By Janet Coulter, MSN, MS, RN, CCM, FCM
In the quiet corridors of hospitals across the country, a profound and emotional ceremony unfolds often unnoticed by the public but never forgotten by those who witness it. Known as the "Honor Walk," this ceremonial procession pays tribute to individuals who have made the courageous and selfless decision to become organ donors. For professional case managers, understanding and honoring this tradition is essential in supporting patients, families, and healthcare teams through one of life’s most challenging and meaningful transitions.
The Honor Walk, sometimes called the “Hero’s Walk” or “Walk of Respect,” occurs when a patient who has been declared brain-dead is transported from their hospital room or intensive care unit to the operating room for organ procurement. This moment signifies not just the end of a life but the beginning of renewed hope for others. The walk is a deeply moving acknowledgment of the donor’s ultimate act of generosity choosing to give life even in death.
What makes the Honor Walk so powerful is its communal nature. Hospital staff, including nurses, physicians, respiratory therapists, chaplains, case managers, and security personnel, line the hallways in silent tribute. In many cases, family members and close friends of the donor accompany or follow behind the hospital bed, sometimes holding hands, photos, or mementos. Staff members often pause from their duties, standing shoulder to shoulder in a solemn show of respect. In some institutions, music may play softly while others observe the moment in silence, with heads bowed. Some families choose to share a few words or play a favorite song of their loved one. Others may wear shirts, pins, or bracelets identifying their loved one as a donor hero. In pediatric cases, the walk can be particularly heart-wrenching, with staff and families alike emotionally united in honoring the young life lost and the legacy it leaves behind.
The Honor Walk serves many purposes. For the donor’s family, it provides a moment of closure and profound recognition that their loved one’s life and death mattered. It reminds them that they are not alone, and that their loved one is seen as a hero. For the health care team, it reinforces the sacred nature of organ donation and the human connection behind the clinical work. And for organ recipients waiting in hospital beds or on transplant lists across the country, the Honor Walk represents the gift of another chance at life.
From a case management perspective, the Honor Walk embodies the very essence of patient-centered care, dignity, and compassion. Case managers often work closely with donor families and transplant teams throughout this process. They may assist in coordinating care, providing emotional support, and advocating for respectful observance of the family’s cultural, spiritual, and personal preferences. Their presence during the Honor Walk emphasizes their critical role, not just in care coordination, but in guiding families through moments of grief, grace, and legacy.
It’s important to note that the Honor Walk is entirely voluntary. It is only performed with the consent of the donor’s family. While some families may find comfort in this ritual, others may prefer privacy. Case managers can help families understand the purpose and logistics of the Honor Walk and support them in making a decision that aligns with their values.
The donor is often referred to as a “hero” throughout the ceremony, and this language is intentional. In the final moments before surgery, the donor is honored not only as a patient but as a lifesaver. Hospitals may place a sign or banner indicating that an Honor Walk is in progress. In some cases, the local organ procurement organization (OPO) provides a flag, certificate, or keepsake to the family, further acknowledging the significance of their loved one’s contribution. While the Honor Walk cannot lessen the pain of loss, it can bring meaning, dignity, and a sense of purpose to a devastating moment. It reminds everyone present of the extraordinary impact of organ donation and the humanity that connects us all. For case managers, participating in or supporting an Honor Walk is both a privilege and a responsibility. It is a chance to bear witness to love, loss, and legacy and to stand in quiet solidarity with those who give life when theirs has come to an end.
In those silent moments of the Honor Walk, we are reminded that even in death, there can be life, and there can be honor.
Honor life. Be an organ donor.
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Bio: Janet Coulter, MSN, MS, RN, CCM, FCM is President of CMSA. She is a transplant case manager with a wide variety of experiences including educator, administrator, team leader, and Director of Case Management. Janet holds a Master of Science in Nursing from West Virginia University and a Master of Science in Adult Education from Marshall University. She has published many articles in CMSA Today and the Professional Case Management Journal and served as a reviewer for the Core Curriculum for Case Management Third Edition. She has served as President-Elect of CMSA, Chair of the CMSA Today Editorial Board, Chair of the Nominations Committee, and Vice-President of the CMSA Foundation board. Janet was the recipient of the CMSA National Award of Service Excellence and Southern Ohio Valley CMSA Case Management Leadership award and was recently inducted as a Case Management Fellow from CMSA.