Organ donation: A study of its representations among organ procurement coordinators and their staff

Making the life-saving treatment of transplantation available to patients who need it requires the cooperation of individuals and families who decide to donate organs. Healthcare workers navigate organizational, bureaucratic and relational aspects of this process, including cases in which a deceased individual has not specified a wish about organ donation and their surviving family members must be asked for consent to donate during a delicate phase of mourning. This research aims to understand the experience of these health workers regarding their work. We collected 18 interviews from organ donation healthcare workers in five of the major hospitals in Rome. The transcripts underwent a multivariate text analysis to identify the representations of organ donation and the symbolic categories organizing the practice of these workers. This research elucidated a symbolic space constructed of four factors: the "Context", involving family and health workers; the "Work purposes", including the procedures and the relationships; the "Transplant", which involves omnipotence and limits; the "Donation", which involves ideals versus reality. The characterizing elements of these representations, belonging to organ donation workers, are the prestige, the certification of brain death, the communication, the transplant, and the salvation. In the lives of these workers, to be a "bridge between life and death2 evokes feelings of prestige rather than difficult feelings associated with confronting one's limitations. These aspects concern the difficulties met by the health staff in their work, and they are useful elements to design a focused training and support program for organ donor workers.