In Practice

Perceptions of nurses’ roles in end-of-life care and organ donation – imposition or obligation?

Kim Crymble, June Fabian, Harriet Etheredge, Petra Gaylard


South Africa has a rich organ-transplant history, and studies suggest that the SA public supports organ donation. In spite of this, persistently low donor numbers are a significant challenge. This may be due to a lack of contextually appropriate awareness and education, or to barriers to referring patients and families in clinical settings. It may also be due to ad hoc regulations that are not uniformly endorsed or implemented. In this article we present the findings of a study in Johannesburg that explored the attitudes and roles of nurses in end-of-life care and organ donation. A total of 273 nurses participated. Most were female and <50 years old. The majority expressed positive attitudes towards both end-of-life care and organ donation, but there was ambiguity as to whether referring patients and families for these services was within nursing scope of practice. The vast majority of participants noted that they would refer patients themselves if there was a mandatory, nationally endorsed referral policy. These findings have implications for clinical practice and policy, and suggest that the formulation and implementation of robust national guidelines should be a priority. Because nurses would follow such guidelines, this might lead to an increase in donor rates and circumvent some uncertainty regarding referral.

Authors' affiliations

Kim Crymble, Wits Donald Gordon Medical Centre, Johannesburg, South Africa

June Fabian, Wits Donald Gordon Medical Centre, Johannesburg, South Africa; Division of Nephrology, Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

Harriet Etheredge, Wits Donald Gordon Medical Centre, Johannesburg, South Africa

Petra Gaylard, Data Monitoring and Statistical Analysis (DMSA), Johannesburg, South Africa

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Nurses; End-of-life care; Organ donation; Guidelines

Cite this article

South African Medical Journal 2017;107(7):573-575. DOI:10.7196/SAMJ.2017.v107i7.12487

Article History

Date submitted: 2017-06-30
Date published: 2017-06-30

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