Appogia production.
Hi everyone, thank you for tuning back into Tenantus for Nurses. I suspec Woodbine here this season. I am so excited to announce that the podcast is being supported by Nutritia, which is a global leader in medical nutrition. They understand the needs of nurses in the nutrition space and for over one hundred and twenty five years have provided products to support child health. Some of Nutrita's pediatric brands include Neo Kate Junior for children who have food allergies and
app to Grow for those fussy eaters. And those of us who have children know many kids who go through the phases of definite fussiness. For more information and resources, visit the nutritiona Pediatrics hub at nutritia dot com dot au forward slash Pediatrics. I just want to say a huge thank you to Nutritia. Their desire to support nurses is truly appreciated, and they are allowing me to continue this podcast so that we could all grow as nurses.
This season, we have some amazing speakers in the pediatric space which I cannot wait to share with you all. Hi, my name's Beck Woodbine and welcome to Tenderness for nurses. I'm grateful for the person that I have the opportunity to be.
So I hit it and parked it for Nellie four years.
We always have free will, We always get to choose. We are autonomous. Hi everyone, thank you for tuning in too Tenderness for Nurses Again. Today we have a really fantastic Part A and Part B podcast. Today I am interviewing Georgia Callahan from Donate Life and she is the donation Specialist Nursing Coordinator DAN in Victoria. And then we are speaking with Justine Holloway, who is the acting Nurse Services Manager for Donate Life Victoria. Thank you Georgie for taking the time to chat with.
Me today, No worry, thank you for having me.
So can you just give us a little bit of background on you and your nursing career state.
Yeah, so I've been a nurse for about fourteen or fifteen years now. I actually grew up in Adelaide where I did all of my undergraduate study, and part of that I really fell in love with critical care nursing. So I first started working in a small ed and from that I did a bit of postgrad where they offered me the opportunity to go up to the intensive care unit to just, I suppose further develop my critical care skills and did about six weeks up there, and
during that time I felt quite nervous. There were lots of beats that was really scary, and wasn't quite sure if that was the place for me, and had always thought that i'd probably stay back down in emergency. And then in that sort of last week, it all kind of clicked for me and I just really fell in love with intensive care nursing, so I did a graduate
diploma in that. When decided I wanted to develop my skills in a bigger ICU that had a few different specialties that we didn't have in the same way in Adelaide, which is how I ended up working at the outfit in their intensive care unit, and I started there back in twenty fifteen, and from that really just started at the bedside, predominantly working with cardiac patients, as that was a bit of a specialty in the unit I was
working in in Adelaide. As a result of that, started working with some people waiting for their transplants and then after their transplant operations as well, and that was an incredibly powerful thing for me to see just how significantly people's lives could change just through the power of being a transplant recipient. Really, and then as I progressed through the ICU, I sort of started doing a bit more in charge and became an ANUM then actually ended up
working as an ANAM in the trauma ICU. So during that stint, I really then got to see the other side. So patients who were admitted under very sort of unexpected and often traumatic circumstances after they'd been in accidents, and throughout their journey of care, if we were unable to get them back to a good level of health and a meaningful recovery, then unfortunately they would be transitioning to
end of life care. And then from that being part of those end of life discussions, and then potential patients going for organ donation, just seeing sort of that full spectrum of that donation and transplantation journey and then really developing a passion for end of life care. And that's how I sort of then transitioned into working in organ donation as a result of that and being able to learn how to support families through a bit of a different process related to end of life care.
Was that a specialized education for you to go into end of life care and into the orgation side of things, or was that just something you segued into quite seamlessly.
Yeah, So there's no further sort of formalized education you do in the specialization of I suppose end of life care or organ donation in particular. It's a very much segue into that field. And then from their getting about a six month training program with Donate Life, and that really teaches you the you know, ways in which to support families and communicate in a very care and respectful manner and providing them with the information they need to be able to make a decision that's right, so they
loved one and their family. And then from that you know all of the other different processes and things that go into getting someone ready for an organ donation operation as well.
So do you still do work in ICU or you full time with Donate Life.
So I a clinicleness consultant in I FEW at the Alfred, but my specialty is organ donations, So we work for semi clinically, I think is probably the easiest way to describe it. So we'll still look at how we can support our I few nursing and medical colleagues through the end of life care processes. However, we are sort of the designated nurses who will complete the work up and information and data collection and supporting families through that organ donation process.
Can you explain the process to us, because it seems like there are quite a few steps.
