Literature Review

Training and practice gaps in nursing home palliative care: A cross-sectional study Journal of the American Geriatrics Society (AGS); by Manali Saraiya, Molly A. Nowels, Rose L. Carlson, Jerad H. Moxley, Catherine A. Riffin, Evan Plys, M. Carrington Reid, Isabella Hastings, Taimur Mirza, Ronald D. Adelman, Daniel Shalev; 9/7/25 We conducted a cross-sectional survey of clinical employees (N = 398) at seven NHs within a single integrated health system in New York State to (1) gauge attitudes toward and knowledge about palliative care, (2) estimate the extent of engagement with advance care planning, and (3) elicit perceptions of the most valuable components of palliative care for NH residents. ... Despite support for palliative care, gaps in knowledge and clinical engagement persist and vary by discipline. Discipline-tailored training and program design may improve palliative care delivery in NHs and help ensure more consistent, value-aligned care for residents with serious illness.

This is the one question leaders need to ask themselves: To avoid burnout, leaders need to pay attention to their energy levels Forbes - Work Life; by Tim Jack Adams; 9/1/25 You’ve carried the weight of big decisions, the pressure to perform, to lead and deliver, all despite what’s happening behind the scenes. You’ve navigated through uncertainty and change, providing the space for everyone else to thrive. It’s a feeling that the most capable leaders feel. It’s not quite burnout, but a kind of dullness. A slow drain. A fog that creeps in quietly and makes it harder to stay clear, connected, and grounded. ... It's not about time, it's about energy. ...Editor's Note: Twenty years ago, this concept revolutionized my workday, productivity, outcomes, and overall well-bing, via the book The Power of Full Engagement: Managing Energy, Not Time, Is the Key to High Performance and Personal Renewal, by Jim Loehr, published 2003. This author's content is fresh, dated September 2025.

[Germany] Yes, we (still) can! A qualitative study on the dynamic process of team resilienceJournal of Management; Silja Hartmann, Matthias Weiss, Martin Hoegl; 7/25Research on psychological resilience in the workplace is on the rise, aiming to better understand how to successfully manage adverse events. To address this research gap, we conducted a qualitative study with a palliative care team that experienced work-related adverse events. This model specifies the experience of adverse events as loss events and illustrates how teams can counteract these losses and enact team resilience through the relational process of caring. Caring in teams can be enacted through four dimensions, which we refer to as understanding, being with, doing for, and enabling. By enacting these caring dimensions, teams can heal social safety and collective action capabilities and can moreover build valuable resources, which may buffer resource loss and fuel resource growth in subsequent team resilience episodes.

The new state of HR: Pressures, systems and skills IBM Corporation; by Molly Hayes; 8/18/25 To prepare for the workforce of the future, HR leaders should face these challenges-head on. Recently, I spoke to Kimberly Morick, Global Technology Practice Leader at IBM, about how HR can create new paradigms within their organizations.

Fear of death may undermine hospice care preparedness for future nurses McKnights Long-Term Care News; by Donna Shryer; 8/6/25 A new study from Central South University in China examined the relationship between nursing interns’ attitudes toward death and their attitudes toward hospice care. ... The researchers found that most nursing interns held a “neutral acceptance” view of death, defined in the study as the belief that death is a natural part of life. This attitude was significantly associated with more positive views toward hospice care. ...  The study also reported that interns who held stronger fear-based or avoidance-based death attitudes scored lower on all six hospice care subscales, including communication and family support.

Demographic variations and temporal trends in hospice and palliative care fellowship matches in the United States Scientific Reports; by Aman Goyal, Samuel L. Flesner, Urooj Shamim, Sonia Hurjkaliani, Priya Goyal, Mohamed Daoud & Amir Humza Sohail; 8/8/25 ... In summary, the number of Hospice and Palliative Care fellowship training programs, positions, and applicants increased. Female applicants, compared to males, and White applicants, relative to their representation in all fellowships, accounted for a larger proportion of applications and had higher match rates. ... Future research should focus on initiatives to address challenges such as the underrepresentation of certain demographics in palliative care and the growing demand for trained professionals as the population ages. 

Insurance companies’ Medicare pullback is here: Insurers are planning to scale back benefits, trim plans and exit from markets. Investors are cheering The Wall Street Journal; by David Wainer; 8/5/25 Many seniors enjoy the perks that come with Medicare Advantage. But those extras—like dental coverage and free gym memberships—are being scaled back. Insurers are cutting benefits and exiting from unprofitable markets, and Wall Street is cheering them on. Once rewarded by investors for rapid expansion in the lucrative privatized Medicare program, companies are now being applauded for showing restraint amid rising medical costs and lower government payments.

