Literature Review

What can we learn from the dying? Newscastle's News Letter Journal (NLJ), Newcastle, WY; by Kelly Evans-Hullinger, MD; 1/26/25 For the last five years, I have had the great privilege of serving my local health system as Medical Director for Home Hospice. Every week I sit in a meeting with the multidisciplinary caretakers on this team ... Patients facing their own deaths want to talk about their lives. Our staff frequently tries to facilitate what they call a “life review” in which a patient can openly talk about their childhood, family, career, service, and sometimes their regrets. This is therapeutic for the dying patient and their loved ones.  ... I have recently thought about this particular human need – to reflect and remember one’s life. I take this as a reminder to both seek those stories from my own loved ones (I wish I had asked my grandmother more questions about her life) and, perhaps, to tell and write about the things in my own life I would want to be remembered after I am gone. For if there is another thing I’ve learned serving patients on hospice, it is that my death is also inevitable; but, I think, life’s finality is what gives it beauty and meaning. 

Palliative care is essential for seriously ill patients—at any ageAMA (American Medical Association); by Kevin B. O'Reilly; 1/27/25 The AMA House of Delegates has adopted new policies outlining physicians’ ethical obligation to provide or seek optimal palliative care for patients with serious illnesses who can benefit from comprehensive management of pain and other distressing symptoms—not only those with terminal illnesses or on the precipice of death. “Physicians have clinical ethical responsibilities to address the pain and suffering occasioned by illness and injury and to respect their patients as whole persons,” says one of the new policies adopted at the latest AMA Interim Meeting, held in Lake Buena Vista, Florida. “These duties require physicians to assure the provision of effective palliative care whenever a patient is experiencing serious, chronic, complex or critical illness, regardless of prognosis.” 

How it feels to be a hospice nurse Post Independent; by Oanh Hoang, Hospice of the Valley; 1/22/25 If someone had asked me this question seven years ago, when I was a new graduate nurse, I would have said it felt terrifying, depressing, frightening, and sad. However, my feelings have changed since I became a hospice nurse 4.5 years ago. ... If someone were to ask me how it feels to be a hospice nurse now, I would tell them to grab a soda, popcorn, and snacks, and get comfortable because I could talk for hours about what it’s like. My feelings start with gratitude. I am grateful to be a part of the final phase of my patients’ lives, walking alongside them and their families toward a peaceful end. For all my hospice patients, time is the most valuable thing they have. ... Along with all these rewarding feelings, I also feel sadness when my patients pass away. But this sadness is different from the sadness I felt seven years ago. 

DEA unveils long-overdue special registration for telemedicine in proposed ruleThe National Law Review; by Marika Miller, Nathan A. Beaver of Foley & Lardner LLP; 1/21/25 In the final days of the Biden administration, the Drug Enforcement Administration (DEA) released a proposed rule that would allow practitioners with a Special Registration to prescribe Schedule III-V, and in limited circumstances Schedule II, controlled substances via telemedicine. Practitioners with a Special Registration would still need to obtain a DEA registration in each state where they prescribe or dispense controlled substances. However, the proposed rule establishes a limited, less expensive State Telemedicine Registration as an alternative to the traditional DEA registration. The proposed rule imposes several obligations on practitioners with Special Registrations when they prescribe controlled substances via telemedicine.  [Click on the title's link to continue reading.]

2025 ushers new era in physician unions Becker's Hospital Review; by Kelly Gooch; 1/17/25 While unionization among healthcare workers and professionals is a familiar phenomenon, resident physicians and fellows joining unions has only grown in recent years. Indeed, since the start of 2025 alone, at least five groups of resident physicians and fellows have opted to form unions at their health systems. "Physician unionization has massively increased since 2020, especially among interns and residents," Rebecca Givan, PhD, associate professor of labor studies and employment relations at Rutgers in New Brunswick, N.J., told Becker's. ... Dr. Givan pointed to an increasing number of staff physicians unionizing as well. In 1998, the American Medical Association estimated that between 14,000 and 20,000 physicians belonged to unions. That number grew to 46,689 in 2014, and reached 67,673 in 2019. 

