342.3: Nurse anaesthetists: The organ donor’s advocate throughout the organ donation process in the perioperative setting.

Abstract

Introduction: In a situation where a possibility to organ donation (OD) occurs, the bed-side professionals (physicians, nurses) are expected to act to realize the OD due to their professional ethics. Perioperative nurses play a vital role in the OD process which includes acting as the donor’s advocate, as well as upholding values to provide the best quality nursing for the donor during the organ procurement. Perioperative nurses work collaboratively within surgical teams by providing intraoperative assistance to procurement teams at the time these procedures are required. The research covering perioperative nurses work situation while participating in OD is limited. The aim of this study was to describe Swedish Nurse Anesthetists’ (NA) experiences and conceptions of participating in the OD process with brain-dead (BD) donors. Methods: A qualitative study was chosen; analysis of the semi-structured interviews was carried out with Phenomenography. Informants: 21 NA (4 male, 17 female); all had experience of OD from BD donors. In addition, 12 NA had experience of organ transplantation. Age 34-64 y (years); work experiences as NA 1,5-41 y; experience of OD 1 - >30 donors. Results: OD was performed with a professional approach but was associated with some challenges e.g. when there was a child donor. To trust and understand BD and to be aware of that the patient is dead was conceived as crucial. All NA had no doubt in the BD concept and the declaration of death, but some described that it was challenging to relate to death when the body was warm, and the heart was beating: “The patient was seen as dead while the body was alive.” Knowledge and experience were essential factors to obtain a sense of safeness in these situations. The results illuminated the importance of routines, including the departments attitudes toward OD. The NA took pride in saving lives and acting as the donor’s advocate. A dignified approach during organ procurement reduced the sense of stress. Conclusions: The benefit of OD was conceived as undebatable. The professional ethics were seen in the NA core values of dignity and respect towards the donor, and to fulfill the donor’s wish to donate. The NA professional pride was illuminated in the conception of that it was positive to be able to contribute to the donors “gift of life”. Experience and knowledge supported the NA and provided safeness in their professional role. Focusing on the positive (the recipients), was conceived as the winning approach.