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According to the United Network for Organ Sharing, more than 85,000 people in this country are on the waiting list for an organ that will save their lives. That’s enough people to populate a small city.

I’m sitting outside in a lawn chair at 11:45 PM waiting for my baby to come home. To be more specific, I’m waiting for my 19-year-old baby to get home in her new car. A thunderstorm is on its way and there are tornado warnings. When she gets home, I will tell her that I am watching the lightning because I am.

The clouds reflect the light from the city and glow a sulfurous gray. There is blue lightning; pale pink lightning; and the closer, jagged branches of lightning are the color of old ivory. I am sitting and waiting because I am a mother, and although I might doze, I can never sleep soundly until everybody is home safe and tucked into bed.

But because I am also a nurse, I experience more than the vague dread that every mother feels. I do not imagine the horror of a late-night knock on the door. Because I am a nurse, my fears are more specific. I fear a head injury, a spinal injury, shattered femurs, or a crushed pelvis.

Every mother fears for her child’s health and safety; I fear for those things and more. I fear the accouterments of trauma, such as a bolt or an extraventricular drain. I dread being told I must make a decision regarding the eventuality of my sweet child’s death. And so I sit and watch the lightning and pray and wait.

The greater good

According to the United Network for Organ Sharing, more than 85,000 people in this country are on the waiting list for an organ that will save their lives. That’s enough people to populate a small city. In 2002, 79,387 people were on that list. That year, 24,544 organs were transplanted. You can do the math to see the gap.

As nurses, we are intimately aware of the need for organs and what that need means to specific patients on that list. We know what it’s like to introduce a family to the idea of organ sharing. We know the faces of the donors and the faces of their families. We know the faces of the recipients and their challenges and their joy. For nurses, the numbers — of the donors, the recipients, and those still waiting — have personalities and hopes and potential.

I have worked on a med/surg nursing unit and cared for kidney, heart, and liver transplant recipients. One man told me: “I never prayed for this because I knew what it would mean to some family somewhere. But, oh, I am grateful!” I now work in the ICU at a Level 1 trauma center and have sat beside mothers who heard the worst news they could hear and then were asked to make a decision. They were asked to comprehend something they couldn’t begin to imagine and then asked to salvage some good from the unthinkable. But I also have seen the comfort the decision to donate can bring.

I have seen physicians work hours and days and nights to save a patient. I have seen what it costs them to have that end-of-life conversation with families, and I’ve seen the comfort they feel when they are able to switch gears and begin to preserve the function of the patient’s organs. I have heard our physicians say, “Now we are working for the patients this patient can save,” and have seen in their eyes that this is a gift to them as well as to the donor’s family. This is part of why they are able to face the sorrow they sometimes have to face.

Balance of life

And what about the nurses? We care for the victims of devastating injuries; we care for their families; and to some extent, we even care for the physicians, the chaplains, and others on our health care team. I have seen nurses comforting housekeepers and nutrition service staff members after a patient is declared and the procurement process begins. However, we also have the pleasure of caring for patients who will go on to live and be able to sit in the dark and watch the lightning. That balances things out.

Advances in medical research ensure that transplant recipients will have a better chance of survival and will enjoy a longer life and a better quality of life. But that also means the number of patients awaiting transplantation will continue to grow as technology improves and the criteria for recipients evolve. And yet the number of donors has remained stable for the past several years.

If we nurses can share information about organ sharing at some point, we can make a difference. If we can communicate the great good that can come from the worst tragedy, we can make a difference. And if we check the little “organ donor” box on our own driver’s licenses, we can make a difference.

There’s the car in the driveway now, and I send up a quick prayer of thanksgiving. Because I am a mother, because I am a nurse, I pray that if things are different some night for me or for my family, we will find the strength and wisdom we need to decide on life.

Elizabeth Bussey Sowdal , RN, is a staff nurse in the surgical trauma ICU at Oklahoma University Medical Center in Oklahoma City.