• Anne Flodén, Marie Berg, and Anna Forsberg.
• The Unit for Organ and Tissue Donation, Sahlgrenska University Hospital Bla straket 5, SE-413 45 Gothenburg, Sweden. anne.floden@vgregion.se
• Intensive Crit Care Nurs. 2011 Dec 1;27(6):305-16.

ObjectivesAccording to the Istanbul declaration, health services should create better routines for identifying potential donors. A previous study involving 702 intensive and critical care (ICU) nurses revealed that only 48% trusted clinical diagnosis of brain death without a confirmatory cerebral angiography. The aim was to study ICU nurses' perceptions of their experiences of professional responsibilities and organisational aspects in relation to organ donation and how they understand and perceive brain death.MethodsA phenomenographic method was chosen. Data collection (interviews) took place in Sweden and included fifteen nurses; one man and fourteen women, from six hospitals serving different geographic areas.ResultsThe findings pertain to three domains: ICU nurses' perceptions of (1) their professional responsibility, (2) the role of the organisation regarding organ donation and (3) death and the diagnosis of brain death.ConclusionThe ambiguity and various perceptions of brain death diagnosis seem to be a crucial aspect when caring for a brain dead patient. The lack of structured and sufficient organisation also appears to be a limiting factor. Both these aspects are essential for the ICU nurses' opportunities to fulfil their professional responsibility during the organ donation process.Copyright © 2011 Elsevier Ltd. All rights reserved.

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