Literature Review

End-of-life conversations: ‘When they open the door, you have to go in’ Oncology Nursing News; by Pattie Jakel, MN, RN, AOCN; 3/13/25Oncology nurses have a unique relationship with patients that allows for difficult but essential end-of-life conversations, says expert Patricia Jakel, MN, RN, AOCN. Jakel, one of the editors in chief of Oncology Nursing News, emphasized that following up with patients and ascertaining what answers and support they need comes with the close bonds that oncology nurses form with patients with cancer. ... [Jakel describes:] We play a really important role. And sometimes patients ask us difficult questions, and we have to be prepared for it. I remember a lovely young patient I had, she had 2 little girls, and she was very sick. And things weren’t going well for her in the hospital, and she just—she looked up at me and she said, "Am I dying today?" And I thought, "She’s opening the door. She needs to have this conversation.” And I said, “It’s not going to be today, but I think it’s going to be soon.” And she kind of chuckled, because her sister was at the bedside, and she said to her sister, “I need my makeup done. I want my makeup on today, if today’s not the day.” And that took us to a whole conversation about what dying would look like for her.Editor's note: Read and share this significant, sensitive video/article from its source, Oncology Nursing News. What communication education and support do you provide for your nurses? Explore this similar article from Oncology Nursing News, "APPs, Oncologists Work Together for End-of-Life Discussions," 11/2/24.

Penny Stamps speaker Gary Tyler shares his wrongful conviction story, empowers communities through artThe Michigan Daily; by Talia Varsano; 3/17/25At 5:30 p.m. in the Michigan Theater Thursday night, nearly every seat was full as the audience welcomed Gary Tyler, a falsely convicted felon of first-degree murder turned artist, performer, youth mentor and community leader. ... On October 7, 1974, Tyler was framed and wrongfully convicted by an all-white jury of first-degree murder and sentenced to death at 16 years old. ... At the event, Tyler spoke about his experience as an inmate at the Louisiana State Penitentiary in Angola for nearly 42 years before his release in 2016. Tyler said the trajectory of his life was completely shifted by his wrongful imprisonment. ... [Tyler's story of imprisonment continues.] Tyler began quilting while incarcerated to raise money for the hospice program at Angola, which provided end-of-life care for Louisiana State Penitentiary inmates. Tyler said he was inspired by his mother and grandmother, who were also quilters, as well as the communities surrounding him. ... Tyler said. “When I do quilts, I try to pull everything around me, because I try to build, I try to put everything that I feel, that someone would identify, someone would recognize, understand, in my quilt.” ... Tyler volunteered for the Angola Prison Hospice program for more than 17 years while incarcerated.Editor's note: Pair this with Death and redemption in American prison," posted 2/19/24 about Gary's friend and fellow quilter at Angola Prison Hospice program, Stephen Garner. 

What Trump has done with Medicare so far Kiplinger; by Kathryn Pomroy; 3/17/25 Since President Trump was sworn into office on January 20, he has proposed or initiated changes impacting Medicare. Here's a roundup. ...

Where are all the nurses? Data show that some states have a far higher number of nurses per capita than othersMedscape; by Jodi Helmer; 3/7/25 During their 12-hour shifts, registered nurses (RNs) in Arizona and Arkansas perform many of the same tasks as RNs in Wisconsin and Wyoming: Assessing patients, monitoring vital signs, administering medications, and charting records to provide the best patient care. The work might be similar, but there are vast differences in the number of RNs in each state. ...  Even states with the largest number of nurses per capita are not immune to the nursing shortage. The National Bureau of Labor Statistics estimates that there will be 195,400 job openings for RNs from 2021 to 2031.  ....

Medicare Payment Advisory Commission [MedPAC] releases report to Congress on Medicare Payment Policy 2025 report on Medicare payment policy Medicare Payment Advisory Commission, Washington, DC; News Release, contact Stephanie Cameron; 3/13/25Today [3/13/25], the Medicare Payment Advisory Commission (MedPAC) eleases its March 2025 Report to the Congress: Medicare Payment Policy. The report presents MedPAC’s recommendations for updating provider payment rates in fee-for-service (FFS) Medicare for 2026, providing additional resources to acute care hospitals and clinicians who furnish care to Medicare beneficiaries with low incomes, and eliminating certain Medicare coverage limits on stays in freestanding inpatient psychiatric facilities. The report reviews the status of ambulatory surgical centers (ASCs), the Medicare Advantage (MA) program (Medicare Part C), and the Part D prescription drug program (Medicare Part D). ... Fee-for-service payment rate update recommendations. ... MedPAC recommends ... payment reductions relative to current law for hospice providers, skilled nursing facilities, home health agencies, and inpatient rehabilitation facilities.  [Click on the title's link to continue reading.]

