So far in 2022, there have been none. The reason? The province’s organ donation program has been on hold since March due to staff shortages, a holdup first reported by online news agency Independent NL earlier this month. Canadian Transplant Society CEO James Breckenridge says the province’s annual total may seem like a small number of donors to lose, but it only takes one donor to change someone’s life. “We have almost 4,000 people now in Canada who are blind and could have their sight restored by a donation,” Breckenridge told CBC News in a recent interview. “A mother hasn’t seen her child in years and suddenly you give her sight from someone who died in Newfoundland – it’s wonderful. So not having donors is just a shame.” The province’s health care system has been facing increasing problems in recent months due to staff shortages, pandemic-related burnout and emergency room closures.
Program may restart later this year: Eastern Health
Dr. Sharon Peters, Eastern Health’s regional critical care clinical chief, said staffing the donation program became unsustainable after one staff member resigned and another retired. “We’re a small program, so it doesn’t take much in terms of personnel turnover to put us in a precarious position,” he said. He said the program has been suspended until new employees are trained to take over as organ coordinators. He said new staff are expected to complete their training this fall, which will allow the program to resume this year. While the donor aspect of the program is on hold, Peters said, the part of the program responsible for importing tissue for orthopedic and plastic surgery has continued. It’s a very intense attitude… It’s very emotional and stressful.- Dr. Sharon Peters Dr. Matt Weiss, organ donation policy expert and medical director at Transplant Quebec, says the average donor death rate in Newfoundland and Labrador is about half the Canadian rate. “We often measure these things in terms of donors per million population,” he said, noting that five donations a year would be about 10 donors per million people. “Across Canada we’re at about 20 donors per million.” He said NL’s low number is not surprising because the province has many logistical hurdles when it comes to harvesting and transporting organs. Provincial health workers do not perform transplants. Instead, staff coordinate with other provinces to procure and send organs and recipients out of province for transplant.
Suspending the program due to staff shortages is unusual, Breckenridge says
Other organ donor programs have been forced to close in Canada in recent years, but only because ICU capacity has reached its limits due to a spike in COVID-19 cases, as happened in Saskatchewan. Breckenridge says he had never heard of a program being suspended in Canada due to staff shortages. “Someone’s not putting money into the program because you could reasonably hire someone from another part of the country to come for six months, be the coordinator there now and teach someone,” Breckenridge said. Peters said she hadn’t heard of that proposal yet, but it wouldn’t be feasible. “Unfortunately, we are not the only ones in Canada with a staffing problem,” he said. He also pushed back against the claim that the program is underfunded. He said the program needs about 2½ full-time positions to operate, which is one full-time and three part-time staff members, and the program receives enough funding for those positions. Peters said burnout is behind significant turnover in the organ donor program. Staff must coordinate with bereaved family members while ensuring successful organ transplantation. “It’s a very intense position,” he said. “It’s very emotional and stressful.”
High turnover rate for organ donor coordinators
It is not unusual for healthcare workers to face stressful decisions and long hours. However, according to Canadian Blood Services, organ donor coordinators across the country face particularly high burnout rates. The average coordinator stays in the position for only three years, according to the nonprofit, which studies donor coordinator attrition rates to come up with strategies to reduce the profession’s attrition rate. The provincial program, based at the Health Sciences Center in St. John’s, is training new staff, which is expected to be up and running by the end of the year. (Paul Daly/CBC) Weiss agrees that organ donor coordinators face many logistical and technical headaches while trying to deal with even a single donor. Because the organ and transplant system in Canada is so interconnected, staff must deal with several medical groups and many hospitals in many different regions of the country. The emotional toll of the job can also be difficult, she said. “As someone in the ICU who sees similar things, many of my patients do well and leave the ICU, but for a coordinator all the families have lost someone. It’s all sadness, all the time, so it’s no surprise that there’s a lot burnout,” he said. Weiss says the coronavirus pandemic has exacerbated issues staff have to deal with, such as frequently changing COVID-19 protocols and having to test potential donors for COVID-19. “The last thing we would want to do is transmit COVID-19 from a deceased donor to someone who received the organ, because those people immediately go on immunosuppressive agents that are going to lower their immune system and make it more dangerous if they catch it,” Weiss said.
System improvement
Weiss said he’s sure the people behind the organ donation program considered all options before putting it on hold. He empathizes with health care workers trying to work with limited resources and staff shortages, he said, but he also stressed the importance of honoring people who have decided to become donors, as well as people waiting for a life-saving donation. “Make sure donation and transplant remain a priority,” he said. “There are many important priorities in health care, obviously, but something that can sometimes get lost in the shuffle is how important a single donor can be to many people.” Read more from CBC Newfoundland and Labrador
