Sandra Clarke, RN, still remembers one of her patients from 1986. She can see his face, hear his voice — and feel the regret of breaking a promise to him.
At the time, the current administrative supervisor for nursing clinical support at Sacred Heart Medical Center in Eugene, Ore., was just starting her night shift on the facility's medsurg unit. The terminally ill elderly gentleman beseeched Clarke to stay with him. She promised to return after checking on her other patients. But by the time she made it back to his bedside, he had died.
"I just felt awful," she says. "You're left with such a sense of guilt and frustration."
That experience troubled her for years, even as she transferred to the ICU where, she says, no one dies alone. But a conversation with Sacred Heart's director of spiritual care about 15 years after the incident prompted her to assuage her regret by founding a program designed to ensure that no other patient at medical center dies alone.
Inspired by Mother Teresa's belief that everyone should die in view of a loving face, Clarke created No One Dies Alone, a volunteer program that provides compassionate companions for hospital patients in the end stages of life who have no family or friends to accompany them in their final hours.
[caption id="attachment_" align="alignright" width="195"] Inspired by Mother Teresa's belief that everyone should die in view of a loving face, Clarke created No One Dies Alone.[/caption]
"Death is the second most natural part of life. Birth and then death. It's a continuum. I think we've lost the interest in that last portion — it's treated as a failure or something to be ignored," notes Clarke, who points out that because of the nature of birth itself, no one comes into this world alone, but too many die alone.
NurseWeek awarded Clarke a Nurse of the Year Award for Innovation and Creativity for her efforts with No One Dies Alone in 2002, the year after she founded the program.
No One Dies Alone is activated about two to three times a month at Sacred Heart. Usually it's a nurse who recognizes that a patient in the end stages of life has no visitors. A quick call to a vigil coordinator puts the No One Dies Alone process into action. Using a volunteer database, the coordinator puts together a schedule of three- to four-hour shifts so the dying patient always has a compassionate companion. Taking cues from the patients, volunteers may put on a peaceful music CD, hold their hands, or just sit with them.
[caption id="attachment_" align="alignright" width="195"] Sandra Clarke[/caption]
Overwhelming Response
On the first day the program solicited volunteers, more than 100 people signed up, says Carleen McCornack, Sacred Heart's coordinator of mission services, who currently oversees the program. The number has grown to about 150, with very little turnover.
Volunteers undergo six hours of training, broken down into two-hour sessions. In the first session, participants discuss what drew them to volunteer. In the second session, the discussion centers on what is helpful and what isn't when sitting with a patient. "In the dying process, people are trying to disconnect from this world. As a companion, we want people to come in and be present and help to make the environment comfortable," McCornack says. The last two hours center on the logistics of what to do when called on to volunteer.
"It's an inexpensive program to run. It's done with volunteer services and with pastoral care usually. It's a matter of setting up the [volunteer availability] website," Clarke says.
She has compiled a guidebook to assist others who would like to establish programs. It is available at www.peacehealth.org/Oregon/NoOneDiesAlone.htm.
"The beauty of it is, it gives the nurse peace of mind to be able to take care of their other patients without neglecting the one who has no one," she says. Many nurses, like Clarke, also volunteer with No One Dies Alone in their free time, as do many staff members who wouldn't ordinarily have direct patient contact, such as kitchen workers or engineers.
"It makes you feel good that you're able to do this," says Clarke, who describes the program as a dream come true for her. "It's a win all over, believe me."
