Role of Specialist Nurse
Role of Specialist Nurse
Specialist Nurses for Organ Donation (SN-ODs) have received detailed training in communication and family support, this means they are able to recognise and to avoid factors that inadvertently and unnecessarily lead to a family refusal. Involving the specialist nurse early in the process, for instance, when breaking bad news, gives time for a relationship between the family and SN-OD to develop and for these factors to be addressed.
Despite these advantages, the timing of SN-OD involvement can be considered contentious by some clinicians, not least because circumstances and clinical practices vary, particularly regarding the confirmation of death using neurological criteria and the timings of the two sets of tests. View more information about donation after brainstem death.
Nevertheless, NICE guidelines has recommended that a patient should be referred as a potential donor as soon as the intention to either withdraw life sustaining treatments or perform brain-stem death tests has been reached.
Professional guidance advocates that as a standard of care, SNODs should be involved in planning the family approach and the initial discussions that raise the possibility of organ donation as a part of end-of-life care.
There are three key stages to approaching the families of potential organ donors:
- Confirming a family have understood and accepted their loss (breaking bad news)
A senior clinician would be expected to lead the breaking bad news conversation before making the transition to the SN-OD, who will lead on the discussion about donation. Donation should not be raised until it is clear that a family have understood and accepted their loss. If this is not the case, the discussion in which donation is raised should be delayed. Donation should be presented in a way that emphasises it’s benefits and should never be described in a negative and apologetic fashion.
Evidence that a patient has previously given their own consent authorisation always be sought before approaching the family, they may have signed up to the NHS Organ Donor Register as an example. If such consent authorisation has been given this should substantially influence how donation is presented to a family.
Once consent authorisation has been obtained the SN-OD will coordinate the Organ Offering and Retrieval process in partnership with the Clinical Team caring for the patient and the family.