Chaplains Oran Lee and Karrie Oertli on taking an active role with organ donation

The Organ Donation Process as Spiritual Care

Our pastoral care department has taken an active role in organ donation practices at our hospital, which has a large transplant center. We understand chaplaincy to include attending to end-of-life issues and thus see chaplains’ unique place “in-between” patients, families, the hospital institution, and the organ procurement organization as an appropriate place for professional organ donation advocacy. Our chaplains and CPE residents are trained as certified requestors for donation and work with our state organ procurement organization to improve donation rates.

When we reviewed our hospital’s data, we discovered our organ donation rate was 50 percent (half of the people approached for donation consented) and was below the national goal of 75 percent. Our hospital’s chief operating officer committed to improve this and created a committee comprised of administration, clinical directors, nursing educators, and a chaplain. Following our department’s commitment, Chaplain Oran Lee began to take an active role. Chaplain Karrie Oertli and Chaplain Lee advocated for him to attend the Organ Donation Breakthrough Collaborative meeting, sponsored by the U.S. Department of Health and Human Services. At the 2003 meeting, he was one of eight chaplains participating (this rate has improved). He observed that chaplains were not involved in the donation process in many hospitals.

With Chaplain Oertli’s support, he began to implement his vision that chaplains could affect donation rates and became co-chair in 2005 and chair in 2006. He also advocated including other disciplines. We believed best practice would include a multidisciplinary team that would encourage all healthcare team members to remain vigilant about organ donation opportunities. The committee would include respiratory therapists, social workers, a neurological ICU chaplain, physicians, surgery educators, administrative supervisors, and bedside nurses. Working together, this group increased our donation rate to 89 percent. Further improvements are expected by recruiting, training, and supporting nurse champions in critical care units.

Currently, Chaplain Lee is leading the committee to revise our brain death policy to a “Death by Neurological Criteria” policy, which will streamline our physicians’ process to pronounce brain death. It would also provide more opportunities for consideration of potential donors. The committee is creating a “Donation after Cardiac Death” policy, which will allow persons formerly not candidates to become viable candidates. In our ongoing pastoral care departmental review, we discuss and follow up with donors, potential donors, and monitor donation rates.

We believe that chaplaincy involvement in the organ donation process is vital. Since chaplains offer unbiased support for patient’s families in making donation decisions and ensuring ethical processes, we believe this work is clearly spiritual care.

Karrie Oertli, M.Div., BCC is director of the Department of Pastoral Care at INTEGRIS Baptist Medical Center in Oklahoma City, Oklahoma.

Do you have thoughts about professional practice you’d like to share with your colleagues? Send an e-mail info@PlainViews.org.