Nurse Sandra Clarke will never forget the final plea of the dying man to stay by his side in his final moments ... or her inability to be there for him.

The experience haunted her, but also led her to develop No One Dies Alone, a program that trains volunteers to comfort the dying who have no family or friends by their side.

Clarke, a critical care nurse at Sacred Heart Medical Center in Eugene, Oregon, wrote about her experience for a 2002 issue of Supportive Voice, a newsletter of Supportive Care of the Dying: A Coalition for Compassionate Care.

The turning point happened in 1986.

"One rainy night ... I had a brief encounter with a man whose name I cannot recall, a man I shall never forget. He was one of my seven patients, near death and a DNR (Do Not Resuscitate). During my initial rounds, he asked, barely audible, 'Will you stay with me?' He was so frail, pale, old and tremulous. I said, 'Sure as soon as I check my other patients'.

"Vital signs, passing meds, chart checks, assessments and bathroom assistance for six other patients took up most of the next hour and a half. When I returned he was dead. I reasoned he was a DNR, no family, very old, end-stage multiorgan disease; now he was gone, and I felt awful. It was OK for him to die, it was his time but not alone.

"I looked around; scores of people were nearby providing state-of-the-art patient care. For this man, state-of-the-art should have been dignity and respect," Clarke wrote.

No One Dies Alone came into being at Sacred Heart in Nov. 2001.

"I am not an especially pious person," Clarke wrote in the newsletter. "I do have a strong belief in human rights, particularly when a person is most vulnerable. No One Dies Alone has been a profound professional and spiritual experience. It gives both job satisfaction and a raison d'ĂȘtre. It is a plan which could be readily implemented in any hospital. In time, it may be true that No One Dies Alone."