Featured Research

from universities, journals, and other organizations

Intensive care nurses have doubts about method for establishing brain death

Date:
June 28, 2011
Source:
University of Gothenburg
Summary:
More than half of Sweden's intensive care nurses doubt that a clinical neurological examination can establish that a patient is brain dead. Intensive care nurses also perceive that this uncertainty can affect relatives when the question of organ donation is raised.

More than half of Sweden's intensive care nurses doubt that a clinical neurological examination can establish that a patient is brain dead. Intensive care nurses also perceive that this uncertainty can affect relatives when the question of organ donation is raised, is reveiled in a thesis from the Sahlgrenska Academy, University of Gothenburg, Sweden.

End-of-life care in an intensive care unit (ICU) also includes caring for patients who are brain dead and who by their death become potential organ donors. The thesis investigated attitudes and actions of ICU nurses in the context of organ donation. Information was gathered through both interviews and a questionnaires that went out to 1,100 ICU nurses in Sweden -- around half of the total workforce.

The survey showed that less than half -- 48 per cent -- of ICU nurses perceive that solely clinical neurological examinations can be relied upon for determining that a patient is brain dead. Swedish regulations stipulate that physicians should perform certain clinical tests to establish that the person is deceased. Supplementary contrast x-ray of the brain is only performed in some circumstances, for example when the patient has been affected by medication.

The author of the thesis, Anne Flodén, a registered nurse and researcher at the Institute of Health and Care Sciences, is of the opinion that it is problematic if the nurses' caring for these patients experience doubts about the reliability of the methods used to establish death. She believes that one explanation for their doubts could be that the concept of brain death challenges most of our preconceptions about death and dying. The deceased patient still has a heartbeat and the body is warm, but is, according to Swedish legislation, deceased.

"If you don't perceive the patient as deceased it's not surprising that you don't see the possibility for organ donation."

Respecting the wishes of the deceased patient was viewed as vital to the ICU nurses, irrespective of whether organs were to be donated or not. Supporting the family through the process and ensuring that the decision about donation reached by them was genuinely considered and taken of their own free will were also considered important.

"Nothing must go wrong" was an expression that came up time and time again, both in terms of the relation to the family and caring for a potential donor," says Flodén.

The nurses' own thoughts on the diagnosis of brain death and organ donation were considered to be important, since nurses will act on the basis of their perceptions, consciously or subconsciously, and their perceptions could also affect the family's attitude to organ donation.

"If a nurse is having doubts, this will be obvious to the family and could also trigger uncertainty in them," says Flodén.

"The questionnaire also showed that 39 per cent of ICU nurses had been in situations where the question of organ donation had not been raised with close relatives as the situation was considered so emotionally delicate that it was felt to be inappropriate," says Flodén.

She is adamant that the responsibility does not lie with individual ICU nurses, but instead points to a need for a clear and supportive organisation and for guidelines for the entire donation process, particularly the early stages.

"This problem was raised by many of the ICU nurses in several of the studies," says Flodén. "They were disappointed in the lack of structure and guidelines and are therefore calling for more support from management on these issues."


Story Source:

The above story is based on materials provided by University of Gothenburg. Note: Materials may be edited for content and length.


Journal Reference:

  1. Anne Flodén, Lars-Olof Persson, Magnus Rizell, Margareta Sanner, Anna Forsberg. Attitudes to organ donation among Swedish ICU nurses. Journal of Clinical Nursing, 2011; DOI: 10.1111/j.1365-2702.2011.03756.x

Cite This Page:

University of Gothenburg. "Intensive care nurses have doubts about method for establishing brain death." ScienceDaily. ScienceDaily, 28 June 2011. <www.sciencedaily.com/releases/2011/06/110628095044.htm>.
University of Gothenburg. (2011, June 28). Intensive care nurses have doubts about method for establishing brain death. ScienceDaily. Retrieved July 25, 2014 from www.sciencedaily.com/releases/2011/06/110628095044.htm
University of Gothenburg. "Intensive care nurses have doubts about method for establishing brain death." ScienceDaily. www.sciencedaily.com/releases/2011/06/110628095044.htm (accessed July 25, 2014).

Share This




More Health & Medicine News

Friday, July 25, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Beatings and Addiction: Pakistan Drug 'clinic' Tortures Patients

Beatings and Addiction: Pakistan Drug 'clinic' Tortures Patients

AFP (July 24, 2014) — A so-called drugs rehab 'clinic' is closed down in Pakistan after police find scores of ‘patients’ chained up alleging serial abuse. Duration 03:05 Video provided by AFP
Powered by NewsLook.com
Too Few Teens Receiving HPV Vaccination, CDC Says

Too Few Teens Receiving HPV Vaccination, CDC Says

Newsy (July 24, 2014) — The Centers for Disease Control and Prevention is blaming doctors for the low number of children being vaccinated for HPV. Video provided by Newsy
Powered by NewsLook.com
New Painkiller Designed To Discourage Abuse: Will It Work?

New Painkiller Designed To Discourage Abuse: Will It Work?

Newsy (July 24, 2014) — The FDA approved Targiniq ER on Wednesday, a painkiller designed to keep users from abusing it. Like any new medication, however, it has doubters. Video provided by Newsy
Powered by NewsLook.com
Doctor At Forefront Of Fighting Ebola Outbreak Gets Ebola

Doctor At Forefront Of Fighting Ebola Outbreak Gets Ebola

Newsy (July 24, 2014) — Sheik Umar Khan has treated many of the people infected in the Ebola outbreak, and now he's become one of them. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

    Health News

      Environment News

        Technology News



          Save/Print:
          Share:  

          Free Subscriptions


          Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

          Get Social & Mobile


          Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

          Have Feedback?


          Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
          Mobile iPhone Android Web
          Follow Facebook Twitter Google+
          Subscribe RSS Feeds Email Newsletters
          Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins