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Hi everyone, thank you for tuning back into Tenantus for Nurses. I suspect 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 can 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 had the opportunity to.
Be, so I hit it and parked it for Nelly four years.
We always have free will, We always get to choose.
We are autonomous.
Hi everyone, thank you for tuning back in to Tenderness for Nurses. Today we have part B of our Donate Life Talk. I've just had a chat with Georgie who is the Donation Specialist nurse and coordinator, and now we have got a chat with Justine Holloway, who is the acting nurse services manager for Donate Life in Victoria. Hi Justine, Hello, thank you for having me. Oh, thank you so much
for coming on. I know you guys are busy and we'd booked this a little way out, but I truly truly appreciate you taking the time to come on and have a chat with us about your role and what you do. So I suppose a good way to start is give us a little bit of info on your background and how you've ended up where you are with Donate Life.
Absolutely so. I started my nursing career nearly twenty years or so ago and initially worked in medical and surgical settings before moving into intensive care and it was in the intensive care unit that I had exposure to people who were going to become an organ donor and also people who had received a transplant and are in the
intensive care recovering after their transplant operation. And it was through that experience that I became really interested in the organ and tissue donation space and the roles such as what you've just heard from Georgie, and then moved into working for Donate Life. So initially I started working as a donation specialist nurse similar to what Georgia was doing, and then moved into a management.
So do you manage the nursing stuff or manage the donation retrieve, all the donation all of that side of things.
Yeah, So the nursing manager role within Donate Life we manage the donation specialist nurses and they are at the front line of facilitating organ tissue donation where we then work closely with the transplant teams and intensive care units and a number of different groups to provide the organ tissue donation service in Victoria. So from my current role acting in the Nursing Services manager position, we are liaising
with the Organ and Tissue Authority in Canberra. The Department of Health in Victoria, the health services within Victoria where we have donation specialist nurses employed, and the number of other key stakeholders that enable us to do our work.
How many nurses do you employ.
We have nurses based in the metro settings in addition to regional settings, so there's up to about thirty oh donation specialist nurses. Yeah, based in fourteen health services.
And do you DA's with the other states as well.
Yeah, we do, so the donation nurses will definitely be liaising with the transplant teams in other jurisdictions. From a nursing manager role, we do liaise with other nursing managers together so we can be working together on matters that are relevant to all of us and to deliver the strategic plan of the augmented authority.
So in a nutshell, can you explain your role is management of nursing stuff, but you also do a fivoit of other things as well.
Yes, quite a diverse role which isn't disimilar to the donation nursing role as well. It's dynamic, it's diverse. No, two days are often the same. We also perform the manager on call role, so that is overseeing the staff and the logistics when we have donation cases occurring in Victoria, to identify where staff need to be and when they need to be relieved and have someone else to come and take over. So we perform that role as well.
Do you look after the transplant team or is that completely separate?
No, they are separate, but we do work closely with them. We're really only half of the journey. Really, You're on the donation side, and then when our part has finished, that's the halfway mark, and then that's when the transplant teams have a more active role than in transplanting the recipients who are waiting on the waiting list and providing that ongoing care to them.
So one of your roles is care of your specialist nurses, which I'm assuming you would take very very seriously due to the type of work that you're all doing. What are some of the strategies you have in place for caring for them.
Yeah. Absolutely, It's a really important point and a key focus for the nursing management team because it is the nature of the donation specialist nursing role. It is very dynamic, it is very unpredictable. It is also challenging at times,
but they're also incredibly rewarding. There's two key components of the donation specialist nursing role, So they could be facilitating a donation case anywhere within Victoria and the next day they're sitting in hospital meetings or educating staff or collecting data.
It's a very diverse role that they perform, so from a management perspective, we meet with them regularly to find out how they're going, how they're progressing with their hospital work, talk about clinical cases that they've been involved in, understand anything else that's on their mind that we need to work together to support. We have a clinical psychotherapist who is available to all of the team to speak to.
We try and or that there are forums where the team can get together and just talk to each other, just discuss cases. We've implemented a reflective Practice meeting where conversations with families can be discussed. We have other forums, such as the Donation and Transplant Coordinator Forum where we can get together with our transplant colleagues and talk about cases. It's really such an individual component of what each person needs and we try and be really in tune with that.
In addition to a couple of years ago, we implemented a professional success program as well, which is looking at
the development of the team. So we had a component of self reflective assessments, the DISC profile, which you might be familiar with, looking at different communications styles, and then we did worked with Gallop where the team did another self assessment tool to really look at what they're good at, what's particularly great around and Gallop, which is a global analytics company looking at a whole range of topics relevant
to management and supporting your team. They say it's about finding out what people are good at, not what's wrong with them, And I think that's really important in this line of work, to find out what makes people tick, giving them opportunities to work on components within their role
that are aligned to that. So we did the DISK self assessment, and we did the Gallop self assessment, and the next part of this professional success program is looking at different development pathways that people may be interested in management or education, a clinical focus, being more involved in the follow up of donor families. So not only did the team focus on their primary role that you'll see outline in their position description, but we also ensure that
we have robust processes for well being and development. And so people have options depending on what they need. It's quite an individualized approach which we then support.
When it comes to the families. How long do you do follow up support for them?
Yeah, so the donor coordinator has that initial follow up when their loved one has become a donor. And then we have a donor Family Support coordinator whose role is focused on an ongoing support of families and it really is dependent on what they would like, what their needs are. And Michelle Skinner is our Donor Family Support coordination, does
a brilliant job in maintaining that contact, especially anniversaries. Donor families are invited to come to a service of remembrance every year as well, so that it really is based on what a family would like in terms of that ongoing support from Donut Life.
And I'm assuming you would ask them what they want.
Yes, absolutely.
And do you have regular meetings with your team so you know how sometimes someone has trouble, they're starting to get burnt out. You don't have insight, but you can tell something's a bit off with them. Do you watch your team on that level, or social worker or a psychotherapist, you know you're always keeping an eye on your team.
Yeah, absolutely, and I think this is where when we meet with them. A big part of it, I think is really building a working relationship with the team, so there is that open communication so the team feel comfortable to let us know when they're starting to feel like they need a bit of a break, or ensuring that they have a proactive leave plan throughout the year, things like that, so we can be intoe with where people are at and what they may need.
That's so important. Actually, I was just chatting about that with Georgie, and Georgie made comment about how important it was for her own self care to make sure that she had regular holidays. And even though it's great to save it up for a big trip, I do think you need to sometimes break it up a little bit and have something to look forward to and in a role that it's not just physical but highly emotive. I think that's so important.
Yeah, yeah, no, I completely agree. And when the team are around death and dying and they're providing so much empathy to the families that they meet, keeping that focus on self care is so important. And I know there's different words out therefore, you know, detached empathy or empathy without absorption, or this way of being able to care for families so genuinely but also preserving that self care.
And I think that's a skill when it's not something that comes instantaneously, but it is something that the team develop over time, and we absolutely want to support the team to develop those skills. And I think when different peers are talking to each other, they can share those strategies that they have developed for themselves as well. I think that that is it's really important.
So can you say those terms again around empathy.
Yeah, so there's different ones out there, but they all mean a similar thing around detached empathy or empathy without absorption. Before coming on here, just to look for a really clear definition of empathy the ability to understand and share feelings of others, but doing that in a way when you're in a profession such as this where you're not taking on everybody's grief because there's a lot of it
and at the same time you're still human. So there's definitely a skill working in this particular profession and other professions in health as well, or ambulance workers, you know, microparamedics, and there's aspects of this role that it's raw, it's really raw, and I think sometimes there are families that the team will talk to and just maybe something relatable about that particular patient or that family where it just
catches you a little bit more. And having that awareness of self to know when that's happened and how to navigate that. Is there a need to step away and someone else to come in and be involved, but it's also what's happening in the team's life outside of work. You know, life can sometimes throw some pretty significant.
