Coping with grieving making a request principles for staff relatives and for organs: training

Abstract

SUM M ARYThe continuing shortage of transplant organs is a m ajor concern for both medical staff and the UK public. M edia interest has grow n recently with the prospect of using anim al organs as spare parts. Even if this procedure is fully developed and rati® ed by the relevant authorities, it is not likely to become a routine procedure for at least another decade. U ntil then, procuring greater numbers of cadaveric organ donors is the main hope for those w aiting for heart, liver and lung transplants. Those people awaiting a kidney transplant have the alternative of a live donor, although the prevalence is relatively low . The inadequate training provided for m edical staff in dealing with grieving relatives and m aking a request for organs is w ell docum ented. This is re¯ected in the high number of refusals from relatives of potential donors and the reluctance of some staff in approa ching fam ilies of potential donors. Clearly there is a need for some training in this area that deals w ith the fundamental principles of understanding the grieving process and using this inform ation in m aking a sensitive approa ch to the fam ily for organ request.Corresponde nce: M r Gurch Randhawa, Lecturer in Epidemiology,

The European Donor Hospital Education Programme (EDHEP): addressing the training needs of doctors and nurses who break bad news, care for the bereaved, and request donation

“…It is widely acknowledged that doctors and nurses find it difficult to deal with death and dying [23, 31,341, and that they hesitate to ask for donation. At least two barriers in the communication with bereaved relatives have been identified: fear of adding to their distress, and the lack of training in communication skills [43].…”

The development of a narrative describing the bereavement of families of potential organ donors: A systematic review

“…The importance of staff training was highlighted ( Christopherson and Lunde, 1971 ; Haney, 1973 ; Perkins, 1987 ; Willis and Skelley, 1992 ), as was the link between staff competence and family satisfaction ( Morton and Leonard, 1979 ; Pelletier, 1993c ; Perkins, 1987 ; Siminoff et al, 2001 ). Staff are encouraged to develop relationships with family members early ( Ashkenazi, 2010 ; Douglass and Daly, 1995 ; Fulton et al, 1977 ; Morton and Leonard, 1979 ; Painter et al, 1995 ; Randhawa, 1998 ; Riley and Coolican, 1999 ) and continue providing support after the family returns home ( Douglass and Daly, 1995 ; Duckworth et al, 1998 ; Holtkamp, 1997 , 2000 ; Sque et al, 2003 ).…”

“… Walker and Sque (2016) noted that symptoms of shock, disbelief, denial, guilt, feeling lost, fear, helplessness, devastation and confusion are to be expected. Families must be provided with opportunities to participate actively in the in-hospital process (including aspects of patient care, family care, and responding to options and choices that become available) to reduce feelings of aimlessness and helplessness while developing hope ( Pelletier, 1993c ; Randhawa, 1998 ; Riley and Coolican, 1999 ).…”

Requesting Organ Donation: The Case of Self-Efficacy ? Effects of the European Donor Hospital Education Programme (EDHEP)

“…Studies have shown that the quality of the communication with bereaved relatives influences the decision made by the next-of-kin. Doctors and nurses find it difficult to deal with death and dying Girgis and Sanson-Fisher, 1995;Randhawa, 1997Randhawa, , 1998Siminoff et al, 1995). Breaking news of death, explaining brain stem death, approaching the next-of-kin for permission to donate organs while also appropriately managing emotional reactions of relatives are complex tasks, which require knowledge about these domains as well as skills to communicate information and understanding.…”

“…Some research has been devoted to the interpersonal competence of doctors and nurses in the areas of death and donation and to the contribution of inappropriate or insensitive communication to family refusal (Cushing and Jones, 1995;Marrow, 1996;. Enhanced awareness of interpersonal variables and training in order to improve competence is necessary for improvement of communication with the bereaved (Novack et al, 1997;Randhawa, 1998). There is, however, little empirical validation of the effects of such training programs Sanner, 1994).…”