid-50's) even though as a former Neuro ICU RN, I know this to be untrue. Hearing your story of losing your husband brought tears to my eyes but also a sense of comfort. Thank you again for sharing.

Organ donation is a subject on which you will hear negatives and positives. It's a very personal decision and one that not all family members may agree on. One of the saddest but yet inspiring story was of a patient I had who suffered a devastating brain injury skiing. He was 19, never smoked, drank, etc. and was in excellent health. He had 6 brothers and sisters and the family was an extremely tight knit group. Through organ donation, he was able to save lives and touch many more. Very sad for him and his family but wonderful for so many others. I have a colleague who left the ICU to work with an organ transplant organization and she loves it. It's not for everyone. I plan on donating whatever I can when it's my time as does my husband. I can put myself into the shoes of a person waiting on a transplant list or who has a loved one on that list...it must be a very scary and frustrating thing, waiting for an organ.

ukstudent · Dec 11, 2009

hello. so i want to start by saying when i renewed my license when i was 21, i marked the "check" to become an organ donor. i felt i was doing a positive thing.. and after all if its my time to go then so be it.. and i hope i can help someone along the way. since then i havent honestly thought much about it.. never really learned about the procedure and such. well, today in my nursing fundamentals course we had a guest speaker who works with families and teaches about organ donating.
i must say, i was floored.. unsure.. and kind of confused by the end of the class. i guess what im mainly confused about is the process of organ donation.. the speaker kept saying.. how the best teaching is done when your in the actual process. im wondering if anyone can steer me in the right direction of understanding...
1. can you be a dnr and an organ donor?
yes and no. there is a difference between being an organ donor (heart, lungs, liver, kidney's etc) and being a tissue donor (skin, bone, cornea's). dnr's are recinded during surgery and unless you have a legal document on you, will be intubated if found down at home, street, work etc.
2. do you have to be on ventilaters and such equiptment?
you have to be on a vent to donate organs, but do not need to be to donate tissue.
3. even though im in my mid twenties.. i feel now more then ever i should make a living will out.. is that weird?
living wills are great at any age. please let your family know your wishes, they not you will be the ones to make the final decision on whether you get to be a donor.
4. am i over thinking this?
no, think about it and talk about it. it is nothing like it is shown on tv.
i realize that this conversation can be a heated one.. filled with ethical issues and such.. my intentions are to just seek answers & not push the issue of whether its "right, wrong, good, bad, or other wise to donate".
thanks for reading.
good luck with an decision you make.

missingunc · Dec 12, 2009

Thank you to everyone who took the time to read my post.. share their personal stories.. and give any input or advice. It means a lot to me and you all have helped clear up my confusion.