It is quite a big process. So, for example, when I came on today, we will check our database to see if we've received any referrals for any people who might be going through end of life care. All patients who are going through end of life care and an ED and ICU should get referred to donate life for consideration of organ and tissue donation. If we don't have anyone sitting on our database, will attend morning meetings in the ICU to see if there's any people who will
potentially be gong for end of life care. If we do have referrals, will then be liaising closely with the ic bedside nurses, the medical teams and any allied health who are relevant to the patient's care just to see where really the patients in regards to their stability and then also more importantly, where the family's at in regards
to the prognosis of their loved one. We would never get involved in any conversations around organ donation unless a family were accepting a end of life care, just because we know that that would be quite damaging and traumatic to families to be raising this as an option when they're not accepting of that transition of that active care into more of one of comfort and dignity through palliative
sort of pathways. So if a family were ready to sort of hear about the next steps in their love one's care, we would then go into a family meeting with the medical team, the bedside nurse. Sometimes we'll have social work, sometimes we'll have interpreters if needed, and we will meet with a patient's family and from that we will gain a confirmation that they're understanding of transitioning to
end of life care. And then from that, when they're ready, I will be introduced as a nurse with a predominantly really to talk families through what those next steps will be, and from that we really try and find out what's going to be important to that patient and their family, So if they have any spiritual or religious belief, if there's any other important family members or friends who need to come and see the patient in the ICU, and once we've ascertained that we're meeting all of the other
needs of not only the patient but their family, I will then provide them with some information about organ donation and then from that there any questions that families may have to help them make that decision, and part of my role as well that I will check the Australian Organ Donor Register as well, and if someone was registered, we would share that information with the family. Conversely, even if they had registered their decline for donation, we would
be quite transparent and open with families through that. But essentially, if a family is open to exploring organ donation for their loved one, we would then sit down with them and in more detail provide them with information about what the organ donation process looks like, the organs we think they loved one may potentially be able to donate, and then from that we do really detailed made a cool questionnaire about their medical and social and lifestyle history, and
then we really start to collate a lot of information about their loved ones health. We'll do some routine bloods that screen for viral illness and any things like hepatitis, HIV, anything that could be transmissible to a recipient. If we discover anything that's an area of concern, we'll liaise with medical specialists just to ensure that donation and transplantation is safe to proceed, and then from that we'll start talking to transplant units to i suppose find the best match
recipients for this potential donor. Then from that we will liaise with the family very closely, and then we would arrange a time essentially for the patient to go for their donation operation, and then from that we would be with the patient in that operation as well, still caring for the patient and then ensuring all due processes followed and that final check sort of in the donation safe and transplantation safe to proceed, and then we share that
information and anatomy and things like that with the transplant units, and then we make sure that those life changing organs are able to get to the transplant centers as soon as possible, just to ensure the best possible outcomes for the recipients at the other end. And then we do follow up with the family down the track and things like that. But in a nutshell, that's probably a very a bruised version of what we do when we involved in someone going for organ donation.
Who actually initiates a conversation with the families.
Generally that will be us. So what I do as a donation specialist, we will provide family generally about the fact that their loved one is in intensive care on breathing machines, ventilators and are being supported that they may be in the rare position to help others through organ donation. And then from that it's really how we can then in a supportive and caring way, provide information to that patient's family so they're able to make an enduring decision for their loved one.
On the whole. What is the response when you do go into a meeting like this.
I think more often than not, is we wouldn't know what our loved one would want. You know, we never spoke about. And I think that's a really normal reaction for families to have. I think a lot of the time when people get admitted to the intensive care unit, it's under quite unexpected and sometimes traumatic circumstances, and when your otherwives fit and well, it's just not something you would ever see happening to you or your loved ones.
So it's then how we can acknowledge and normalize that for families that it is okay not to know, but it's about then how we can provide information to them to help try and have an informed decision and enduring decisions for that family.
In Victoria, I mean astray wide, there's the option for people to put their name down to be an organ donor. How uncommon is it that people do that?
Yeah, it's pretty uncommon actual effect. So we know that the majority of Australians do support all donation, and we know that the national average is about thirty six percent of people have actually taken that step to register their wish on the Australian organ don't register and even in Victoria that's even lower than the national stent. So I think we're seeing at about twenty five or twenty three
percent actually. So we know that when I've spoken with families who have had a loved one who has registered their wishes, you can just see a weight spin lifted from their shoulders. That it then the burden of trying to make quite a big decision on behalf of their loved one. It really becomes more empowering to families. And then it's how can we help our loved ones fulfill
that wish? And it's just a very different conversation where I think families feel quite proud that their loved one has taken the time and it's then for them to be able to help fulfill that for them as part of their end of life care.
