A critical discourse analysis of the introduction of an embedded, dedicated nursing role supporting Organ and Tissue Donation in Victoria, Australia

Damien W. Hurrell¹, Kathleen Tori²

¹Nurse Donation Specialist, Medical & Critical Care Services, Bendigo Health, Bendigo, Victoria, Australia, ²Lecturer/Emergency Nurse Practitioner, Department of Rural Nursing and Midwifery, Rural Health School, Faculty of Health Sciences, Latrobe University, Bendigo, Victoria, Australia

BACKGROUND:

As part of Australian Organ and Tissue Donation (OTD) reforms introduced in 2009, embedded, dedicated nursing roles (initially titled Hospital Senior Nurse, Organ and Tissue Donation (HSNOTD); since renamed Nurse Donation Specialist (NDS)) with responsibility for supporting OTD were created in 76 Australian hospitals.  There is little information in the professional literature about these roles and their specific responsibilities.

METHOD:

Documents such as position descriptions, codes of conduct, training materials, evaluation templates, government policy documents, acts of parliament, scholarly publications and media articles were collected and analysed using Critical Discourse Analysis.

RESULTS:

HSNOTD roles were introduced into a complex system of Australian Organ and Tissue Donation stakeholders including a newly established national authority, established state level government departments and non-government authorities, local general health services, transplant services, advocacy groups, and persons who had received or were waiting for organ and tissue transplants. This complex context resulted in multiple lines of formal and informal responsibility and accountability. HSNOTD responsibilities included auditing, professional and community education, policy development and implementation, and support of donation processes and donor families. Emphasis on various responsibilities varied between different stakeholder groups.

CONCLUSION:

This study describes the context for and responsibilities of the HSNOTD as envisioned in the available documents establishing the role. Further studies are required to explore aspects of the role such as the challenges faced during the implementation of the role and strategies used to overcome them, development and evolution of the roles since implementation, and differences between the evolved roles in different contexts.