Intensive Care Staff Attitudes to Deceased Organ Donation

Abstract

Intensive care staff may harbour mixed emotions toward organ donation after circulatory death. We wished to compare these attitudes to donation after brainstem death, as well as explore attitudes toward Specialist Nurses in Organ Donation, who have been embedded into UK intensive care units since 2008. At the Mid-Trent Critical Care Network (MTCCN) annual conference, participants were asked, in small group workshops, to write down words they associated with donation after brainstem death, controlled donation after circulatory death and Specialist Nurses in Organ Donation. The words were later collated and assigned to have either a positive or negative association by three blinded individuals: a medical lawyer, a hospital communications manager and a final year medical student. One hundred and eight intensive care staff participated: 24 (22%) doctors, 61 (57%) nurses and 23 (21%) allied health professionals; 75 (69%) of the participants were female. Participants at the workshop offered a total of 211 words, 93 associated with donation after brainstem death (44%) and 118 (56%) associated with controlled donation after circulatory death. The numbers of positive and negative words associated with the two forms of donation were significantly different (p<0.001) (donation after brainstem death - 68 positive words, 25 negative words; donation after circulatory death - 29 positive words, 89 negative words). This difference remained significant (p<0.001) even after all words (n=48) that did not have unanimous agreement between the three blinded word assigners were excluded. Significantly more positive words (95) were attributed to the Specialist Nurse in Organ Donation than negative words (18) (p<0.001). We conclude that this group of intensive care staff were generally positive toward donation after brainstem death and the embedded Specialist Nurse in Organ Donation, but could harbour negative attitudes toward controlled donation after circulatory death. Only by continuing to address the opinions of healthcare professionals will donation after circulatory death become a usual and not an unusual event.