The intent of this Position Statement is to respond to inquiries from the professional nursing community with regard to the role of registered professional nurses in the identification and care of organ and tissue donors and their families, as well as their role in public education and awareness.
The New York State Nurses Association believes the registered nurse may assume an integral and valuable role in overcoming the shortage of suitable, viable organs and tissue for transplantation.
Transplantation of living human organs and tissue has become an increasingly significant life-altering and life-saving therapy for thousands of people in the last several decades. The supply and demand for organs and tissues continues to be disproportionate and the equitable distribution of this scarce resource remains an ethical issue. In 2004, there are more than 86,000 candidates for transplantation on the national waiting list, and more than 8,200 are from New York . ( www.optn.org, 2004). Every day, about 70 individuals receive an organ transplant, but 16 die waiting because there are not enough organs available. ( www.organdonor.gov, 2004). Many patients wait years for a suitable organ. There are complex reasons for the shortage of organs. Some of the issues being addressed though public awareness and education are:
T ransplants can enrich, prolong and save lives. Efforts across the nation are being spearheaded by public and private groups as well as the legislature to increase the availability of organs and tissues for donation. In 2004, the New York State Legislature introduced legislation that would place in statute the establishment of a state organ and tissue donor registry (A.11301-A/S.7058-A). The New York State Organ and Tissue Donor Registry currently operated by the Departments of Motor Vehicle and Health facilitates the process of collecting the names of individuals who have registered their desire to donate organs and tissue. This legislation would place New York among the 20 other states who already have operational donor registries.
Registered professional nurses are often the primary care givers for patients approaching the final stage of life. It is the nurse who facilitates the coping of the patients and their families. Traditionally, professional nurses have helped facilitate the process for organ and/or tissue donation. Unfortunately, barriers have occurred that interfere with the professional nurse’s ability to serve as an advocate for organ and tissue donation and to appropriately provide supportive end-of-life care. At the NYSNA Convention of 2000, the voting body forwarded a Resolution on Organ and Tissue Donation to the ANA House of Delegates (2000 Voting Body Actions). Subsequently, an ANA House of Delegates (HOD) Action in 2001 recommended that these barriers be addressed with organ donation and transplantation organizations. The ANA HOD agreed that ANA should advocate for and promote a more collaborative relationship between professional nurses and organ procurement teams. (ANA House of Delegates, 2001 Action Request).
Approved by the NYSNA Board of Directors, 9/18/96. Reviewed/Revised by the Councils on Ethical Practice and Human Rights on 8/27/04. Approved by the Board of Directors on 9/15/04 .
Note: The use of the term “patient” anywhere in this document is intended to be generic and refers to the recipient of nursing care.
American Nurses Association. (2001). Report of the New York State Nurses Association . 31 (10), 14.
American Nurses Association. (2001). Professional nursing practice: End-of-life care and organ donation. In Summary of proceedings, American Nurses Association, 2001 House of Delegates (pp. 47-52). Washington , DC : Author.
American Nurses Association. (2002). Code of ethics for nurses. Washington , DC : Author.
Benner, P. (2002). Living organ donors: Respecting the risks involved in the "gift of life". American Journal of Critical Care, 11(3), 266-267.
Childress, J. F. (1995). Ethical and legal issues regarding cadavers. In W. T. Reich (Ed.), Encyclopedia of Bioethics (pp. 1857-1861). New York , NY : Simon & Schuster MacMillan.
Exley, M., White, N., & Hoot Martin, J. (2002). Transplantation: Why families say no to organ donation. Critical Care Nurse, 22(6), 44-51.
Molzahn, A., Starzomski, R., & McCormick, J. (2003). The supply of organs for transplantation: Issues and challenges. Nephrology Nursing Journal, 30(1), 17-28.
Position Statement: Role of the emergency nurse in tissue and organ donation . (2002). Retrieved June 15, 2004 , from www.ena.org/publications/statements/Position
Silverman, H. J. (2002). Organ transplants - Pressing ethical issues. The Maryland Nurse, 8(2), 9-10.
Tartaglia, A., Dodd-McCue, D., Suthy, S., Myer, K., & Faulkner, K. (2003). Care for the critical care provider, too? American Journal of Critical Care, 12(6), 545-547.
The organ donation breakthrough collaborative: Best practices final report (September 2003). Nephrology Nursing Journal, 30(5), 529-531,590-591.
U.S. Department of Health and Human Services, Health Resources and Services Administration, Office of Special Programs, Division of Transplantation. (2002). In Guidelines for donor registry development conference final report (pp. i-ix). Washington , DC : Author.
U.S. Department of Health and Human Services. The organ donation breakthrough collaborative: Best practices final report. (2003). In Executive Summary (pp. ii-xi). ftp://ftp.hrsa.gov/osp: Author.
(2004). www.alliancefordonation.org: The New York Alliance for Donation, Inc.
(2004). www.optn.org/latestdata: United Network for Organ Sharing (UNOS).
(2004). www.organdonor.gov: U.S. Department of Health and Human Services.
For more information on nursing practice, contact NYSNA's Education, Practice and Research Program at 518.782.9400, ext. 282 or by e-mail.