Making the Critical Difference

The Purpose

"Making the Critical Difference," a continuing education program for critical-care nurses and all nurses who work in acute-care situations, was developed by the National Kidney Foundation (NKF) in collaboration with the American Association of Critical-Care Nurses (AACN). The workshop is designed to help nurses understand their underlying feelings that may hinder their participation in the organ and tissue donation process and to provide information necessary to facilitating the donation process. More than 10,400 nurses across the nation have completed this training since 1990.

For the nurse participants, the objective is to make offering the option of donation part of the care they give their patients and families. For the organizations promoting organ and tissue donation, it is to increase the possibility that the option to donate will be offered more often.

The People

The transplantation process involves a large network of people-the donor family, the hospital staff treating the potential donor, and the staff of the organ procurement organization. Within this group, the critical-care nurses play a pivotal role. They have continuous contact with the dying patient and the family. They are the most appropriate persons to offer the option of donation, to facilitate the process should the family choose to donate, or to assure families who do not donate that their decision is right for them. To support a family through this devastating time can be overwhelming unless the nurses can see their work as a positive part of their care-giving role. Nurses must deal with their own feelings about death before they can help others deal with theirs.

The Program

"Making the Critical Difference" is an eight-hour continuing education workshop that uses videos, slide presentations, group discussions and role playing to encourage nurses to participate in the organ and tissue donation process by helping them to:

  • understand personal feelings and attitudes that interfere with their participation
  • determine the parts of the process they can comfortably perform
  • strengthen their skills in approaching families about donation.

The workshop is conducted by a trained transplant professional on the staff of the sponsoring procurement organization. The moderator is a critical-care nurse. A local donor family member and several transplant professionals and/or donor coordinators ensure that accurate information is provided on the emotional, technical and legal aspects of transplantation. Logistical assistance is provided by local chapters of the AACN and NKF Affiliates. The program is administered by AACN as part of its continuing education initiative.

Personal Interaction

Participants reflect on their personal feelings about death. Through interactive videos designed to provoke both intellectual and emotional responses, they confront barriers nurses face daily. They role play as initiator, facilitator and supporter in the transplant process, learning what they can bring to the process. From actual donor family members they gain a deeper understanding of what the donor process means to the families. Nurses become familiar with local and national laws and regulations and such issues as donor criteria and legal and medical requirements for determining brain death. Finally, they learn to understand and skillfully participate in the asking process.

If you would like to become a volunteer and find out more about what's happening where you live, contact your local NKF Affiliate.

If you would like more information, please contact us.

©2012 National Kidney Foundation. All rights reserved. This material does not constitute medical advice. It is intended for informational purposes only. No one associated with the National Kidney Foundation will answer medical questions via e-mail. Please consult a physician for specific treatment recommendations.