Less wealth at death linked to more end-of-life symptoms McKnights Long-Term Care News; by Kristen Fischer; 3/10/25 Older people with less wealth showed a higher burden of symptoms when they approached the end of their lives compared with those who had more wealth, a study found. The report was published in JAMA Network Open on March 6. Investigators looked at data from 8,976 older adults. The team evaluated 12 end-of-life symptoms including difficulty breathing, frequent vomiting, low appetite, difficulty controlling arms and legs, depression, and severe fatigue or exhaustion.Then they correlated symptoms to individuals’ wealth. Wealth was broken into three categories: low wealth was having less than $6,000; medium wealth was having between $6,000 and $120,000; and high wealth was considered having more than $120,000 at the time of death. Of respondents, 22.5% had low wealth, 50.5% had medium wealth and 27.1% had higher wealth. People who had less wealth were more likely to have a higher burden of symptoms compared to those who had more money. Functional impairment, multimorbidity and dementia were factors that affected the association, data revealed.Editor's note: Click here for this important JAMA article, posted in our Saturday Research issue 3/15/25, "Wealth disparities in end-of-life symptom burden among older adults."

The roots of palliative care: Michael Kearney, Sue Britton, and Justin SandersGeriPal - A Geriatrics and Palliative Care Podcast for Every Healthcare Professional; by Alex Smith; 3/13/25 ... As far as we’ve come in the 50 years since Balfour Mount and Sue Britton opened the first palliative care at the Royal Victoria Hospital in Quebec, have we lost something along the way? In today’s podcast we welcome some of the early pioneers in palliative care to talk about the roots of palliative care.  Sue Britton was the first nurse hired on that palliative care unit. Michael Kearney on a transformational meeting in Cicely Saunders’s office, with Balfour Mount at her side and a glass of sherry.  Justin Sanders wants to be sure the newer generations of palliative care clinicians understand the early principles and problems that animated the founders of hospice and palliative care, including:

Happy St. Patrick's Day! May the blessings of each day be the blessing you need the most. Editor's note: For a treasure trove of more Irish blessings, click here.  Click for the the History Channel's "History of St. Patrick's Day."

The path to excellence: How nursing education can propel your career WFMA-TV 69 News; Allentown, PA; by Valencia Jasira; 3/11/25 ... Why higher education matters in nursing: Expanding expertise beyond the basics is becoming more essential in the medical profession. Institutions and employers now prefer staff members with comprehensive training and credentials. This trend is largely due to evolving regulations, technological advancements, and the push for better service quality. ...

Leadership with grit, grace, and a bold heartTeleios Collaborative Network; by Lynn Flanagan and Tina Gentry; 3/14/25 Leadership is not for the faint of heart!  It demands adaptability, resilience, and empathy. We all know that when we talk about leadership, we often use metaphors. The metaphor that strikes a chord with both of us is that of “grit, grace, and a bold heart.”  Leading in this way sometimes comes with titles such as “The Velvet Hammer” or “The Big Heavy,” but we digress. Grit, grace, and a bold heart may seem contradictory, but they are all essential elements to create an environment where people and ideas thrive. ... When these three elements - grit, grace, and a bold heart —come together in a leader, they create a powerful combination. It is the resilience to weather storms, the empathy to connect deeply with others, and the passion and courage to drive transformative changes. ...

[UK] RCGP shifts to position of neither supporting nor opposing assisted dying RCGP - Royal College of General Pracitioners, London, UK; Press Release; 3/14/25 The Royal College of General Practitioners' Council has voted to move to a position of neither supporting nor opposing assisted dying being legal. The RCGP UK governing Council - elected representatives of the wider College membership – today voted to determine what the College’s stance should be on whether or not assisted dying should be legal:

Terminally ill Stanford professor teaches class about dying from cancerCBS News, Bay Area, CA; by Elizabeth Cook; 3/13/25 A Stanford University professor's new curriculum explores the multiple aspects and phases of a person dying of cancer, and it comes from a person with first-hand knowledge. Dr. Bryant Lin has been a professor for almost two decades. He's used to being the teacher, not the subject of his classes. But that all changed in 2024 when he was diagnosed with stage 4 lung cancer. ... The diagnosis was a dose of cruel irony. Lin co-founded the Center for Asian Health Research and Education. One of the priorities for the foundation is researching non-small cell adenocarcinoma, also known as "never-smoker lung cancer," the same cancer diagnosis that Lin received. ... The class is called "From diagnosis to dialogue: A doctor's real-time battle with cancer." Within minutes of being posted, the class and the waitlist were full. ... The 10-week course covers the entire spectrum of cancer as seen through the eyes of someone who is living it. ... Stanford University recorded every session of the class so that they could live on for future physicians. If you would like to watch them, they can be found on YouTube. 

The 1 truly difficult part about being a caregiver that often gets overlooked HuffPost; by Kimberley Richards; 3/13/25 Emma Heming Willis, wife of actor Bruce Willis, recently talked about the needs of caregivers on social media. Experts share what to know about the vital role. ... Among the different ways society may overlook the various caregiving experiences, there’s one aspect of it that isn’t often talked about: Many times it’s an “invisible” job. ... Hemings Willis’ post sparked conversations online about caregivers and the many struggles that come with it. And experts say perhaps one of the most isolating is the issue of “invisibility. ... She said that caregiving is often seen as a “family duty,” which prevents it from “being recognized as a broader issue requiring systemic attention.” “This view is often compounded by gendered expectations, where women are traditionally expected to take on caregiving roles, leading to feelings of guilt and pressure when they seek assistance,” she said. “The lack of formal policies ... only deepens the invisibility of this vital role, making it even harder for caregivers to balance their responsibilities with their own well-being.”