The Very First Time

Though it was decades ago, I can still recall like it was yesterday. The first time I cared for an organ donor. A brand-new ICU nurse, I was just a few years older than my patient. They lay in the bed, body perfectly intact and healthy, brain obliterated by a high impact crash while not wearing a helmet. I remember looking at them and finding it nearly unfathomable that this young, healthy person was clinically dead. Gone. I cracked open the window and set about my work maintaining the health of their organs while awaiting organ allocation and the arrival of the surgical team.

In my work as a palliative care nurse practitioner, I have the privilege of caring for patients and families facing the decision for organ donation. When a person is a candidate for organ donation, something disastrous and tragic has occurred: a motor vehicle accident, cardiac arrest, physical assault or a catastrophic brain bleed. Subsequently, the family is left devastated. When the family learns that their loved one is a candidate for organ donation, they often find that authorizing donation brings a sense of purpose out of a tragic event.

First Person Authorization

There are times when the decision for donation can bring great distress. This can be seen when an individual is a first-person authorized donor. A first-person donor is an individual who has registered in advance to donate their organs. This is often completed when applying for or renewing a drivers license or through an on-line organ donation registry. When a person is a registered donor, the decision to donate a loved ones organs no longer lies with the family. State statute honors the decision of the registered donor. For families who don’t agree with the decision to donate, news that they don’t have a choice in the matter can be very upsetting. Fortunately, the transplant support team is able to provide support to guide families through this process.

Brain Death

After finding their adult child unresponsive and pulseless, they administered Narcan and started CPR. But they had been down too long. While resuscitation efforts had been successful, sadly they were left with a catastrophic anoxic brain injury (injury secondary to lack of oxygen to the brain). Following several days of advanced medical intervention, they were declared dead by neurological criteria (brain death). Learning that their child was a registered donor, the parents felt like they had been hit by a truck as they were unaware of their child’s decision. They didn’t want to donate their child’s organs. Wanting the nightmare to be over, they could not fathom one more day of seeing their child in their current condition. After visiting with the transplant network, they ultimately donated their child’s organs and many lives were saved. In the end, they were able to find purpose and peace through the gift their child was able to give.

Donation After Cardiac Death

Following a traumatic injury to the brain, they were notified that their child had an un-survivable brain injury. While they did not meet criteria for brain death, the team determined they would be unable to survive long term without machines. They would live in a vegetative state. It was felt that death would occur quickly following the removal of life support giving them the opportunity to donate. This process is called donation after cardiac death (DCD). Their mother knew how important it was to them to donate their organs. In life they had always been generous and caring. They had spoken out loud to family about their desire to be an organ donor. Honoring their loved one’s choice to donate brought them a great sense of peace and purpose in the midst of tragedy.

Talk About It

The message I hope to convey with this post is the importance of talking about organ donation. Everyday, 17 people die awaiting an organ transplant. Everyday, people’s lives are saved or their quality of life is improved through organ, eye and tissue donation.

One’s desire and decision to donate should be clearly communicated with loved ones. My husband knows I want to give away as many parts as possible to save as many lives as possible. I am a registered donor. Being transparent and clear about my wishes takes the thinking out of it for my family. I have seen numerous times when a family was unaware that a loved one was a registered donor and struggled with feeling like they had no right to refuse. In the midst of trauma and tragedy, where everything is already out of their control, this adds an extra layer of complexity and distress that is unnecessary. Taking the extra time for the donation process can also be distressing for an exhausted family but when it is known that donation is the final wish of their loved one, they make it a priority.

When I look at my own children, I know that I would do anything for them. If they were in need of an organ, I would pray that someone would be generous enough to donate life. I want that for others. If ever given the opportunity, I would give that gift a million times over. Won’t you consider it, too?

Want to know more about organ donation? Visit:

Facts About Organ Donation | UNOS Organ Donor Facts

“7 Reasons Not to Be an Organ Donor” | Anthropological Perspectives on Death (emory.edu)