As our national celebration of Donate Life Month draws to a close, it’s important to remember what the frontline workers of organ, eye, and tissue donation will be doing next month—and every month after that: Navigating the enormous responsibility of helping families overwhelmed by grief come to the decision to donate their loved one’s organs.
I am a licensed clinical social worker specializing in counseling emergency service professionals—firefighters, EMS, emergency dispatchers, and hospital personnel—to overcome workplace and critical incident stress.
In this capacity, I also work with the men and women “on the ground” in the organ donation and transplant field, a highly specialized facet of the healthcare sector that is distinct from other emergency service professions in one critical respect: Every encounter is an encounter with death. Their constant interactions with grieving families create stressors distinct from other frontline occupations. These donation professionals do not answer a call or rush to the hospital for any other reason than because someone has died—the victims of a wide and heartbreaking range of tragedies that include drownings, drug overdoses, motorcycle or car accidents, homicides and suicides—but their organs are still functioning.
Many rely on very little sleep, as they must respond at any hour of the day or night. Many carry the weight of asking bereaved families for anything, even though they are making the request on behalf of desperately sick people praying for a second chance at life. And some have entered into the profession because they have a personal experience with organ donation; they want to use their talents to give back but are often reminded of their own trauma.
The stressors these frontline staff endure have only risen during the pandemic, as incidences of violent deaths leading to donation have risen as well. According to the United Network of Organ Sharing (UNOS), the US saw a 6% increase in deceased donors last year—from 11,870 in 2019 to 12,588 in 2020. Specifically:
-Deaths due to homicide, suicide, and child abuse all saw an increase in 2020 over 2019.
-Deaths due to suicide was the highest ever recorded since UNOS began collecting this data in 1994: 1,132 in 2020 vs 1,109 in 2019.
-Deaths due to homicide was the highest recorded since 2008: 469 in 2020 vs 438 in 2019.
Add to this the disruptions that have lately threatened a process that cannot be disrupted. The life of an organ outside the body is brief; after a certain number of hours, organs will begin to deteriorate. The frontline workers of organ and tissue donation—and the team members who support them—are not only responsible for securing permission from families for donation of their loved ones’ organs, but for ensuring these organs quickly arrive at transplant hospitals where transplant patients are waiting.
These first responders must be ingenious and relentless in the face of COVID-19-induced transportation problems, civil unrest such as what Minneapolis has just experienced, or weather catastrophes such as the recent Texas snowstorms. Regardless of circumstances, they have only one option: to successfully ensure organs arrive at their destinations on time and viable for transplant.
Given the enormous complexities of the organ donation and transplantation process, I constantly marvel that it happens at all. I have been imbedded for several years with the team at LifeSource—the nonprofit organization (one of 57 across the country) that coordinates donation and transplantation for Minnesota, North Dakota, South Dakota, and portions of Wisconsin—and stand in awe of the extraordinary commitment and resiliency of the more than 170 members of the LifeSource team.
Yet, I also have come to recognize in them many of the same conditions that can lead to acute stress, and burnout, depression, and anxiety in similar first-responder and frontline worker fields. Yes, they help to save and heal lives daily; they are proud of what they do and proud of one another. But they also are well aware and highly sensitive to the fact that they are only able to fulfill their mission due to lost lives.
It is a constant source of mental tension: as members of the interdependent network responsible for more than 35,000 successful transplants annually in the US, their specific role in interacting with families to discuss donation places them on intimate terms with the often-horrific circumstances required to make those 35,000+ transplants possible.
My role is to make them aware of the ways in which every aspect of their lives—physical, cognitive, emotional, social, and spiritual—can be impacted by the unique stressors they face and to train them in the skills necessary to successfully regulate their stress responses. This involves developing:
-physical skills, such as deep breathing and brief mindfulness practices to regulate the negative physical impact of stress
-cognitive interventions, such as asking, “What am I saying to myself? Is it true and is it helpful?”
-emotional regulation skills to maintain compassion, engagement, and professional quality of life in the face of strange and unpredictable work hours and possible social stigma related to discussing one’s job
-perspective on one’s skewed world view; donation and transplant frontline workers can understandably see the world as a very dangerous place with death around every corner and must be reminded that most places are safer than not.
It is my deep privilege to do this work. The first responders of organ, eye, and tissue donation are exceptional, mission-driven people who are drawn to the field from other professions because they view the complexities and challenges of organ donation and transplant as a way to push themselves beyond their limits. But they also tend to be perfectionists. And perfectionists are hard on themselves.
I help them to stay the course, because the people in their service areas across the country need for them to stay the course. From Donate Life Month this April to Donate Life Month next April, these consummate professionals will enter into the dark of a family’s blackest night, engage with their pain, and help them as they make it possible for their loved one to be the gift of life to another. Then they will ensure that family’s gift is transported to someone else. And that someone will live to see another dawn.