My wife is a volunteer for a wonderful program at our hospital that ensures our patients receive compassionate care and emotional support at a time when they likely need it the most. I am talking about patients who are terminally ill and experiencing the last days and hours of life.
We adopted the "No One Dies Alone" (NODA) program at our hospital in January of 2011. This program has attracted the support of our nursing staff, our chaplaincy program, our hospice program and our community like no other program we have ever implemented.
Every time when I think about the NODA program, it reminds me of my experience with my dying father. My father died at age 74 of colon cancer. He passed away at home in his own bed. On the night before he died, my sister and I made a pact that we were not going to allow our father to die alone. We took turns staying up with him all night. He expired the next morning with all four of his children at his bedside.
I have always been comforted by the fact that we were together as a family on that morning. Since that day, four years ago, I have been completely sold on bedside vigils like the one my sister and I established that night.
The NODA program at my hospital follows the guidelines of the pioneering program of the same name, originated by Sandra Clarke, a registered nurse at Sacred Heart Medical Center in Eugene, Ore., in 2001. As a result of making a promise to stay at the side of a dying patient at her hospital and then not keeping her word, Sandra created an award winning program in palliative care. Each year, more and more hospitals adopt this program.
If you are not familiar with NODA, here is how it works: It is a volunteer program in which volunteers (many of whom are nurses at my hospital) sign up to be on call as a "compassionate companion" whenever we have a patient who has reached their last 72 hours of life and has no family or friends to stay with them. Whenever a patient presents on our nursing floor and meets the criteria of (a) having no family or friends in the immediate area and (b) having a life expectancy between 48 and 72 hours, then the nursing staff may make a call to the nursing supervisor about initiating a NODA vigil. Only the nursing supervisor is empowered to begin a vigil. We call it an "activation."
Beginning a vigil involves the two types of volunteers that are the core of our program. There are vigil coordinators, like my wife, who volunteer to maintain a list of trained volunteers and to make calls to fill each hour at the bedside until the patient expires. Then there are the bedside volunteers or "compassionate companions" who must complete an eight-hour training program and pass a drug screen and a criminal background check. We do not ask volunteers to spend more than two hours at the bedside in any given 24-hour period.
Our experience with this program in the past 15 months could not have been more positive. It is an extremely good fit with the values of my organization for wellness, healing and holistic care. NODA has been so successful that one of my nurses calls it "the best program that we have ever begun at our hospital." And that is saying a lot, as we are considered a very innovative hospital with a large array of services and programs for our community.
I highly encourage any readers that would like to establish a program with a high amount of acceptance from the community and the hospital staff to seriously consider "No One Dies Alone." In my case, the process was easy--one of our chaplaincy volunteers had heard about the program and wanted to start one at my hospital.
As palliative care becomes more and more important in reducing healthcare costs in the United States, it will be compassionate programs such as NODA that will differentiate the high-performing hospitals.
Raymond Hino, MPA, FACHE, is the Chief Executive Officer of Mendocino Coast District Hospital in California.