Yeah, I think it's very important. I've certainly put my wishes down and we've discussed it previously on the podcast for people to do that, because we actually have had a couple of recipients that organ donation has saved their life on the podcast and they are truly truly grateful. So I actually, after speaking with one of them, went home and checked that it was current and that I
definitely had done it. So those of you who are listening and haven't checked, how would they checked Georgie to make sure that they're on the register.
Yeah, I think the easiest way is to go to the Donate Life website and then from there you're able to see if you're registered and if you're not, it also sends you to a link where you're able to then sign up on the register and all you need is your Medicare card, So it is quite easy to do, and yeah, you can even do it through the Medicare app, and yeah the donate Life website which is Donatelife dot
dot au. But then I would also then encourage people to talk to your families about the fact that, hey, this is what I've done today, because it is surprising that people, I suppose, don't assume that your family know
what you want. Speaking from personal experience as a nurse, when I had signed up many years ago on the register, I remember telling my parents at dinner because I was still living at home, and my mum, who was also a nurse, was really surprised that I had made that decision in my early twenties, and then just seeing how her perception had then shifted to be like, oh, wow, okay, I understand why you would do that. So even from a family of healthcare professionals, it was still a bit
of a shock to my family. So I think, you know, never assume, and it is a bit of an awkward conversation to have sometimes because it sometimes does feel like it's coming out of left field, and we honestly hope your family never has to make those decisions, but it's just that piece of mind knowing that if Heaven forbid, the worst thing were to happen, that your family would know what your wishes were.
Absolutely. We had Mary Lee Miller spoke on our podcast and her son Cole was killed with a coward's punch here in the valley and she tells the story, and she told it on the podcast how she was driving down from the coast and she knew he had passed. She just had this feeling, and she was a nicer U nurse and she just knew that they had to donate his organs and they did, and it does give them comfort to know that he's living on in other
people and has saved other people. And you wouldn't wish that on any family, on anyone ever, never, But how brave was that family and she he speaks so highly of the whole process of the organ donation and how respectful everyone was here at the hospital and in Brisbane, and that he lives on and I do believe it's a source of comfort for.
Her And that's something that we do here from families.
One of our colleagues her role is purely to support families who have had a loved one become an organ donor, and we hear quite regularly that obviously it doesn't take away the awful grief that they feel for the loss of their loved one, often in very tragic circumstances, but a lot of families feel proud in the fact that they know that their loved one has been able to help other people and help prevent other families from, I suppose, feeling what they're feeling and losing a loved one through
the life changing power of organ transplantations. So I think I agree with you, Beckett. You never wish this upon anyone, and you really don't realish having these conversations, But to seeing the power for families to be able to make
that decision for their loved one is pretty incredible. And how selfless they are in wanting to help others in the midst of their own very real, very raw grief is something that I think is just such a uniquely special part of the job that I do on It feels like a true privilege to be able to support these families in whatever way we can through this process for them.
It is such a privilege, And there's so many parts to nursing that ask such a privilege. I can just tell by talking to you that you're an exceptionally empathetic kind person that has its own problems. How do you look after yourself like there must be some stories or conversations with people that really stand out for you. How do you deep and look after yourself and not get burnt out doing what you do?
Yeah, it's an interesting one because I think I had actually over COVID in a few years before, was working in some nursing management roles which had burnt me out in some pretty significant ways, and really then had gravitated back to this role that I'm doing now because I needed to have that truly fulfilling aspect of my role
and being able to support families. But I do acknowledge that this is a pretty emotionally fatiguing job at times when you are having end of life conversations, not quite daily, but pretty frequently. I think for us as donor coordinators, we're a pretty small, tight knit group, so we are pretty good at reaching out to one another to just debrief talk through some particularly tough cases that we've been
involved in. And I'm pretty lucky my best friend lives a kay up the road for me, so there's often a walk to just get some fresh air to just have a chat and just take a step back from everything. And it sounds a bit cliche, but it is, you know, needing to refill that cup, so you know, whether it's then just cooking a really nice meal for myself. So I'm almost like physically nourishing myself to then try and
then emotionally kind of nourish myself as well. And I think really to just be able to lean into those really important friendships and relationships you have outside of work, your family, your friends, and then also I think his nurses just regular and you'll leave. I think that that is just something that we are probably not good at doing that. I know my friends who are nurses certainly feel that at times you need to really savor lya
for something big and amazing. But it's really about how can we incrementally take some leave to just take a breath, have a bit of a reset, and then prevent that significant burnout from happening. Because all of the people I know who do this job, we agree that it's an incredibly special job to have, but we need to recognize when we are potentially feeling that burnout creeping in, and then how we can sort of stop it from becoming a full blown dramatic theme for us.
