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Palliative Care and the ICU

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Post organ donation for terminal extubation patients
Author: s2white
Date: Dec 8, 2010 5:59 pm
Our Palliative Care Service is involved in some but not all terminal weans in the ICU's. Up to now, Spiritual Care has discussed organ donation with the families. We do have a chaplain on our team, but he does not feel comfortable or competent to discuss this with families. I'm curious to know how other centers are handling this. Thanks in advance.
Replies: order by [Date] [Author] [Subject]
+ Re:organ donation for terminal extubation patients (by SueWaltherAPN on 12/09/2010)
Our Palliative Care service is also a 'family support service' so we are involved with all terminal extubations and brain death situations. If the ICU docs or RNs have not called us the Sharing Network coordinator involves us....usually we have already met the families. We have a joint approach to families and whenever possible the Sharing network coordinator is present. They are called within an hour when a patient meets criteria outlined in our state regs. The sharing network has chaplains if necessary, we have a volunteer chaplain group that is not familiar with sensitive conversations regarding end of life or donation issues.
Re:organ donation for terminal extubation patients (by rnlcsw on 05/16/2012)
Our PC team functions similarly. The hospital has a family support liaison who is a chaplain and ensures coordination with LifeShare. We are often both involved in pts who will be extubated to comfort and work collaboratively. We ensure that family support is part of family mtgs re: possibility of extubation to comfort and we always defer for the 'ask'. As the LCSW on the team I coordinate with them as to who it makes sense to take the lead in supporting family - depending on if one of has an existing relationship with family, if there are mental health concerns, etc. It was a rocky start, but now we have figured out where the other fits in and everyone is pleased.
Re:organ donation for terminal extubation patients (by rnlcsw on 05/16/2012)
Our PC team functions similarly. The hospital has a family support liaison who is a chaplain and ensures coordination with LifeShare. We are often both involved in pts who will be extubated to comfort and work collaboratively. We ensure that family support is part of family mtgs re: possibility of extubation to comfort and we always defer for the 'ask'. As the LCSW on the team I coordinate with them as to who it makes sense to take the lead in supporting family - depending on if one of has an existing relationship with family, if there are mental health concerns, etc. It was a rocky start, but now that we have figured out where the other fits in everyone involved is pleased.

Christine Lau RN,LCSW
Four Seasons Compassion for Life
Re:organ donation for terminal extubation patients (by rnlcsw on 05/16/2012)
Our PC team functions similarly. The hospital has a family support liaison who is a chaplain and ensures coordination with LifeShare. We are often both involved in pts who will be extubated to comfort and work collaboratively. We ensure that family support is part of family mtgs re: possibility of extubation to comfort and we always defer for the 'ask'. As the LCSW on the team I coordinate with them as to who it makes sense to take the lead in supporting family - depending on if one of has an existing relationship with family, if there are mental health concerns, etc. It was a rocky start, but now that we have figured out where the other fits in everyone involved is pleased.

Christine Lau RN,LCSW
Four Seasons Compassion for Life
Re:organ donation for terminal extubation patients (by babcc on 05/16/2012)
We have a policy written for Donations after Cardiac Death which explains who should be involved. LifeLink in Georgia has asked that our palliative counselors be available to provide family support and counseling throughout the organ donation process. Recently I had a wonderful experience with staying with the family in the OR at extubation up to the point of cardiac arrest and then we left the operating room for the organs to be retreived.
Carol Babcock Medical Center of Central Georgia

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