Literature Review

A doctor’s life-changing realization about empathy after becoming a patient [podcast] MedPage Today's KevinMD.com; podcast by KevinMD; 11/10/24 Join us for a conversation with Fazlur Rahman, a hematology-oncology physician and author of Our Connected Lives. In this episode, we explore how Fazlur’s journey from physician to patient transformed his understanding of empathy. He reflects on the importance of personal connection in medicine, the impact of a lack of empathy on both doctors and patients, and the need for medical education to include the humanities to foster compassionate care. This episode dives deep into the role empathy plays in improving patient outcomes and doctor-patient relationships. Fazlur Rahman is a hematology-oncology physician and author of Our Connected Lives. He discusses the KevinMD article, “From doctor to patient: a life-changing lesson in empathy.”

Signs and symptoms of end-of-life kidney failure Health; by Lindsay Curtis; 11/8/24 Kidney failure, or end-stage kidney disease (ESKD), occurs when the kidneys lose their ability to filter waste and excess fluids from the blood. As toxins and fluid build up in the body, other health problems can develop, increasing the risk of life-threatening complications. ...

The dozen phrases doctors warned never say to patients, including ‘everything is going to be fine’ What's New 2Day; by Alexander; 11/8/24 “Everything is going to be okay.” No doubt you or someone you know has heard those words from a doctor, but doctors are now being warned to stop doing so because it could raise false hope. A new report has identified 12 “never phrases” that doctors should never use with patients with serious illnesses, such as heart failure, cancer and lung disease. They explain that these “isolated words or phrases not only lack benefits but can also cause emotional harm and accentuate power differences.” If a patient is seriously ill, for example, a doctor should never mention the words “withdraw care,” as this implies that the medical team is “giving up.” While “everything will be okay” may seem like a comforting phrase, researchers say this could offer false hope when dealing with a serious illness and a better expression might be “I’m here to support you through this whole process.” [Click on the title's link for the dozen phrases they identify, with alternative language and rationale.]

Most heart failure patients miss out on guideline-recommended palliative care Cardiovascular Business; by Dave Fornell; 11/6/24 Over the past decade, the American Heart Association (AHA) and European Society of Cardiology have recommended integrating palliative care into heart failure management. Despite these recommendations, the use of palliative care for heart failure remains low in the United States. Racial and geographic variations in access and use of palliative care are also pronounced, highlighting health disparities. These were the findings of a recent study in the Journal of the American Heart Association. Researchers at Saint Louis University led the study and said only one in eight patients with heart failure in the United States receive palliative care consultations within five years of diagnosis. Their study highlights the alarmingly low uptake of palliative care among adults with heart failure in the U.S., especially compared to patients with cancers that have the same mortality rates. The study also pointed out significant racial and geographic disparities. Black patients were 15% less likely to receive palliative care compared to their white counterparts. They said this disparity is particularly concerning given the higher cardiovascular risk and mortality rates in the Black population.

Nurse burnout the root of decreased resident safety, medication errors, study shows McKnights Long-Term Care News; by Zahara Johnson; 11/6/24 A new study has found a direct link between nurse burnout and unfavorable patient and facility outcomes, including medication errors and a degraded safety culture. The meta-analysis of 85 studies and 288,581 nurses, compiling more than 30 years of research, concluded that nurses who suffer from burnout – emotional exhaustion, depersonalization and a low sense of personal accomplishment – have a negative impact on patients.

Pennsylvania LPNs will now be able to make death pronouncements Tri-State Alert; 11/4/24 A bill sponsored by Sen. Lynda Schlegel Culver (R-27) was signed into law this week to enable licensed practical nurses (LPNs) working in a hospice setting to make death pronouncements. “I am grateful for the governor’s support of this important legislation,” Culver said. “LPNs are with patients and their families until the moment of death, providing essential care during emotional times. Allowing LPNs to make death pronouncements, which was previously only a function of doctors, RNs, physician assistants, and coroners, can alleviate wait times that grieving families often experience.” The bill was amended in the House of Representatives to also provide needed clarification on the waiver of birth and death certificate fees for members of the armed services, veterans, and their families. The law now outlines specifically whose documents qualify for the waiver, as well as applicants and scenarios for which the fee may be waived. 

Physician explores family's end-of-life journey in new podcast: "There were so many places that we ran into unexpected obstacles" MedPage Today; by Rachael Robertson; 11/4/24 As host of the TED Health podcastopens in a new tab or window, Shoshana Ungerleider, MD, is no stranger to podcasting. But now, the internist turned the mic on herself to explore death and mortality through the lens of her own experience losing her father to pancreatic cancer. Her eight-episode show is called "Before We Go" and is available on all podcast platforms (Spotify, Apple) with new episodes each week through early December. ... Ungerleider: My father died from pancreatic cancer in the spring of 2023. In my experience as an internist and as someone who is an expert on end-of-life through my work with End Well, there were so many things that kind of shocked me along the way. Despite the fact that I had the knowledge, the expertise, and the resources to provide him with a good end-of-life experience, there were so many places that we ran into unexpected obstacles. I wanted to share my story, really, with the goal of helping other people who might be facing the same kind of journey, and how to find the balance between being a doctor and being a daughter.  ...

