"You say you are doing your job but it feels like so much more..." An exploration of the Intensive Care Nurse and Organ Donation

Sharella Robinson¹, Fiona Cox¹

¹ICU, Alfred, Melbourne, Australia

“You say you are just doing you job but it feels like so much more”

The Intensive Care Nurse and Organ Donation

The Alfred Intensive Care Unit is a fast paced, dynamic unit. The nursing staff are remarkably adaptable, resilient and work under high levels of stress. When a life cannot be saved, the focus changes to end of life care. Organ and tissue donation offers loved ones the opportunity to salvage something positive from the tragedy of loss. The bedside nurse is crucial in supporting families though this process. It is highly complex and emotionally taxing, yet so rewarding and a privilege to be a part of. This study was inspired by the title of the abstract, a statement from the wife of a patient who became an organ donor.

The role of the bedside nurse in organ donation was explored though surveying ICU nurses. Consisting of 11 questions, the results provided insight into the perception ICU nurses have of donation and how confident they are in this role. The majority of respondents were Clinical Nurse Specialists (CNS) with 5-10 years of ICU experience. It was described as a “mostly positive” experience with 81% reporting being comfortable caring for this patient group. When given a list of words to describe the process, Brain Death (BD) donation was described as respectful, compassionate, rewarding and professional. Donation after Cardiac Death (DCD) was described as challenging, demanding and emotive. It was evident that the DCD process was more stressful and confronting. Three quarters of nurses surveyed felt confident in supporting families through this time, the main barriers noted as being “caught up in emotions” and “it’s the questions that throw me….. I feel as their nurse I should have all the answers” as well as a lack of rapport with family.

The survey demonstrated nursing staff develop a bond with their patients and loved ones that is unique to organ donation. It often becomes difficult to simply '''switch off’’ emotions. These patients often stay with us long after the shift is over. It’s a privilege to be a part of this process, hence why being involved with this special group of patients is more than just a job.