Curve polls, absolutely, and when.
You're in a role such as this, I think sometimes it can have more of an impact depending on what the day looks like and what the donation that's may be required to do on that day. You know, are they on call for the statewide service and they've got something else going on, and navigating that in a way that still supports everybody with what they need with what's going on for them.
When you go in and have a chat with a family, you know, you're talking about the end of life for a loved one, there's been a traumatic incident. Emotions are really high at that time. How do you bring it down so that you can have a viable conversation because I know what I'm really upset, I might only keep tying a little bit of information. How do you go about that? Is it numerous conversations, numerous visits with that family?
How do you bring the emotions down and allow for an informed consent.
It's a good question, and the donation nurses have communication training for facilitating conversations regarding donation. A big part of it is working closely with the treating team at the health service to understand what's happening for this family, what other dynamics might be there are their family that need to travel from into state or overseas, or how long has their loved one been in the intensive care unit?
For example? What information can the donation nurse gather before walking into the family meeting to best care and provide information, but learn about their loved one and understand what is important for them regarding end of life and organ and tissue donation has been a part of that. Sometimes it's a number of conversations, sometimes it might be only one. It really is based on the family and what they need.
It must be highly confronting to think about someone keeping a loved one alive. To take out different organs of their body, and I would assume that one of the questions would be what happens after that, So.
Donate life are only ever involved once there's been a transition in the patient's care to end of life, and part of that conversation is understanding what's happened to their loved one and understanding why there's been that transition to end of life and ensuring that there is an understanding or an acceptance that there is that transition to end of life care before donation is ever raised. And then part of raising donation is understanding the wishes of their
loved one and what they would have wanted. And I think for the team, when the family are aware what their loved one would have wanted in terms of donation, that's a different experience to when they're completely unaware of what their donation isshes may be. And that's a big part of the media and communications teams within the Organance Issue Donation Network to raise awareness around donation and to encourage people to register their wishes and to have a
conversation with their loved one. So if they're ever in this position where they need to talk about donation, they have confidence in knowing what their loved one would have wanted.
It must be highly confronting to be sitting in a room someone's just loved ones just had a traumatic incident. Yeah, and then you're being asked the question about organ donation. Are we in Australia the only country that does organization as a donation like in the States, is organs paid for?
No, that's certainly in Australia. There's no financial incentive for anyone to pursue organic tissue donation. It's very much an altimistic gift and it's very rare. There's only two percent of patients that die in a way where organ issue donation is possible. There's a very very rare set of circumstances where donation can be discussed with a family just sept that's what their life one would have wanted.
So overseas in those places, do people pay for organs?
Not to my knowledge, but I'm not across the across the details of what happens in each major country and how they facility. You know what their donation program looks.
Like because I remember being a student nurse at PA when doctor Strong set up the liver transplant unit and they started doing their first liver transplants. Now that was back in nineteen eighty eight eighty nine, and then, I mean I was too young and stupid within as a nurse and for any theaters to go into those theaters, but I can remember looking in in absolute awe of
what they were doing and how remarkable they were. And then once I went, I did some work at the Royal Children's and you know, there were a couple of incidences where I was a scrub nurse there, but it felt like it was such a privilege to even be around it, let alone be part of it, you know, And you guys must feel that on a daily basis.
Yeah, And I think it's we'll see, you know, how many patients may have been you know, may have received a transplant, live a transplant, or the national numbers to see how many lives have been saved. But when you actually talk to someone who has had the experience of being on the waiting list, waiting for this call because their own organ is failing, and just that uncertainty to hopefully receiving a call that a transplant is available to
them and then their recovery. But I guess thinking about what that means for them, but it's also much broader than that in terms of what that means for their family, what that means for their children, or what that means for their spouse or their parents and their friends, or
being able to get back to work. You know, it often has such a significant impact on their day to day quality of life and the relationships around them that when you hear a recipient tell their story, it's so incredibly moving because they're their story has often started many many months before they've received a transplanting and you're hearing them talk about the impact that it's had on them.
