Just before the gate opens and the hands come down or up from the ground.I believe that many pt's know they are dying and when it comes right done to it,if you REALLY listen to your pt's, many will utter the word GOD.So,you go for it and pray all you want.Because if the pt does not hear your words the Mighter One will!!!! If I am ever in need at the end of my time I hope and Pray that my nurse will pray with me.