Yeah, look it's real Georgie. And the research is there that doing what you do, like catching up with a friend and going for a walk outside, that's really important.
The fresh air, it's grounding, it's quite significant. It's a difference that makes And the other big research is having something to look forward to, having a holiday to look forward to, you know, and what do they say you should be rebooking your next holiday before you've completed the current holiday because it actually fills your cup, gives you something to look forward to and it's like a goal. I suppose that you're working towards. Do you look after
children in your specialty? Is that only adults?
We sometimes will so even though I'm based at the Alfred, if we're on call, we will service the whole Staates Victorious, so that will encompass the Royal Children's Hospital and the Monash Children's as well. There are two main pediatric centers here in Melbourne, so there are times we will care
for pediatric patients and that's pretty form just. I think it always really sort of hits you in the emotions, probably a little bit harder than other cases at times, and then it then probably becomes a bit of a debrief or we'll do case reviews together to just be able to talk through those cases in particular. And we have an amazing pediatric nurse specialist who really tries to care for us and as well as you know, the
patients and the families within her unit as well. And that's like a really great resource to have in having our colleague mail pediatric specialistners because coming from the adult field, little people is something that is probably scary for me. When I see them in a hospital bed, particularly one who's gone through end of life care, I think it
becomes very emotional. And then how we care for those parents any other sort of family members as well within that space is emotionally pretty taxing when you.
Go in and chat with a family. And this is going to seem like a really dumb question, because I'm thinking of myself, here, are you allowed to cry?
I think so. I don't actually think I've cried in a meeting with a family. I've certainly had a few teeries over the years when we've been going for a donation operation with some families that have really struck a chord with me in a bit of a different way, or I'll have a bit of a cry on the way home. But I do try, and I think hold it together because I know that even though it's incredibly sad what's happening, it's not necessarily my grief, and it's then how can I care for families to help them
through their grief. That it's probably my preference, probably not too because I feel like I couldn't be the nurse I need to be for them if I was getting really emotional, But I certainly think it's something that's you know, it's not necessarily frowned upon, but just for me and how I provide care, it's something i'd probably try and not do.
It's funny when I did palliative care, very rarely did I suppose when I was caring for them, I think you do put a different hat on. But hearing stories or when I interviewed Mary Lee, or when people are talking about their journey and their raw grief, it's a whole other ball game. For me. I just sit there and just like tears roll down my face and I do wonder sometimes how I would be in that role, and I'm sure death I was gonna say, sure, a shit, No, I couldn't do kids because I just couldn't.
Yeah, it's funny. I mean, for me, when I started my career, you know, death and dying really scared me as someone who was in their early twenties and started nursing and probably hadn't emotionally matured to the point where I could sort of see past my own discomfort in
some ways. But it is really confronting, and I think even though I try and not cry at work, I think I certainly have become a much more emotional person outside of work, and it probably doesn't take much for me to have a good cry these days, Like it does hit you, and I think it gives you a greater perspective on the spectrum of life and death and
everything in between. And I think, for me, certainly, how much more thankful I need to be in sort of embracing and being thankful for the little moments that I can have with family and friends, because we just sort of see the whole gamut in this role, whether you're young, old, just what awfully tragic things can happen to people. I think.
So it's very interesting that you so insightful and so aware of the little moments. Do you think doing this job has made you that person? Or were you always that person and it's just enhanced your awareness of that need.
I think I probably had that tendency already, And I think because this job is so unique but also in some respect such a hard job. I don't think you could do this job if you weren't already that way incline to be a bit more empathetic and caring. But I definitely think this job has certainly changed my perception and view on life and just sort of the different walks of life people come from and different things people
can go through throughout their life. And it's certainly, yeah, I think shifted how I view things and yet embracing the small things in life and just not sweating the small stuff. I suppose it's probably a really big thing for me.
Yeah, I'm assuming you have become a pretty non judgmental person through this process, I think so.
