This quote from Diane Setterfield's 'Once Upon a River' eloquently captures the profound emotions and realities surrounding the process of dying. Rita, the nurse, embodies a significant role not only in the physical care of patients but also in providing emotional support during one of the most difficult times a person can face. The poignant statement, "Dying could be lonely," underscores a universal truth that the act of facing mortality can bring isolation, even amidst loved ones. Yet, the nurses and caregivers stand as pillars of empathy and companionship, bridging that gap that sometimes even family members cannot cross.

Rita’s unwavering gaze communicates strength, presence, and acceptance—a non-verbal reassurance that facing death does not have to be endured alone. Her role in guiding people to confront "what was coming" speaks to the essential human need for honesty and companionship when grappling with the end of life. The quote encourages reflection on the unique relationships forged in such vulnerable moments, revealing that comfort often arises from unexpected places.

Moreover, this excerpt touches upon the themes of vulnerability, connection, and the human condition at its most fragile. It invites readers to think about how society views mortality and the vital place caretakers hold in this journey. The reference to the nurse being sometimes "an easier person to talk to than family" also invokes the complexities of familial dynamics when confronted with mortality. Overall, the passage is a sober and sincere meditation on death, compassion, and the strength found in simple human connection.