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The need for change

Jackie Newby is Head of Referral and Offering at ODT where she is overseeing the change of the Duty Office into the ODT Hub. Here she writes about what the Hub is about and what it means for people.

I am now six weeks into my new role – and many people are asking me “what is the ODT Hub and what’s going to change for me and the service I provide?”. I can’t fully answer this yet as we are still discussing ideas, but I can share our objectives and I can share my personal reason for believing we need change.

Recently, I had a donor family withdraw their consent. The person’s wishes to donate were overruled, the family did not experience good bereavement care and three people remained on the waiting list.

In the four hours I was with this donor, I completed an assessment of their condition (through our Donor Path system); I took five new donor referrals; I coached two consultants on how to approach for donation as we had no Specialist Nurses - Organ Donation (SN-ODs) to attend; I offered organs; I spoke with a GP; and I organised a retrieval team.

I thought I had done a great job… but I couldn’t have been more wrong.

When I went to update the donor’s family on progress, I knew immediately that I had lost them. They were angry at the doctors, angry at the time donation takes, very angry at the reality of losing their loved one. By this stage, there was nothing I could say to placate them and they demanded immediate withdrawal of ventilation.

I had spent too much time away from this family; I trusted a very junior nurse to recognise a difficult situation; and I had missed the point where I could have stepped in and turned the situation around.

Our SN-ODs are fantastic – they are excellent communicators and they have the training to recognise and intervene in difficult situations, but they can only do this if they are not bogged down with administration – and this is exactly one of the objectives behind the Hub.

The ODT Hub wants to provide administration and support for every SN-OD, so they have the time and freedom to do the job that only they can do.

There will be many donors where SN-ODs don’t need extra time at the donor bedside, or there may be no donor family in the hospital to give extra contact time to – but there will also be many donors where you wish you didn’t have to spend hours on the phone.

As I said before, I can’t say for certain what will or will not be changing, but in order to achieve our objectives we do have to change.

Change isn’t so bad – we do it all the time, just think where you would be without it (I would still be the paper clagga’s ladda hadda – and I may be again if Sally Johnson reads this!).

Jacki Newby
Head of Referral and Offering at ODT