Counseling teams boost organ donation rates
Program combines grief and information
Finding the right balance between obtaining consent for organ donations and respecting a family’s need to grieve is one of the great barriers to improving organ donation rates. But the University of Nebraska Medical Center in Omaha has instituted a bereave-ment counseling program that bridges that barrier and has boosted donation rates nearly 75%.
The program allows staff to walk the family through the dying process and provides a "bona fide mechanism for offering organ donation as an option to a grieving family," says Robert Duckworth, director of the hospital’s organ recovery service and a member of the bereavement team.
While the program is not a function of the organ procurement process, it provides a natural forum to discuss it. "A lot of this service is helping the family take the first step past the moment of death," says Gary Sproat, MDIV, BCC, a minister and coordinator of the four-year-old service.
Each death at the 500 plus-bed teaching hospital is attended by the bereavement team, and services include help with funeral arrangements, psychological counseling for family members particularly children and offering the family the options of autopsy and organ donation.
Other members of the bereavement team are full-time and on-call pastoral care staff, four nurse resource coordinators who also serve as evening and night nursing supervisors at the hospital, and members of the organ recovery staff.
Donation consent forms are part of a deceased-patient packet given to families. The form has these three options for a family member to choose from:
• I have been offered organ donation and consent.
• I have been offered organ donation and do not consent.
• I have been offered organ donation and cannot donate.
The hospital has seen a tremendous increase in its donations; five years ago less than one in 20 families on average consented to organ donation, says Duckworth. In 1996, 21 patients were declared brain dead, five patients did not meet the medical criteria for donation, and the families of 12 others consented to donation. In addition to an increase in organ donation, many families consent to donation of corneas and tissue, he says.
Duckworth adds that the key is educating the medical staff about possible organ donors. "For the first 20 years of transplantation, everyone thought of traumatic brain injury as the only cause of brain death. Now we are recognizing the potential for donation in brain death caused by intercranial bleeding, stroke, and even asthmatic attack," he explains.
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