Takeaway
For patients without family present, pause to say, “I’m here with you.” Offer chaplaincy, social work, and volunteers to accompany dying patients in their final moments.
Lifelong Learning in Clinical Excellence | November 25, 2025 | 2 min read
By Nettie Reynolds, MDiv, interfaith chaplain, Chicago, Illinois
The room where no one else is coming
Years ago, as a hospital chaplain, I sat with a man who’d been brought in from the street. He had no identification, no listed contacts, and no one who knew he was there. His breathing was shallow. I held his hand and said, “I’m in the room with you. The sun is out today, and it feels warm. You matter to me, and I’m glad I can care for you.” He squeezed my hand. It was a quiet reminder that no one should leave this world without someone near them.
The gap we don’t always notice
Clinicians carry so much. Full census, charting, medications, rounds, and the steady flow of tasks that fill every shift. In that rush, it’s easy to pass by the patient who arrived without family or a contact number. When someone is alone, even if sleeping or in a coma, there’s evidence that patients may still hear the world around them. Your words and steadiness can reach someone whose body has grown quiet. Presence becomes part of care, reminding the patient that they’re still worth being seen.
Small gestures that carry weight
Sometimes support is as simple as pausing at the bedside. A nurse resting a hand on the blanket. A clinician offering calm words. A chaplain sitting quietly, letting the room settle. Small gestures make an impact.
Research on social touch suggests that holding a patient’s hand can activate neural pathways that reduce pain and fear. And simply gently saying, “I’m here with you,” can help a patient feel less alone. When someone doesn’t have a loved one with them, your presence becomes their “someone,” even if only for a few minutes. These gestures may feel small, but they can matter a great deal.
Bringing the team into the circle of care
The care team, volunteers, social work, nursing, and chaplaincy can all help build a circle around patients who would otherwise have no one. Ask the patient what they hope for in their care. Even when they can’t respond, they deserve to be addressed as an adult with a full life behind them. Calling a patient by name, speaking at eye level, and offering choices preserves dignity in vulnerable moments.
Chaplains are also here for clinicians. When your census is high, when the emotional load feels heavy, or when you need a moment to breathe before entering the next room, chaplaincy can offer support. Caring for yourself allows you to keep caring with compassion.
When a patient comes in alone
When a patient arrives without family, especially a patient who is older or someone living on the margins, consider what would help them feel known. A gentle touch or calm explanation of what you’re doing can make a difference. These small acts honor a person’s humanity. And when the work feels heavy, reach out for support. Exceptional care isn’t only about tending to every patient. It also means remembering that you need care too.
This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.