Burnout eases for doctors at every career stage as support rises American Medical Association (AMA); by Sara Berg; 7/22/25 Physician burnout is showing promising signs of decline, according to exclusive survey data from the AMA. The analysis reveals that burnout rates have fallen among physicians at every career stage after residency or fellowship training. At the same time, measures of job satisfaction and feeling valued in the workplace are on the rise—an encouraging shift that suggests meaningful progress in efforts to support physician well-being.  ... Nearly 18,000 responses from physicians across 43 states were received from more than 100 health systems and organizations that participated in the AMA Organizational Biopsy® last year. The AMA national physician comparison report—which is exclusive data to the AMA that is not published anywhere else—reflects 2024 trends on six key performance indicators—job satisfaction, job stress, burnout, intent to leave an organization, feeling valued by an organization and total hours spent per week on work-related activities ... 

Negotiations move forward as Essentia delays return of striking workers Minnesota Nurses Association, Duluth, MN; Press Release; 7/25/25 On Tuesday [7/22], clinic nurses, surgery center nurses, healthcare workers at Solvay Hospice House, and Advanced Practice Providers (APPs) with the Minnesota Nurses Association (MNA) concluded a powerful strike across Essentia Health facilities that involved nearly 700 frontline workers. The two-week strike by nurses and healthcare workers and 13-day strike by APPs brought statewide attention to Essentia’s unfair labor practices, including unlawful intimidation, surveillance, and clear attempts to bust the union. Yet, even after the strike’s end, Essentia is continuing to keep on travel nurses, when former striking healthcare workers are available and want to return to work. 

6 health systems that faced worker strikes this month MedCity News; by Katie Adams; 7/22/25 Healthcare workers at six health systems across the country have launched strikes in July so far. These healthcare employees cite unsafe staffing levels, low wages and retaliation against union organizers as their main reasons for going on strike. From hospice centers to emergency rooms, frontline healthcare workers across the country have been striking this month to protest what they say are unsafe patient care conditions and poor bargaining behavior. Below are six examples of union activity resulting in a strike — all of which occurred in July.

Systems lean into nurse educator initiatives Becker's Clinical Leadership; by Mariah Taylor; 7/18/25 There is a key driver behind the nationwide shortage of nurses: a severe nurse faculty shortage. To solve both shortages, more systems and nursing programs are creating formal venues to enlarge the nurse educator pipeline. Like the nurse shortage, universities and nursing programs are facing a nurse faculty shortage that has reduced their capacity to accept and train students. Too few nurses are pursuing advanced degrees and becoming educators in the field, according to the American Association of Colleges of Nursing. So systems are developing programs that boost interest and remove barriers for nurses who want to teach. These programs — many of which launched in the last year — range in commitment and scale. Here are a few examples: ...

Palliative video consultation and symptom distress among rural inpatients-A randomized clinical trialCritical Care Medicine; Marie A. Bakitas, DNSc, RN; Shena Gazaway, PhD, RN; Felicia Underwood, MSW, MPS, LICSW-S; Christiana Ekelem, BS; Vantrice T. Heard, PhD; Richard Kennedy, MD, PhD; Andres Azuero, PhD; Rodney Tucker, MD, MMM; Susan McCammon, MD, PhD; Joshua M. Hauser, MD; Lucas McElwain, MD; Ronit Elk, PhD; 7/25The triple threat of rural geography, racial inequities, and older age has hindered access to high-quality palliative care for many people in the US. Only 70% of the deep South vs 85% to 94% of the rest of the US has palliative care despite the deep South having the greatest needs due to suboptimal health care access and elevated morbidity and mortality. In this RCT [randomized clinical trial] among Black or African American and White chronically ill hospitalized adults, culturally based specialist palliative care video consultation was not associated with statistically significant reduced symptom distress compared with usual care, but there was a clinically meaningful difference ... between groups. Contrary to our hypotheses, intervention participants’ QOL [quality of life] and resource use (secondary outcomes) also were not improved. Assistant Editor's note: This study reminds us that palliative care delivered virtually, as opposed to in-person, may not be of benefit to some individuals. It also reminds us that palliative care, at its best, is delivered on an ongoing basis by a known, trusted professional, as opposed to a one-time session with a consultant.