MultiCare volunteer program ensures no patient is alone in their final moments

As COVID-19 cases soared and visitor restrictions went into place across the nation’s hospitals in 2020, health care workers faced yet another tragedy — patients dying alone when family and staff couldn’t be by their side.

This was not a new occurrence, of course.

A patient could be alone for any number of reasons, explains Brittany Zimmerman, RN, a charge nurse in MultiCare Valley Hospital’s critical care unit (CCU). Their family could live out of town or have conflicting work schedules. Some patients have estranged relationships with their family. Some family members may also just need a break.

Staff try to be with these patients as much as they can, she says, but when units get busy that’s easier said than done.

“It is so heartbreaking to me when a nurse has five or six patients under their care and a comfort care patient who is passing away, and I know that nurse wants to be in there with the patient but physically they just can’t,” Zimmerman says. A comfort care, or hospice, patient, is a patient receiving comforting measures to improve their quality of life as they near death.

Watching patients die alone in increasing numbers during the pandemic, Zimmerman says, “I couldn’t stand by anymore and continue to see people die alone.”

That’s when a team of Valley nurses and staff teamed up with MultiCare Inland Northwest spiritual and volunteer services to develop the No One Dies Alone (NODA) program, aimed at providing a bedside companion for comfort care patients, regardless of their situation or condition. It also provides extra support and resources to families.

Through NODA, staff at Valley and MultiCare Deaconess hospitals now receive an updated checklist for comfort care patients, which includes notifying NODA if a volunteer is needed to sit with a patient and a reminder to provide family and caregivers with an updated resource packet.

Valley medical-surgical health unit coordinator Debbie Hardwick says the formalized program has been an important step forward for patients and families and improves staff’s ability to provide the best care possible.

Hardwick has been offering patients this kind of support on her own for 40 years. During her breaks, after her shift ended or if she had time to spare, she would sit and hold a patient’s hand.

“I don’t think anybody really wants to die alone,” she says. “I think everybody has that want to know somebody cares and will be there.”

She says having better guidance and a pool of volunteers to pull from has been the biggest benefit of NODA. To help grow that volunteer roster, Hardwick signed up as one herself.

“I wear my heart on my sleeve. I truly feel that I was put on this earth for this. To just be that warm hand, that beating heart that’s with them as theirs slows to a stop,” she says. “I still remember the first patient I ever sat with. It sounds weird to say rewarding, but it was an honor to see that last breath and to know that they were comforted to have me there.”

Beverly Parker, a retired VA physician and fellow NODA volunteer, brings decades of experience specializing in geriatrics to the program.

“When I retired, one of the things I had on my bucket list was to work for hospice,” Dr. Parker says. “Death doesn’t offend me or make me upset, so I thought it was something I could do for others.”

“I almost never changed how long someone lived,” she says of her time as a practicing physician. “But I had a big impact on how they lived. People die on their own terms, and death is not a bad thing in my world. Part of it is just being present.

“Most of us don’t know what is happening in that moment,” she continues. “A lot of experts agree that the last things to go are hearing and touch. While some people may want privacy to die, for others just your hand on their arm or holding their hand and speaking can be soothing.”

Patients may not always hear or understand, she says, but they know they’re not alone.

Dr. Parker sat with one NODA patient and recalls how thankful the staff on the floor were for her presence.

“They would say ‘oh thank God you’re here, I can relax that someone is with them,’” she says.

For a patient’s family, Hardwick says NODA can also ease some of the stress or guilt they feel at what is already an emotional time.

“They don’t have to be afraid to ask for help,” she says. “It is there. It’s not a weakness.”

As part of the program, new comfort care carts were developed to come equipped with handmade quilts, teddy bears donated by local law enforcement, jars to collect mementos, a bereavement tray and an updated NODA resource folder. The folder includes information about regional funeral homes and grief counselors, articles to help families process their loss and guidance on what to say to their loved one. It also includes FAQs on death certificates, mourners’ rights, how to memorialize a Facebook page and other topics.

“I want families and patients to take away that this hospital cares about them,” Zimmerman says. “It’s not just a business. MultiCare is part of this community, and we care about every part of their life — birth, illnesses and death.”

Parker adds that she hopes this program helps to ease the fear most people have around death, whether they sign up as a NODA volunteer or appreciate the benefits it brings.

“Death is not our enemy, it’s something we all do once,” she says. “I hope we can focus less on ‘They’re dying’ and more so on how we can make the time that is left as easy and as pleasant as possible. It’s not when you die, it’s how you live.”

If you’re interested in learning more about becoming a NODA volunteer, please visit multicare.org/volunteers and complete a volunteer application and select NODA under “assignment preferences” or contact Jennifer Tucker, director of volunteer services for the MultiCare Inland Northwest region at 509-473-7675 or [email protected]