Nurse highlights the importance of organ donation

This week, we talk to Noelle Melarkey, a Specialist Nurse in Organ Donation (SNOD) at the SWAH.

Here, Noelle reflects on the challenges and importance of her role, and how transformative – and necessary – organ donation is to the lives of many people and families across Northern Ireland.

What motivated you to pursue a career at the SWAH?

Fermanagh has always been my home, and the SWAH is my local hospital.

I knew from early on in my nursing career that this is the area that I would want to remain to raise my family and provide care to those in my community.

Since qualifying as a nurse in 2000, I have worked within the Western Trust between Omagh and Enniskillen.

Could you share a significant challenge you’ve faced in your role and how you overcame it to provide quality healthcare services?

In 2018, I took up a role within the Northern Ireland Organ Donation Services Team, leaving a long career within the theatre department in the SWAH.

I had always been interested in the role of a SNOD, and when the opportunity arose it was a privilege to join the team.

However, the role was multifaceted and emotionally intense. The six months training period and long on-call hours was particularly challenging for myself and my family.

Further on in my role, I understood the importance of this bespoke training, which not only provided me with a special toolkit of knowledge and expertise, but also a compassionate perspective to deal with the complexities while facilitating the organ donation pathway.

I feel that having a familiar face when working collaboratively with SWAH healthcare professionals, providing end of life care to the community as a part of organ donation, helps with the best continuity of care even at the most difficult and traumatic time in someone’s life.

How do you believe your role contributes to the wellbeing and recovery of patients within our community?

The most important priority for a medical team is to do everything they can to save the life of their patient.

If, despite the medical team’s best efforts, both doctors and family agree that death is inevitable, only then would specialist nurses approach a patient’s family, collaboratively with a critical care team, to discuss the possibility of organ donation.

It is my role to support families in that extremely emotional time, to think about what their loved ones would have wanted when it comes to discuss organ donation.

Organ donation would only ever go ahead with the family’s agreement, and once all life-saving measures have been exhausted.

We know when families have had the conversation about organ donation, and know what a loved one’s decision was.

This tends to make the organ donation discussion much easier for everyone.

Organ donation is, and will always be, a precious gift. One donor can potentially save or transform up to nine lives through the gift of organ donation.

Patients and families who receive the lifesaving call to tell them that an organ has become available, frequently tell us that their donors are “heroes”, and an organ is the greatest gift that they can receive.

The generosity of the donors and their families is never forgotten or underestimated by families, or by staff who work in organ donation.

Can you highlight a particular patient interaction or medical achievement you are particularly proud of, and why?

I am very proud of every organ and tissue donor and their families that I have had the honour to care for within the past four and a half years.

The selfless act of organ and tissue donation can be the ongoing legacy of kindness and a means of something positive coming from the loss of a loved one.

It never seizes to amaze me in my current role, how our donor families can think of others, who are total strangers, at a most distressing time of their lives.

The courage and humility they show is truly inspiring. This encourages me and my colleagues to continuously strive to achieve the best outcome for our donors and donor families.

How do you ensure the delivery of compassionate and effective care in your specific healthcare discipline?

As SNOD [staff], we work very closely and in collaboration with the critical care teams across Northern Ireland in facilitating organ and tissue donation for our donors as a part of end-of-life care.

The organ donation pathway is complex, and requires input from a vast range of specialities in the hospital setting.

The SNOD co-ordinates the organ donation pathway, but this couldn’t happen without the collective input from the multi-disciplinary team members.

What aspect of your work do you find most rewarding, and how does it resonate with your personal values and mission?

I have always been an advocate for organ donation and signed up to the Organ Donor Register even as a teenager, many years ago.

But since coming into this role, I find the most rewarding part is knowing that the donor families that I have supported over the years share the same collective view about saving and transforming lives through donation.

We know from our donor families that when they support donation, it brings a sense of comfort and solace, knowing their loved one is helping others to live, and possibly saving other families from going through the anguish of loss. This always humbles me.

How do you manage the demands of your job; what strategies do you employ to ensure exceptional healthcare service delivery?

My role is both physically and emotionally demanding. We maintain effective teamwork within the Northern Ireland Organ Donation Team, and efficient collaborative working with every hospital professional involved in the organ donation pathway.

There is also a compassionate, inclusive work circumstances and access to timely health and wellbeing support services within NHS Blood and Transplant.

The excellent training systems available to specialist nurses ensures that all members of staff have access to continued personal and professional developmental opportunities throughout their career.

Developing and maintaining coping mechanisms to deal with emotive circumstances and complexities of organ donation pathway is a crucial developmental aspect of the role.

Have there been any mentors or colleagues who have significantly influenced your practice and in what way?

I was very lucky to have so many people help me shape my career as a nurse whilst I worked within the Theatre Department in the SWAH and the Erne Hospital.

I was given many opportunities to develop my professional career, by access to university degree courses, anaesthetic and theatre courses, leadership courses, to name a few.

Sr. McGarrigle, Sr. McDermott and Sr. Beaumont always provided the opportunities to develop professionally.

My previous colleagues in theatre, who I worked so closely with, demonstrated the meaning of effective teamwork every single day.

What are your aspirations for the future, and how do you envision the evolution of your role within the SWAH?

My plan for the future would be to further my professional learning within my role as SNOD.

I would also be keen to further develop my skills within bereavement care and counselling.

I am excited to promote more collaboration of our service with the Trust Clinical Psychology team, supporting children and young people with the loss of a loved one.

How do you believe your efforts contribute to the overall excellence and advancement of healthcare services in our local community?

Organ donation undoubtedly saves and transforms the lives of many people.

Currently, 156 people are waiting for a transplant across Northern Ireland. There are now more than one million people in Northern Ireland who have registered as an organ donor on the NHS Organ Donor Register.

This is 53 per cent of the whole population. Last year in Northern Ireland, there were 59 donors, who enabled 140 lifesaving transplants across the UK.

Sadly, 15 patients died while awaiting a transplant in Northern Ireland.

Being a part of the team that provide the best care to donors when facilitating organ and tissue donation, the opportunity to support donor families, making a real difference to those awaiting a lifesaving transplant, and ultimately contributing to the NHS, are the most rewarding parts of my role.