Providence, nurses union step up war of words as new Portland-area hospital strike looms The Lund Report; by Jake Thomas; 10/31/24 Providence is accusing the state’s largest nurses union of “power flexing” after nurses at Providence St. Vincent signaled they are willing to strike in what could be another widespread work stoppage at the hospital system. The Oregon Nurses Association announced Thursday that 1,800 nurses at the hospital located in unincorporated Washington County, just west of Portland, gave union negotiators the green light to call for a strike. ... Nurses and allied health care workers at Providence’s Portland and Seaside hospitals as well as its Home Health & Hospice service went on strike in June last year. Each of the three workplaces eventually reached contracts with Providence. But the new contracts had shorter timeframes than usual because of the strikes and are set to expire on Dec. 31, 2024. All three began negotiations again with Providence management last month. 

We invite you to listen to our latest podcast: Imagine Heaven, with John Burke TCN Talks (Teleios Collaborative Network); podcast by Chris Comeaux; 10/30/24 In this inspiring episode of TCNtalks, Chris Comeaux sits down with John Burke, New York Times bestselling author of Imagine Heaven and Imagine the God of Heaven, for a soul-stirring conversation on near-death experiences (NDEs) and their profound implications. John shares the overwhelming evidence of the commonalities of near-death experiences (NDEs) and the evidence that supports their validity from across the world and from across many different cultures.  Chris begins by recounting his own transformative experience reading Imagine Heaven over his summer sabbatical, describing it as a refreshing oasis for the parched soul. John delves into the fascinating and consistent patterns found in NDEs worldwide, revealing how people from vastly different backgrounds describe similar encounters of leaving their bodies, seeing with a spiritual clarity—even those blind from birth—and entering realms filled with light, love, and peace. 

How to initiate goals of care discussions with familyExpertClick, Denver, CO; by Pamela D. Wilson; 10/30/24 ... While many adults set these conversations aside until a health diagnosis or other situation occurs, having goals of care discussions early in life allows more effective planning.

Providence Alaska Medical Center tests virtual care model, announces hospice partner Alaska Business - Healthcare, News; 10/28/24 Providence Alaska Medical Center (PAMC) recently launched a new way of caring for patients that combines bedside nursing with a virtual or remote nurse and a dedicated patient care technician or certified nursing assistant. Known as co-caring or virtual nursing, the bedside nurse manages direct patient-care duties while the virtual nurse coordinates other support tasks. Also this month, the Washington-based not-for-profit healthcare system that operates PAMC announced it will partner with Compassus...Co-Caring Model Leverages Skilled Nurses: Virtual nursing is a response to a strained labor market. A study by the National Center for Health Workforce Analysis shows Alaska is projected to lead the nation in nursing vacancies, with as many as 23 percent of openings unfilled, by 2030. The co-caring model helps address the impending shortage while providing added patient care, Providence officials say.

A moral code: Ethical dilemmas in medicine — three physicians face crossroads in patient care MedPage Today; podcast by Genevieve Friedman, Perspectives Editor; 10/25/24 We are back for another episode of our medical podcast, which we hope isn't really a podcast about medicine, but a podcast about life, death, dilemma, the challenges, and sometimes the joys of medicine. ... Now, medicine is complicated because a lot of times there aren't hard and fast rules ... One treatment isn't always right or wrong for someone. One surgery isn't always successful or unsuccessful, and one diagnosis isn't always correct. Decisions aren't black and white, they're varying shades of gray. So we come up with principles to help handle this -- codes if you will. But even those get a bit marred by complexity at times. As you'll hear in this episode of Anamnesis with the theme of "A Moral Code: Ethical Dilemmas in Medicine," one of our biggest codes is "do no harm." But what is harm? Who decides what harm is, what happens if we disagree?

What is narrative medicine? Finding humanity in health care Rheumatology Advisor; by Matthew Eck, MS; 10/25/24 Health care requires humanity. At its roots, narrative medicine embodies this ideology. Coined in 2000 by internist and scholar Rita Charon, MD, PhD, the field is “medicine practiced with the narrative competence to recognize, interpret, and be moved to action by the predicament of others.” ... Narrative medicine is less a specific practice and more a theoretical framework that equips caregivers and health care professionals with tools to provide more holistic care. These tools stem from storytelling principles and literature, which can hone our empathic and listening skills. ... Medical schools across the country are increasingly tailoring their curricula to include humanities-focused aspects, ... Conclusion: Regardless of one’s feelings about health care infrastructure in the United States, narrative medicine illuminates a profound truth — more can be done to accommodate patients of different backgrounds. Narrative medicine can offer health care providers a new way of thinking, attending, and recognizing. It could bring us closer to the human condition than ever before.