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Think, Care, Act: The Role of the Nurse in Organ and Tissue Donation


This continuing education course is offered free of charge to registered nurses practicing in New York State through a generous grant from the New York Alliance for Donation.

The New York State Nurses Association is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

This program has been awarded 3.4 CHs through the New York State Nurses Association Accredited Provider Unit.

The New York State Nurses Association is accredited by the International Association for Continuing Education and Training “IACET” and is authorized to issue the IACET CEU.

The New York State Nurses Association is authorized by IACET to offer 0.3 CEUs for this program.

In order to receive contact hours/CEUs, participants must read the course material, pass an examination with at least 70%, and complete an evaluation. Contact hours/CEUs will be awarded for this online course until April 9, 2018.

NYSNA wishes to disclose that no commercial support or sponsorship has been received.



Course Introduction

The Need for Donation

She was such a wonderful woman…she had primary biliary cirrhosis…she had been waiting for a liver for years and was doing fairly well, but then suddenly her health started deteriorating. She just got sicker and sicker…she was so sick…fading away, really. The wait was unbearable…You get so close to these patients. Her family was starting to give up…the entire team was distraught-the physicians, the secretary, the surgeons, the nurses, the coordinator, the social workers-the entire team was getting desperate. We kept saying, "We have to get her a liver tonight!" But still she waited; no matching liver became available.

These are the words of Maureen, a registered nurse for over 25 years, who works on a liver transplant team in a large metropolitan medical center. Having committed her professional life to organ and tissue donation, she is clearly passionate about organ and tissue donation and the patients who need them.

The patient kept saying, "I feel so bad because I'm waiting for someone to die." But we kept saying to her, "No, you're waiting for someone to donate!" Still she got sicker and weaker. But then, just at the 11th hour, she got a liver! It was just sheer luck! Although the recovery took time because she had been so sick, she's now doing beautifully. Ultimately, it was a gratifying experience.

This was a good outcome, according to Maureen. But she and many nurses continue to struggle with frustration related to organ and tissue donation. The solution seems so simple for patients who are awaiting transplant. Many people hope until the last moment and the organ doesn't come.

An average of 21 people die each day while awaiting transplantation (organdonor.gov, 2015). Many of these patients would live if all medically suitable potential donors or their families say “yes” to donation.

According to the United Network for Organ Sharing (UNOS), as of January, 2015, there were more than 123,500 individuals waiting for a life-saving organ transplant across the United States. As of January, 2015, the list included 1,001 children younger than 18 years of age. The need for kidneys tops the list, followed by liver and heart. Transplant hospitals place individuals on the national waiting list after they are given careful medical evaluations. Each month, approximately 500 people in the United States are added to the national waiting list.

Nearly 29,000 Americans (about 79 each day) receive organ transplants every year with the vast majority, nearly 23,000, receiving a transplant from a donor.

There is a particularly urgent need for minority organ donation. The need for transplant in minority populations is disproportionately high, due to the frequent incidence of conditions such as high blood pressure or diabetes, both of can lead to the need for a kidney transplant. While skin color is not a barrier when it comes to organ donations and transplants, the odds of a transplant being successful are much greater when a minority recipient receives an organ from a minority donor (New York Alliance for Donation, 2015). As of January, 2015, approximately 35,000 African-Americans, 20,000 Latinos, 8,000 Asians, and over 2,000 other non-Caucasians were on the waiting list. However, in 2013, only about 1,370 African-Americans, 1,111 Latinos, 189 Asians, and less than 140 other non-Caucasians donated organs at the time of their death (UNOS, 2015).

More than 10,300 New Yorkers are on the national waiting list for transplantation; this list includes approximately 3,700 Caucasions, 3,600 African-Americans, 2,000 Latinos, 1,000 Asians, and 80 other non-Caucasian individuals (UNOS, 2015a).

In 2013, 9,171 people died in the United States under conditions that made them medically suitable, potential organ donors. However, only 8,268 of those who died in 2013 became organ donors (UNOS, 2015b).

In 2013, of the 574 individuals who died in New York State who could have potentially become organ donors, only 356, or 62%, actually donated their organs. This is significantly below the national average of 76% (UNOS, 2015b).

The value of donation does not only translate into saved lives. The following two stories are from New York residents who chose to donate the organs of their loved ones. More can be read at www.donormemorial.org.

Dale Brachtenbach, Organ Donor
1949 - 2004

My dad loved life to the fullest. He raised me to be the best I could. His entire world revolved around my needs and happiness. When I was a little girl he would take me on vacations to Florida or we would go to Canada for a weekend just to get away. My dad and I also became a foster family for nearly 20 greyhounds in about a six-year period. He spent many weekends going to pick up retired greyhounds from tracks to give them a chance at a happy home life. We actually had four greyhounds of our own. My dad had the biggest heart I know of. He was and still is my world. With my parents being divorced it was he who got custody. I am happy to say that I was with my dad until the very end and he is now my guardian angel. He was the greatest man in my life and am proud to call Dale Brachtenbach my father. He was wonderful, and was taken from me entirely too early. He was only 55 when he passed away from a cerebral hemorrhage. I chose to give his gift of life to others; he was a giving man and would have done the same. My father will forever be the greatest man and influence on my life. The grieving has not gotten easier; it's just one more day to deal with a great loss. I love him more than life itself. I am proud of my father and I know he is proud of me.


Maryann Drago, Organ Donor
1969 - 2002

Maryann was a wonderful person and the best sister. She was very outgoing and loved by everyone. She loved to go out and sing Karaoke, even though she wasn't the best of singers. At parties she never sat down. She loved to do every dance from the Macarena to the Chicken Dance! On my wedding video you actually see her more than you do me! She worked as a teacher at a day care center and was just about to get a promotion. She had a son named C.J. He was nine when she passed away. About a year and a half before she passed away, she married a man named Michael. She was very happy... On April 10, 2002, at the age of 32, this all changed. My sister suffered from a severe asthma attack. She stopped breathing, and went into cardiac arrest. Two days later she was pronounced brain dead. It was so sudden and devastating to my whole family. We were all in total agreement in the decision of donation. My sister would have wanted to help other people; that was just the kind of person she was. That decision has helped me cope with a lot of pain and grief. I know that while I was crying for the loss of my sister, my friend, others were crying tears of joy, for the new life of their loved one. I know that they appreciate the gift of life and hope they live life to the fullest everyday. There is not a day that goes by that I do not think of my sister. I love her very much and am very thankful for the time I had with my big sis!

© 2015, NYSNA, all rights reserved.



 

Course Objectives

Upon completion of this course, the learner will be able to:

  • Discuss the need for organ and tissue donation.

  • Discuss challenges regarding organ and tissue donation.

  • Describe the process of organ transplantation for the organ recipient.

  • Identify the benefits of organ and tissue transplantation on the recipient.

  • Discuss the laws and regulations that impact organ and tissue donation.

  • Distinguish between circulatory death and brain death and how they relate to organ and tissue donation.

  • Identify critical aspects of the authorization process.

  • Discuss the role of the registered nurse in organ and tissue donation including referral, donor management, recovery, and aftercare.





To enroll in this course, please click the "Register" button below.




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