I think probably a not much makes me blush anymore from hearing about, you know, different escapades people have gone on. But I also think that nothing really that anyone does you can really be in a position to judge them for I think it's how you then care for someone in that bed at that point in time and what they need and what their family need, and aspects of
their history become somewhat irrelevant. And it's how we can make this palliative process the most respectful and dignified thing for them, because no one wants to die, particularly in the hospital, I don't think, So how can we make it less clinical? What nice? I suppose it's not nice to be losing a love bum but what things can we do to make it feel more personal? If it
playing music? Can we bring things in from home? We've certainly had doctors sneaking cats and dogs and things like that over the years that you know, no request is kind of knocked back immediately, though some have been a bit outrageous, but you know, ultimately it's what's going to be important to that family and how we can then try and help support them with that as well.
So important, Georgie quickly, can you go through organs that can be donated to other people?
Yeah, so one person you know, could potentially save up to seven lives through organ donations. So there's things that are or lungs could be donated to someone who is really critically ill. The kidneys could help two people come off of dialysis which they might need to attend three times a week, so it can really, I think, significantly impact their quality of life and allow them to do things that they haven't because they've just been so constrained
by this regular sort of weekly dialysis requirement. Live a donation, so potentially even in someone their liver could be donated to two people, So not always, but it is something that can occur. And then even pacreous could be donated to help cure someone for diabetes, which is pretty significant.
And then very rarely do we see someone be able to donate their stomach and intestines, which might only happen once a year here in Victoria, but it could be someone who's maybe never been able to eat a meal in their life and they've been too fed, So it can have huge, huge impacts for people who have been unwell in that regard. So there's also tissue an eye donation which can then help impact people's lives and be
quiet life altering as well. So someone could restore the site of two people through eye donation, which is pretty powerful.
So powerful. Is there one particular story that stays with you? With one family.
Yeah, I think maybe not a donor family, but I think it was just a patient who I cared for that really opened my eyes to just the power of what a difference a transplant can have in someone's life.
Where I was caring for a lady who was admitted to ICU because she was awaiting along transplant and was on some different infusions to try and help optimize her long function, but was pretty bedbound, could really only speak in sort of one word responses, and simple act of toileting on a bedpan would almost mean we'd have to hit the emergency bell because she would desaturate so significantly.
And I cared for a for few nights and night gene and then had days off, and as you do, the patient gets discharged and you don't see them again. And then many many months later, I was walking back into the ICU after taking a patient to the ward, and I could have sworn I heard someone say my name and then had to look around, and I was like, oh, there's no one here I know, so I'll just keep walking.
And then I hear someone call my name again, and I look and it's this lady sitting out of bed in a chair with just some small little prongs of oxygen in her nose, and she had told me that she had a transplant two or three days previously, and that she was doing really well and was hoping she'd be able to go to the ward. And the fact that she could then see one of her children get married, which she just didn't even think was ever going to be possible for her, is now going to be incredibly
possible for her. And that was something that made me think, oh, my goodness, this is the most life changing thing ever where we just couldn't even get this lady to almost safely be able to use a bedpad because she was so unwell. So then a few days after her transplant to be sitting out of bed talking to me in full sentences and I'd never really heard her voice before, which was kind of mind blowing to me because she
was so out of breath. And then that made me really think, wow, like families who can sent their loved ones to organ donation are so incredible in what they are doing for people that they will never meet, that they will never really get to hear about all the
amazing things that they can do. And for me, that was just a really small glimpse into that, and it was just really made me want to be able to work in this area and care for those families that have made such an amazing decision for their loved one.
It is life changing for so many people, isn't it. Georgie, Thank you so much for taking the time to chat with me today. But I appreciate you coming on having a chat, and I just want to say, I'm sitting here admiring your skin as a dermatology. I'm in awe and I don't know what you're doing, but I don't know it's the camera.
I feel like it's bumping me up a little bit.
Oh no, it looks amazing and I'm sitting here going, oh, look at that glow.
Kay Beauty products the skin career in Bomb, isn't it.
I've actually got some of their blush on. Love it so anyway, and fourteen dollars for the blush. You can't go wrong, can you bargain?
Yeah?
Absolutely, thanks Georgie.
My pleasure.
This season. I am so excited to announce that the podcast is being supported by Nutritia, which is a global leader in medical nutrition. They understand the needs of nurses in the nutrition Space and for over one hundred and twenty five years have provided products to support child health. Some of Nutritiona's pediatric brands include Neo Kate Junior for children who have food allergies, and app to Grow for
those fussy eaters. And those of us who have children know many kids who go through the phases of definite fussiness. For more and resources, visit the nutritiona Pediatrics hub at nutritia dot com dot au forward slash pediatrics. I just want to say a huge thank you to Nutritia. Their desire to support nurses is truly appreciated, and they are allowing me to continue this podcast so that we can all grow as nurses.