Tuesday, July 2, 2013

Gift of Life: the new bullies in town

When a person has a very poor prognosis, but the condition of their body is still such that they have viable organs, we have an organization called Gift of Life who handles possible or prospective organ donation. We are required to call them when the death of a patient is imminent or on the horizon, or after a quick or unexpected death.

Yesterday, the Gift of Life team was sitting on my side of the unit, keeping track of a patient who was going to be an organ donor. They did a chart review on the patient we had whose brain had herniated, and whose husband would be withdrawing support from, and decided she was a potential donor. In the meantime, the resident approached the husband and asked if he would like an autopsy to be performed following her passing (this affects the way we do postmortem care, but I still prefer to ask the family AFTER their loved one has passed). He then asked the husband if his wife had ever expressed interest in being an organ donor, or did he think that was something she would have wanted. The husband said no, neither she nor he was interested in her becoming an organ donor.

I told Gift of Life that he was not interested, and the lady immediately got up on her high horse and made a grand speech about the policy in the hospital and state being that THEY (Gift of Life reps) are the only ones qualified to approach family members about organ donation. Ok, fine, the resident broke with policy. Whatever. Either way, the husband had been asked, and had no further questions, and was firm in his decision. As the patient's nurse and advocate, and therefore her husband's advocate, I did not wish for her to continue to pester him about organ donation. She insisted that she had to be the one to ask. Why? Is it not redundant? Are you not laying it on thick at this point? And yes, I did say that to her, in those words. I told her that it is my job to protect this family, and at this point asking about organ donation AGAIN becomes a form of pressure and intimidation and I DO NOT LIKE THAT.

You know what? She went in there anyway. And the poor man was very irritated with her (and us) because he had already very clearly stated his wishes. And she (and as far as he knew, we as a hospital) was coming across like a vulture circling the body of his not-yet-deceased wife in his hour of greatest pain.

I really, really did not like that.

She left the room with a red face, and the intern told me how awful it was in the room when she was asking. He said not only did the husband repeat his wishes in a very agitated tone of voice, but the lady continued her spiel even after he spoke up. NOT ACCEPTABLE.

I will be going to my manager about this situation. Organ donation is a wonderful, beautiful thing, but it cannot and should not be pushed upon family members. It should be perfectly acceptable for a physician or nurse who already has rapport with the patient and their loved ones to inquire about interest in organ donation. If the family says they would be interested in learning about the options, we can get the Gift of Life rep in ASAP. Nothing like this should EVER happen.

I'm still so pissed.

1 comment:

Alwais Threa said...

Wow. That's really not ok of them!