No one dies alone
August 25, 2004 -- Today Wong Sher Maine's piece in the Straits Times (Singapore), "At Alexandra, someone is with you till the end," describes a new program at a local hospital through which staff volunteer to be with terminal patients who receive no other visitors. The piece notes that the program, which appears to be primarily the work of the hospital's nurses, was inspired by a similar program started some years ago by a nurse in the United States.
At Alexandra Hospital, the piece explains, the "No one dies alone" program began in June with about 40 nurses, physicians and administrative staff volunteering to be companions for dying patients who are not visited by friends or family, for whatever reason. During their off hours, volunteers in the program sit with patients, hold their hands, talk to them, read to them, play music, or otherwise fulfill last wishes. The piece is careful to make clear that this is not something nurses can do as part of their normal duties: Koh Kim Luan, the assistant director of nursing, notes that "[n]urses have their own workload and may not be able to give precious time to interact with these patients." That is especially true in the many parts of the world where nurses now confront critical short-staffing and may not even be able to do what is necessary to save patients' lives.
As the article notes, the original "No one dies alone" program was started by a nurse at Sacred Heart Medical Center in the United States after the nurse was unable to find the time to be with a dying patient who had requested it. The piece does not provide more detail, but in fact that nurse was Sandra Clarke, now a nursing supervisor at Sacred Heart in Eugene, Oregon. The program, which she started in 2001, has received national recognition, and has apparently inspired similar programs at other U.S. hospitals. Though the work of the program's "compassionate companions" is not necessarily nursing, Ms. Clarke's creation of it is a good example of nursing leadership and innovation on behalf of patients. In a 2002 piece explaining the work of her program, Ms. Clarke herself sets the program in the overall context of her hospital's progressive end-of-life care, which also includes unit-based nurse ethics resource teams. She also tells the story of the dying man she was unable to be with many years earlier because of her heavy workload keeping other patients alive. She notes that this man was a "Do Not Resuscitate" (DNR) with end-stage multi-organ disease and no family. After he died, she looked around at the "scores of people providing state-of-the-art patient care. For this man, state-of-the-art should have been respect and dignity."
See Wong Sher Maine's article "At Alexandra, someone is with you till the end" in the August 25, 2004 edition of Singaporean Straits Times.
See the original "No one dies alone" program at Sacred Heart in Eugene, Oregon below.
At Alexandra, someone is with you till the end
By Wong Sher Maine
NURSES at Alexandra Hospital look out for dying patients who receive no visitors for they believe that no one should die alone.
Some of the staff volunteer to act as surrogate relatives, befriending these lonely patients and talking to them. There are two or three such patients a month.
Said the hospital's assistant director of nursing, Ms Koh Kim Luan: 'A lot of people are frightened of dying alone, it's a fear of the unknown.
'What the patient wants is someone to sit with him and hold his hand.'
The 'No one dies alone' programme began in June with 40 nurses, doctors and administrative staff volunteering.
It was inspired by a programme started by a nurse at the Sacred Heart Medical Centre in the United States. A patient had asked her to stay with him but, by the time she finished her duties, she found him dead.
Five 'compassionate companions' have since been 'match-made' to terminally ill patients estranged from their families or whose families are overseas.
Said Ms Koh: 'Nurses have their own workload and may not be able to give precious time to interact with these patients.'
The volunteers do their befriending after working hours; some, even every day.
They change out of their work clothes - so that other patients won't demand their attention - and pick up a volunteer kit bag which contains a CD player, religious texts and inspirational poems.
They may read, play music or help the patients to fulfil last wishes.
A 69-year-old odd-job labourer with lung cancer said he enjoyed these visits. The volunteer also helped him to cut his nails, he said.
Sometimes, the dying patients can't talk.
Senior staff nurse Seow Geok Huay, 40, was at the bedside of an elderly woman with lung cancer.
'She just opened her eyes and looked at me. But when I held her hand, she gripped it. I was very happy,' said Ms Seow.
Senior staff nurse Doss Emerentia, 44, said that she played Tamil music and held the hand of an Indian patient. He was already comatose but she felt his hand move in response. He died soon afterwards.
She is eager to befriend another patient, saying: 'As nurses we come across a lot of deaths but this goes beyond that as we are connecting on an emotional level, making the patient happy.'
After working hours, volunteers like Ms Seow befriend terminally ill patients who are not visited by relatives. -- STEPHANIE YEOW
INSPIRED BY US NURSE
THE 'No one dies alone' programme at Alexandra Hospital began in June with 40 nurses, doctors and administrative staff volunteering. It was inspired by a programme started by a nurse at the Sacred Heart Medical Centre in the United States. A patient had asked her to stay with him but, by the time she finished her duties, she found him dead.