It certainly puts into perspective the fragility of life. Absolutely not getting caught up in you know sometimes just things that we just get a bit stuck on sometimes and you only need to listen to someone share their story, be that a don't the family or a transplant recipient, to just help your refocus a little bit sometimes on what truly is important and what the connections and the relationships around you me.
How do you look after yourself because you're also looking after said nurses as well as you know, other avenues of your career and your job, But how do you look after you.
Yeah, I think because I'm now in a role where I'm removed from the frontline stuff, so to speak. I see my role and where I get my self care from is doing all I can to set up a work environment for the team that supports them. I feel that sense of responsibility to make sure that they have everything they need to do their job well and to
care for themselves. And I guess from my perspective that may be looking at our workforce planning or different things like that which enable us to staff the roster well so people do get breaks and there's more options for more people that have leave or that's where I focus my attention and I feel a real sensive responsibility. And then outside of work, I try and ensure that I prioritize doing the things that help me recharge my batteries, be that spending the time with my family or you know,
just having the odd weekend away. And this is also where I've really enjoyed the work that we're putting into the strengths, finding out what our strengths are, because not only did the team do that, but the nursing management team did that as well. So those times where you're just feeling a little bit stuck on something or just feeling a bit low. I often will look at the report that is about me and I look at key things in there that I think, Oh, what else can
I focus on? You know what else can I look? I love learning, so maybe it's listening to a podcast or I think that self awareness of knowing what you need to take care of yourself is so important because it's different for everybody. What works for me may not
be effective for someone else. And I think this is the other part of not only my role, but the other nursing manage your roles and the donation nursing team that you know there's senior nursing positions, because we need people to have those self care strategies to take care of themselves even the work that we're involved in, either directly or indirectly, to have those skills to perform this work not only as actively as best as what they can,
but a huge part of this is having developed strategies for self.
Care and care for others. And I would assume to some degree, at some stage all of you have either felt some degree of moral injury or vicarious trauma in your role and having a psychotherapist, social worker on your team would be wonderful to speak to, but often you don't realize that's occurred until after the fact. Are there times when someone comes in to ICU and it's such a traumatic event that you just once it's dealt with, you're like, okay, debrief, we've got to really look after you.
Does that happen?
Yeah, that does happen. Definitely happens, and not only just for the donation team, but we often will then work with the stuff that have been involved at the health service to facilitate whether it be a clinical debrief, so they understand what may have happened before they were rostered on and were involved, or what happened after they had left and they went on some days off, or whatever the case might be, and understanding what the need is so we can ensure that we can bring as much
information as we can if that's what's required, or whether we need to come in and be involved for more of that debrief from a self care and a looking after each other perspective, because everybody is human and this is a pretty intense area to work in and be around death and dying all the time, So sometimes it's just a matter of having a good cry and being
with your colleagues, just letting that out. And sometimes the need is different and what that is for each person will sometimes just vary a little bit, but we definitely try and ensure that we've got avenues there for whatever maybe have, so we can be responsive to that. And often if it is similar to what you mentioned earlier, is asking people what would be helpful right now? Is that having some time off, is that having some debrief
type sessions. Is that speaking with the clinical psychotherapist who's LinkedIn with Donate Life, Or is there perhaps something at the health service EOP that is available to someone to support them. Sometimes people have their own private support networks that they might engage with a little more, And I think a lot of that does come down to the relationship we have with the team and individually to know where they're at and what we can do to support them.
The other part that we introduced three or so years ago was an annual engagement survey, and within the survey, the different items that we ask the team unpacks what their basic needs are to knowing what's expected of them and do they have everything they need to do in their job to their individual needs and their team needs,
and their development needs. And this enables us to keep our eye on the ball on areas that may fluctuate within those groupings of questions and where we can then focus as a management team to go, oh, actually there's a bit of a need here for some more resources or some more education, or so you know, whatever it
may be. So we can ensure that when people come to work they feel as engaged as they possibly can be to perform the role, and that they can be as open as they can with us as their managers, to communicate how they're feeling and what else they may need.
