Planning the Donation Conversation
Timing of the donation conversation with the family of a potential donor is very important. Donation should be discussed with discretion and sensitivity with respect to the circumstances, views, and beliefs of the families of potential donors so that they make their best donation decision in one of their worst moments. Early and unplanned mentions of donation before a family has accepted that their loved one will not survive can be perceived as insensitive and may lead to distrust of the healthcare professional. Therefore, the donation conversation should be separated from and occur following determination of death or after the family has made the decision to discontinue the ventilator and other mechanical or chemical circulatory support. The donation conversation should also be discussed according to a plan that is identified and agreed upon by the healthcare team and the Iowa Donor Network coordinator during the donation huddle.
The Donation Huddle
The goal of a donation huddle is to ensure that the healthcare team and Iowa Donor Network work together to develop a plan to discuss donation with the family. A donation huddle between the healthcare team and an Iowa Donor Network representative should occur prior to any discussion of donation with the family.
Goals of the Huddle:
- Determine the next steps in the plan of care.
- Determine registry status, legal next-of-kin, family dynamics, and needs of the family.
- Identify the right time, right place and right person to offer donation to the family.
Steps to a successful planned donation conversation:
- Conduct a donation huddle – it’s a team approach!
- Healthcare team determines death by neurological criteria and communicates diagnosis to the family (ensure family verbalizes understanding).
- Healthcare team and IDN coordinator speak to family together in a private setting.
- Healthcare team introduces IDN coordinator to the family.
- IDN discusses donation with the family or the family is made aware that their loved one is a registered donor.
Remember....donation is a conversation to be had, not just a question, and never a mere mention.