Q&A with Vasuki Paramalingam, organ and tissue donation co-ordinator
Toronto, August 13, 2014
By Heather Brown
Vasuki Paramalingam. (Photo by Yuri Markarov)
Paramalingam, along with the critical care clinicians and operating room staff, has been instrumental in raising St. Michael’s organ donor rates. For 2013-14 the hospital’s conversion rate -- the number of potential donors who actually donate an organ -- was 82 per cent, which means that of the 34 potential donors, 28 went on to become donors. She began her career at St. Michael’s in 2009 as a registered nurse in the Trauma Neurosurgery Intensive Care Unit and has been in her current role for the past two years.
Q. Can you describe your role?
A. My interaction with a family begins when a patient has been legally declared brain dead or there has been a decision to withdraw life-sustaining therapies. I discuss the option of organ donation and help support them through the decision process. Once a decision has been made, I facilitate medical tests required for the donation process and liaise with the physicians, nurses, multidisciplinary teams, anesthetist and operating room staff until the organs have been allocated and the surgical recovery has taken place. Post recovery, I support the families and staff involved in the care. The other part of my role involves educating our clinicians about the organ donation process at St. Michael’s, working with them to implement best practices.
Q. What is a typical day like for you?
A. Each day is different for me. A lot depends on whether I’m involved with a family. I usually start my day on a conference call with the other organ and tissue donation co-ordinators across the province to review the potential cases at our sites. I spend time in the intensive care units meeting with the charge nurse, reviewing charts, providing orientation to new unit staff around St. Michael’s organ donor process and staying on top of other administrative work I have. If a case comes up, all of this is pushed to the side and it becomes my priority.
Q. On average how many families do you speak to about organ donation in a week?
A. It really depends on what the week is like. Typically it tends to be one or two per week.
Q. Are there themes or major questions that every family has?
A. Yes, I often get asked:
- Can my loved one have an autopsy and still be a donor?
- Can they still have an open casket following organ recovery?
- Will my religion or culture let me be a donor?
The answer is yes to these questions.
Q. What is the main message you try to share when you speak to the families?
A. This is an opportunity to honour their loved one and a positive way to give something back in the face of a tragic event.
Q. How does it feel when you hear that a family is going to donate their loved ones organs?
A. It’s great. I meet some of the nicest people at the worst time in their lives. People have been very receptive to having me as part of the care team. I don’t begin to assume that I know what they are going through, but being there with them as they make this decision is an honour.
Q. Is there one case that sticks out in your mind, if so why?
A. Each case is unique and special, but there is one that sticks out for me. The reason I remember it so well is because of the difference our entire team at St. Michael’s made for the family that day. I can’t go into specifics of the case but what I can say is that although I’m the co-ordinator and the one the family develops the rapport with about the donation process, it take much more than just me to make the process work. On this day our entire team worked well to turn a tragic situation into a positive event for a grieving family.
Q. What is most rewarding about your job?
A. Being part of something that makes a difference in other people's lives. Whether it’s supporting them in their time of tragedy or thinking about the person that gets a second chance at life, I feel fortunate to hold the role I do. I also feel supported by the leadership team at the hospital, especially Sonya Canzian, Dr. Andrew Baker and Dr. Jeff Zaltzman who are an integral part of this program.
Q. If you could dispel one myth about organ donation what would it be?
A. There are a few myths that keep people from becoming an organ donor. One is that they believe physicians won’t work as hard to save their lives if they have registered their consent for organ and tissue donation. As a clinician, our primary concern is always to save a life. Only when a life cannot be saved is the opportunity for organ and tissue donation introduced. Another misunderstanding is that if you signed one of the old paper donor cards it means you are registered. To register you need to enter your consent into the Ministry of Health and Long-Term Care database and you can do that online at www.beadonor.ca, or in person at a Service Ontario centre by completing a Gift of Life consent form and mailing it in.
Q. What do you do to unwind at the end of the day?
A. If I am not on call, I turn my Blackberry off and relax at home.
About St. Michael's Hospital
St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael's Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.