So it's all about a safe work environment.
Yeah, absolutely, and it shouldn't be unique to our line of work because it's how you feel that night before you come to work, right, like, oh gosh, do people dread it or they think, oh, yeah, I'm working tomorrow, that's great. Or when you're out socially and someone says to you know, I have work going, what answer do
people give you? I think gives a really clear indication of how engaged they're feeling in their workplace and how can we prevent people from feeling burnt out or just that exhaustion of the unpredictability that comes with our work. In particular, what is within our control to prevent those things from occurring.
I think it's wonderful that you are looking ahead, you're supporting your team, you're looking at different and new ways of management, which I think is fantastic. And it's really wonderful to hear because I've sat here and listened to nurses, midwives, paramedics, and the stress and the burnout they're feeling in hospitals is phenomenal and nothing's changing, like there's no changes, Whereas you've got this amazing group of people and you've come in and recognized that it could be a very high
burnout position. You're dealing with a lot of trauma, vicarious trauma, you know, sadness, death, dying, grief, and you're doing everything you can to look after your nursing team and team I'm sure there's other people in that team in the healthiest way possible. And I can't tell you how impressed I am right now because I've sat here and listened to people just going I don't know where nursing's going, you know, like I don't want to be a nurse anymore. I am so tired. And here I am hearing you
guys talking about loving your job. It's a really you know, high stress position. You want to look after your team. Georgia loved going to work. I mean that says so much to me as a nurse. And I'm a little bit in awe of the organization, to be fair, And does that come from the top or the type the people you employ? I mean, how do you get to that position?
I think it's a bit of everything, to be honest, and we can't achieve anything as a one man band in Donate Life Like it's absolutely a team effort in terms of the work that we do, but I think it's a bit of a mixture. And I reflect on COVID and just how disruptive that was for everybody. And during that time, you know, as a leadership team, we were looking going, oh, you know, we haven't experienced anything
like this before. What can we do? You know, with the lockdowns and you know all these things, especially in Victoria, what can we do here? That's a bit different because we had some members of our team who were redeployed to support other areas of the health service, and then we had staff who were continuing to deliver our donation service. You know, some people were living at home and they
had roommates for their families. Some people were living on their own, and the experience for everyone was very different. And one of the initues we came up with during that time was to introduce a food for Thought Tuesday, and I think it was a wellness Thursday. So we had these micro learning sessions virtually and then a wellness session where someone might come on and guide us through some deep breathing or some stretches in the chair or
just matting anything to go. Yeah, and really, some people will engage with that because it helps them, and some people may not engage with that as much or they think it's a bit fluffy or it's just not for them, which is completely fine as well. But from an organization, it was there, it was available. We're giving it a go because you know, we're all kind of trying to find our way in our respective roles, and I think that's what has so on a bit of a seed
to go. We need to just continue to be open minded with how to keep moving forward as an organization,
given the importance of the work we do. Without a doubt, yeah, And I think for someone coming into the donation specialist nursing role, part of our recruitment when we're interviewing people, we want to be confident that they are pursuing this role for the right reasons, that they feel really passionate about quality end of life care and having a bit of an understanding the process is helpful as well, but coming into this line of work to be really aligned
with what our purpose is because then when we're working together, or when there are times where everything's a little bit challenging or there's a few things going on and we really need to band together to make it work, you know, then everybody's aligned with this shared goal of moving forward.
So that's certainly something we look at when we recruit for nurses to join our team, who are often from either ICU, the emergency department, or the operating theater, and they often have had some exposure to donation or transplantation. And I have to admit sometimes when we read a letter, it's so moving and the person can really capture why they've seen this role and they would really love to join the team, which is as in a nursing management role.
