Thanks to commenter Pagan Chaplain (Twitter ~ web) for pointing out the No One Dies Alone program, where volunteers under nursing supervision support patients who would be otherwise alone at the end of life. The program was started by Sandra Clarke at Sacred Heart Medical Center in Eugene, Oregon. She cared for a patient in similar circumstances to what I described in my post and felt the same sort of distress:
One rainy night at Sacred Heart Medical Center, Eugene, Ore., I had a brief encounter with a man whose name I cannot recall, a man I shall never forget. He was one of my seven patients, near death and a DNR. During my initial rounds, he asked, barely audible, “Will you stay with me?” He was so frail, pale, old and tremulous. I said, “Sure as soon as I check my other patients.”
Vital signs, passing meds, chart checks, assessments and bathroom assistance for six other patients took up most of the next hour and a half. When I returned he was dead. I reasoned he was a DNR, no family, very old, end-stage multi-organ disease; now he was gone, and I felt awful. It was okay for him to die, it was his time—but not alone.
I looked around; scores of people were nearby providing state-of-the-art patient care. For this man, state-of-the-art should have been dignity and respect.
The last sentence is particularly striking — and true. It speaks to the core of what ought to be good nursing practice. In critical care areas we are sometimes entirely too focussed on the technical/technological aspects of care, when the reality is often much simpler. In the event, the wonder of it is not that such a program exists, but why it took so long for someone to come up with the idea, so obvious it seems in retrospect.
This is how it works: