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760 S P E C I A LT Y P R A C T I C E I N C R I T I C A L C A R E

Case study, Continued
2200: Family leaves the hospital to go home. Knowing that the 0630: The donor coordinator rings the next of kin to inform them
retrieval will commence in the early morning, they agree to that the retrieval has gone according to plan and promises to call
the offer by the DonateLife donor coordinator to phone them in again the following day with updates on the recipients’ progress.
the morning to confirm the outcome. Ongoing monitoring of
ventilation and haemodynamics, and care including physiotherapy Day 6
treatments.
1030: The donor coordinator contacts the transplant teams to find
Day 5 out the recipients’ progress and then phones the donor family and
0200: Retrieval commences; it takes 4 hours to retrieve the heart, the staff of critical care and the donor theatre suite. Letters detail-
lungs, liver, kidneys and pancreas. The liver is split intraoperatively ing this information are sent to the family and the staff of critical
for two recipients. care and theatre within days of the retrieval.

Research vignette
Flodén A, Forsberg A. A phenomenographic study of ICU-nurses’ achieving sample representation as for a quantitative study. There
perceptions of and attitudes to organ donation and care of poten- was no justification for the selection of 9 participants, with no
tial donors, Intensive and Critical Care Nursing 2009; 25(6), indication whether ‘data saturation’ had occurred after that
306–13. number of interviews. The interview and subsequent analysis was
Abstract clear and methodical. Participants were interviewed using open-
There is a lack of organs for transplantation and the number of ended questions, beginning with their associations to the words
potential organ donors is limited. Several studies indicate that the ‘organ donation’. Interviews were audiotaped and transcribed for
most crucial factor is the attitude to organ donation among data analysis. The timeframe of interviews was not stated. Analysis
intensive care staff. The aim of this study was to describe intensive of the interview data was performed in seven steps: familiarisa-
and critical care nurses’ (ICU-nurses) perceptions of organ donation tion, compilation, condensation, grouping, comparison, naming,
based on their experience of caring for potential organ donors. A and contrastive comparison. Transcripts and interpretation were
phenomenographic method was chosen. Nine nurses from three not returned to participants for member checking and trustwor-
different Swedish hospitals were interviewed. All were women; thiness of the analysis.
aged 36–53 years, with 3–27 years’ ICU experience. The analysis
revealed the crucial perception: ‘nothing must go wrong’. The analysis described three ‘parts’ to nurses’ perceptions of organ
donation, each with member ‘domains’: Situation (burden, respon-
The findings can be described in three parts: organ donation as a sibility, respect); Phenomenon (uncertainty and unease, success,
situation, organ donation as a phenomenon and different attitudes failure, holism, dignity); and differing Attitudes (alleviate suffering,
to organ donation. In conclusion: various perceptions adopted by duty of care to the living, remaining neutral, unpleasant process).
ICU nurses might influence the chances of a potential donor The findings were clearly articulated, with participant quotes used
becoming an actual donor. This study demonstrates that nurses to elaborate the identified issues.
who promote organ donation strive to fulfill the will of the poten-
tial donor by taking responsibility for the perception that ‘nothing The researchers provided recommendations for future research
must go wrong’. including identifying the prevalence of these same perceptions
Critique among a larger sample of Swedish ICU nurses, to inform the devel-
This small Swedish qualitative interview study was undertaken in opment of an education program for ICU nurses. A similar process
2006. The sample comprised nurses who had provided care for has been adopted by Australia and New Zealand critical care
potential organ donors that resulted or did not result in donation. nurses through the ADAPT workshops, which are targeted at
A phenomenographic method was used, and described appropri- medical, nursing, allied health professionals and those involved in
ately as an ‘exploration of the different ways people perceive expe- the support of families in critical care areas. ADAPT Workshops are
rience, assimilate … and understand different phenomena’; the facilitated by local experienced intensivists, donor family support
focus is on ‘explaining variations in perceptions’ (p. 307). coordinators, DonateLife education coordinators and qualified
bereavement consultants.
Participant selection varied between sites, but being a qualitative
study the focus was on seeking participants able to articulate Overall, this paper embraced the feeling of caring for the potential
their experiences and reflections on caring for organ donors, not organ donor and their family.