It was a typical night shift on the med/surg floor when a patient with a do-not-resuscitate order asked Sandra Clarke to sit with him. She said she would, as soon as she'd seen to her other six or seven patients. But by the time she returned, the man had died.

"I felt awful about that," Clarke said. "Here we are in a society with all this technology, and we can do fabulous things, but we can't do something simple like be with somebody when they are most vulnerable and alone."

At the time, the hospital was becoming more involved in issues like end-of-life care and comfort care for the dying, and Clarke was on a new ethics resource team for the ICU. She mentioned her thoughts to other members of the team, and the pastoral care director asked her to write a proposal.

As a result, all manner of hospital employees-secretaries, administrators, engineers and, of course, nurses-volunteered for the program to sit with those who are alone and dying. (Volunteers are required to be hospital employees, for reasons of confidentiality.)

Now, when a nurse on the floor determines a patient is dying and in need of someone to sit with them, a volunteer calls people who have signed up for the particular shift, until someone is found to come and sit with the patient until the end. And so, at Sacred Heart, "No one dies alone."

Clarke wasn't aware of any programs like the one she proposed, and still isn't, but says it really has struck a cord with the people who have volunteered. They sign up over and over again. Nurses who have gone into administration and are no longer doing bedside care sign up because it is a part of nursing that they miss.

"It happens about three or four times a month. I have found it to be a really joyous experience for many volunteers, including me," said Clarke, whose regular responsibilities as nursing house supervisor include any and all problems that come up during the night shift.

Hospital administration bought into the program quickly, buying a CD player for volunteers to use and providing them with parking passes and meal tickets. Orientation packets are provided for volunteers and a monthly orientation is conducted for volunteers who are not normally at the bedside. The hospital is proud of the program, Clarke said.

"I have a great belief in human rights and what is just. There are rights for the dying and one of them is no one should die alone. In old societies that would never happen, but in our high-tech society now, dying is just not done. It is not proper somehow. But people have outlived their families, or are alienated from friends and family, or just have accidents or heart attacks while they are passing through [the hospital is on a major highway between Los Angeles and Seattle]. But why couldn't we figure out a way for them not to be alone?"

The concept is so simple, she is surprised it isn't more widespread.

"As a nurse, the dying process is a very spiritual experience. It is like birth, so unique. You feel as though it is a privilege to be there, not a burden."