Archive for the ‘Organ Donation’ Category

Organ Donation, comment

April 8, 2010

Organ donation at death is indeed a sensitive subject which, as the writer states, must be approached with sensitivity and empathy. When organs are donated, however, the transplant recipient receives hope and a chance at life. Many parts of the human body can be harvested, and while it used to be rare to care for a transplant recipient, it is now quite common in all areas of health care to receive patients who may have had a transplant either recently or years ago. Of course these patients must continue to take anti-rejection medications on a life long basis; therefore it is a must that the nurse be familiar with these medications. Cyclosporin is generally the drug of choice for the transplant recipient. It is used to prevent primary rejection and is usually taken in conjunction with prednisone, a glucocorticoid. When given in liquid form, it must be accurately measured with a calibrated pipette and can be mixed with milk or orange juice. Since this medication suppresses rejection, it also places the patient at a risk for infection in addition to the immunosuppresent effects of the glucocorticoid. The nurses must be watchful of signs of infection and organ rejection, and teach these to the patient as well. Cyclosporin is a nephrotoxic medication; BUN and serum creatinine must be monitored along with drug levels, which should be drawn just prior to the next dose. The nurse must know that elevated BUN and creatinine along with low cyclosporin levels might indicate organ rejection. We must know what medications increase or decrease its effects, since this can be life threatening. One important food interaction is grapefruit juice which may raise systemic cyclosporin levels dramatically. Finally, the nurse must practice aseptic technique in all invasive procedures and maintain a clean environment while reinforcing teaching to the patient and family about minimizing the risk for infection and rejection. The patient must become knowledgeable about all aspects of this medication and the care of their transplant.

Original Post
April 2, 2010
Title: Organ Donation
The question of organ donation at the time of death can be a difficult one for many people to answer, especially if the death was sudden and unexpected. A great deal of sensitivity is needed to effectively approach families with the subject. The manner in which this is conducted has the potential to leave either devastation in its wake or a very positive outcome for all involved. Having experienced this on a personal level made me acutely aware of the need for everyone involved in the process to possess excellent communication skills and empathy for the suffering of others. As a health care professional, I see firsthand the positive outcomes of organ donation. As a family member, hearing that voice on the other end of the phone asking what body parts were willing to be donated and for what purpose, was devastating. We need to create an environment and an atmosphere that supports organ donation and convey that to every survivor’s family with whom we interact. You never know when it might be you.

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Organ Donation

April 2, 2010

The question of organ donation at the time of death can be a difficult one for many people to answer, especially if the death was sudden and unexpected. A great deal of sensitivity is needed to effectively approach families with the subject. The manner in which this is conducted has the potential to leave either devastation in its wake or a very positive outcome for all involved. Having experienced this on a personal level made me acutely aware of the need for everyone involved in the process to possess excellent communication skills and empathy for the suffering of others. As a health care professional, I see firsthand the positive outcomes of organ donation. As a family member, hearing that voice on the other end of the phone asking what body parts were willing to be donated and for what purpose, was devastating. We need to create an environment and an atmosphere that supports organ donation and convey that to every survivor’s family with whom we interact. You never know when it might be you.

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Organ Donation

May 21, 2009

As a Critical Care RN, we see many cases in which the patient becomes “brain dead”, loses brain function and stops breathing.  Weather brain dead results from motor vehicle accident, assault, or an intracranial hemorrhage, when GCS drops below 5, we call One Legacy.  True, it is based on our true assessment of the patient’s neurological status that the call is made.   The concept of who is going to break the news to the family, the question of donating their loved ones organs has been a controversial issue for long.  Will it be the physician or the nurse who are in direct contact with the patient and family?  A loved ones death, and then being asked to donate his/her organs; the family will have to be very strong.  For us nurses, those incidents are challenging and very hard to overcome without upsetting the family. What happens if we make that call to One Legacy and have the professionals who are trained to be proficient at this area break the news to the family.  This way, we have completed our nursing assessment and duty to inform the people in-charge.  Once, One Legacy has spoken to the family, then as nurses we can continue the bedside care, explain to the family what to expect, and offer emotional support.  Taking responsibility to make the initial call is the key to a knowledgeable nurse’s care.

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Using the Internet to Assist in End of Life Decisions

April 27, 2009

After reading one previous posting it brought me back to a situation that had occurred about 4 years ago.  A close friend of mine died unexpectedly at the age of 35.  After her husband had been told that she was not going to make it he was faced with the very tough decision about organ donation. Unfortunately, he was so overwhelmed and emotional at the time that he denied organ donation.  Knowing my friend and how caring and giving she was I believe if she had the chance to make the decision she would have donated.

I believe that a short question on the back of a license is not enough for people to become organ donors.  Having detailed information available on the Internet gives much needed information about the process so people can make an educated decision prior to a crisis.  This also takes the burden off the family if individuals make the decision for them.  End of life is such an emotional time especially if it is unexpected; it is our duty as individuals to help our families by making the tough decisions about our own care for them.

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Organ Donation

March 30, 2009

I am both a OR nurse and an ICU nurse. When it comes to death and dying and making sure that pts are comfortable, it can quickly become a heated issue. At our hospital, we started participating in DCD cases a few years ago. Many of the anesthesiologists, and other staff members that work here were bothered by the DCD protocol. When these pts family members decide to donate their loved ones organs, the Gift of Life team begins orchestrating where these organs will go. When the time comes, the patient is extubated and we must wait until the patient is asystole. Then the organs may be harvested. Many times the family members are present when extubation occurs. I believe that there is no max to give a pt, I believe it is our duty to make sure that the family is at peace and believes that their loved one is pain free. Having watched a loved one be extubated and pass away, sometimes those first few breaths after extubation can seem strenuous, and painful, they gasp, and cough. Family members deserve to not see a family member suffer. Most of the time the family members are the ones that have made the final decision.

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