Every day, tens of thousands of people anxiously wait for the call notifying them that an organ has come available. Thousands will not live long enough to receive an organ. New Jersey nurses are working to change those odds.
Every organ is a life, says Kathie Kelley, RN, CCRN, TNCC, a critical care nurse at St. Josephs Hospital in Paterson, one of 13 hospitals in the state to receive the U.S. Department of Health and Human Services 2008 Medal of Honor for Organ Donation last fall. The facilities had eight or more potential organ donors during a 26-month period and sustained a donation rate of 75% or more among eligible donors for at least a year.Kathie Kelley, RN, of St. Joseph Hospital in Paterson, N.J., was the State of New Jersey organ donation nurse champion in 2005.
We saved a lot of peoples lives last year, adds Marisa Scibilia, RN, MSN, clinical manager of critical care at AtlantiCare Regional Medical Center City Campus in Atlantic City, another Medal of Honor recipient. Forty-four patients received transplants from 17 donors at the hospitals city campus.
Linda Irvine, CCRN, MSN, CS, clinical nurse specialist at Overlook Hospital in Summit, another Medal of Honor recipient, credits early identification of candidates and collaboration with the organ procurement organization and within the hospital with helping it achieve the high conversion rate.
Were working together for what we feel is an excellent cause, to potentially give seven or eight lives out of one tragic event, Irvine says. Its nice to provide families with the option.
As of April 29, the Organ Procurement and Transplantation Network reported 101,947 candidates were waiting for an organ, and more than 6,000 people died while waiting for a transplant every year since 1999. In 2008, 27,961 transplants took place nationwide, and New Jersey physicians transplanted 575 organs.Denise Fochesto, RN
The Health Resources and Services Administration launched an Organ Donation Breakthrough Collaborative in 2003 to bring together donation professionals to share best practices. Since then, the number of organs from deceased donors has increased, with an additional 3,905 organs transplanted between 2003 and 2007. Morristown Memorial Hospital was one of the first to join. Overlook followed the next year. Both received the HHS honor.
Morristown and Overlook recruited nurse and physician champions to participate in the federal initiative, educated all nurses about assessing a patient to determine if the person meets donor criteria, and empowered the nurses to call the organ procurement organization. The procurement organization has trained the two facilities hospitalists and neurosurgeons about the best ways to approach a potential donors family, because they often cannot wait for a coordinator from the procurement organization to arrive.
Its not an easy time for the family member, but its a possibility something good can come out of something devastating, Irvine says. Its sometimes reassuring and comforting to families.
Morristown organ donor champion Denise Fochesto, RN, MSN, APN, CCRN, manager of the intensive care unit, hyperbaric medicine, and nursing education at the hospital, adds she often is amazed at how well families respond. All clinicians involved in an organ donation case meet after to debrief and learn from the case.
AtlantiCares organ donation committee meets monthly and reviews outcomes, looking for areas to improve conversions and evaluating the best times to approach a family about the issue.Linda Irvine, RN
Working as a team is the most important thing we do, says Scibilia, explaining that nurses, physicians, and anyone else on the care team huddle together with the procurement organization representative to come up with a plan for approaching families.
St. Josephs also waits for the procurement organization representative to arrive before talking with a family. However, with first-person consent being the law in New Jersey, the hospital does not have to obtain family permission.
After the transplant, procurement organizations often notify the hospital where the organs went and the type of patient, without disclosing any identifying information. Scibilia finds that information important and motivational. Kelley met a gentleman who received a heart from one of her patients at an event celebrating lives saved through donation.
It gives a good feeling, Kelley says. I saw this man and felt the heart beating in his chest. Its just incredible. It makes us stay committed to the process of organ donation.
Nurse-to-Nurse DonationCharlotte Santiago, RN, left, was given a kidney by coworker Joan Lewandowski, RN, both nurses in the cath lab at Newark (N.J.) Beth Israel Medical Center.
New Jersey nurse Charlotte Santiago, RN, recently came off the transplant list, thanks to Newark Beth Israel Medical Center cath-lab colleague, Joan Lewandowski, RN, who gave her a kidney.
What Joanie did was extraordinary, giving part of herself to somebody else, Santiago says. I still get goose bumps thinking about it and talking about it.
Lewandowski knew the difference transplants make in patients lives, having once served as a nurse coordinator for the hospitals heart transplant program. She had registered as an organ donor.
Why wait until I die before my organs can be put to use? Lewandowski says.
Although the nurses had worked together for about a year, they were not friends outside the hospital. Lewandowski noticed her colleague often felt tired and had headaches, hand cramps, and weakness related to dialysis treatments. The autoimmune disorder IgA nephropathy caused extensive inflammation and damage to her kidneys.
[Being on dialysis] seemed a sub-optimal way to live, Lewandowski says. I decided to give it a shot, and if we were a match, it was meant to be.
Sure enough, they were a match, and the donation took place Oct. 23. Both nurses were back working in the cath lab by January. Santiago feels great and does not tire as easily.
I dont know how to say thanks to her, Santiago says. I want people to realize that being an organ donor is a big thing because it changes the lives of those who receive the gift of life.
Debra Anscombe Wood, RN, is a freelance writer.