I just find that I love reading that. Yeah, so I think it's doing it for all the right reasons and obviously having career progression, which is really important for people who want that. But you're pursuing this because you want to be a part of something bigger than yourself and give back and have an appreciation for what this
actually means, which is so important. And I think when people enjoy their job and they have everything that they need to do the job well, I think it really does help prevent burnout when they've got a good team
around them and great relationships with other people. That we've obviously got a nursing and a medical component to how our organization works, but we've also got an administration team and a meter and communications team, and an education team, data analyst, and you know, we rewind everybody to make us successful in the work that we do, so we all need to be aligned to build that trust and those working relationships to work effectively together because ultimately, the
community are relying on us to get this right.
Two hundred percent, I couldn't agree with you more, Justine, Thank you so much for taking the time. I am truly in awe of the exciting way you guys are moving and caring for your nurses and sitting there talking about it with me. You know, one of the number
one reasons people get burnt out is feeling underappreciated. And it seems like you really value and your organization values the nurses and the other team members greatly and what they do and you can't do what you do without these guys, so exactly, I really appreciate you taking the time.
I've already spoken with Georgia about how people can sign up to make sure that the loved ones know what their decisions are when it comes to organ donation, and George just went through what you need to do, whether it go through donatlife dot org or through Medicare, and I'll put those details up on our show notes so that people if they just want to want to check
where they're at with it, can click on it. But it saves so many lives and it just takes the burden of a really tough decision off the family during a really traumatic time making that decision, and then it's there on your Medicare card. So is there anything else you want to add to that?
No, I really appreciate the opportunity to speak to you. Really about what we do, but also about the team because we do really value the work that they do and the difference that they make with the families, also the many health professionals that they interact with on a day to day basis. We feel very fortunate to have them, and we feel really really fortunate to have a job that has such an impact on those needing a transform.
Just see if we had more nursing leaders like you and the organization you're working for. I don't think nurses would be leaving in droves like they are. And it doesn't take much, just takes a little bit of thought into what your team needs, and like you said, it's just those funny little things and whether they choose to engage or not, it's there and it's offered and it's powerful.
It's so powerful, and I think sometimes we have an expectation for the team to be curious about their ongoing learning and development. I think it's really important as the nursing leadership team, and this extends into our education team as well, that we also maintain that curiosity to ensure we're the best possible leaders that we can be as
a team. And we've actually recently introduced a regular kind of session in house to just keep talking about the topics that are relevant, be it change management or crucial conversations, or you know, a range of things that we think, oh, let's just have a bit of a refresher on that, because we do have such a responsibility in nursing leadership management roles for the type of environment that we've set for the nursing team in our organizations or our departments or wherever.
We may be based, because leadership comes from the top.
Absolutely, yeah, completely agree. You know, you have to continue to be monitoring when we do an engagement survey. It's not a flushing a pan, you know, or we've done that tick box like, it's something that we'll come back to and it will inform different actions that we take to continue to refine what we do to keep the team's engagement on our radar and the things that we still need to focus on, or they're things that pop up from time to time that you do need a
little bit of work. But I think that's normal and I think as long as we continue to look at that, that's the main point. So we do continue to move forward and address them.
Well, I think it's wonderful and I know you are super busy, and thank you so much for taking the time to chat with me. Like I said, we'll put information up on the show notes. I'm in awe of your leadership, Justine. Thank you so much for taking the time to chat to us. And you know, I really hope other nursing leaders have listened to this and take on board a couple of those little pointers. One was Gallop and what was the other disc? Disk disc.
You can just put it into Google and there'll be plenty of content that comes up. And I think Gallup in particular often has resources for managers just hone in on little disperse team or you know, different topics that are very relatable that can just give some tips or you know, just things to think about when you're managing the nursing tea.
Oh I love it so thank you so much and I appreciate you taking the time.
Oh thanks both, It's been a pleasure speaking with you.
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 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 Nutrita. 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.