At United Hospice good leadership makes all the difference Mid Hudson News, Goshen, NY; by Mid-Hudson News Staff; 1/19/25 In the world of healthcare, there are few environments as emotionally charged and delicate as hospice care.  Here, patients face the final chapter of their lives, and their families must grapple with the profound weight of grief and impending loss. It’s a space that requires not only clinical expertise but also an extraordinary level of compassion, empathy, and resilience. At the heart of it all is leadership—a factor that can profoundly shape the quality of care, support, and comfort patients and families receive during this challenging time. [Cara Pace, United Hospice CEO] noted that leadership in hospice care is not about wielding authority or simply managing logistics. It’s about embodying a vision of compassionate, patient-centered care that resonates throughout the organization. A good hospice leader knows how to create a culture of empathy, where every member of the team understands the profound impact their work has on the lives of patients and families.

Knoxville nurses bring wedding to UT Medical Center for bride’s dying mother WATE Knoxville, TN; by Molly O'Brien; 1/15/25 Nurses on the Progressive Care Unit at UT Medical Center planned a wedding for one of their patient’s daughter. Samantha Barry and her now husband, Phillip Bastelica, were supposed to get married in a few months. Barry, like most daughters, always planned on her mother being at her wedding day. Her mother, Lynn, is battling a terminal illness and was recently released from the Progressive Care Unit to hospice. ... It seemed unlikely that Lynn would be able to attend the wedding planned for August, so Barry and Bastelica decided to move the day up. ... The nurses who cared for Lynn jumped into action to plan a wedding for Barry.

How poor communication is killing patients and burning out doctors Medpage Today's KevinMD.com; by Pamela Buchanan; 1/14/25 This week alone, I had two particularly heart-wrenching encounters [as an Emergency Room physician]: A 65-year-old man with metastatic lung cancer, convinced his shortness of breath was just pneumonia. When I explained the progression of his disease, he was shocked. No one had told him that his cancer was likely incurable. A 97-year-old woman brought in for “failure to thrive.” She was frail, pale, and not eating—classic signs of the final stages of metastatic cancer. When I suggested hospice care, she seemed blindsided, as if this reality was completely new to her. Both cases highlight a troubling trend: Patients often come to the ER not just for care, but for clarity. They don’t understand their diagnosis, prognosis, or treatment plan. ...

Introduction: ‘Those who have made death their life’The Daily Yonder - Keep It Rural; by Hannah Clark; 1/15/25 Hannah Clark spent six months riding along with the nurses and certified nursing assistants (CNAs) of Hearth Hospice who provide in-home care to those living in Northwest Georgia and Southeast Tennessee. These hospice workers often drive up to a hundred miles a day to visit a handful of patients scattered across the Appalachian landscape in both rural towns and urban centers. What will follow this introductory essay is her photo reportage in three parts, documenting what she has witnessed accompanying these caregivers. The intimate portraits and vignettes show tender moments at different stages towards the end of one’s life. Their beauty lies in the companionship Clark captured in moments of need and vulnerability. 

Medical schools report steep drop in enrollment of Black and Hispanic students after Supreme Court ruling STAT; by Usha Lee McFarling; 1/9/25Enrollment of Black and Hispanic students in medical schools dropped precipitously last year after the Supreme Court banned the consideration of race in admissions, according to data released Thursday by the Association of American Medical Colleges. The number of Black enrollees fell by 11.6% compared to last year, while the number of Hispanic enrollees decreased 10.8%. The numbers were even starker for Indigenous students; the number of American Indian or Alaska Natives dropped by 22.1%, while students who were Native Hawaiian or Pacific Islanders dropped by 4.3%. 

Home … where we all want to be The Journal; Dr. Sarah Phillips, Medical Director Hospice of the Panhandle; 1/12/25 Two days before Christmas, I arrived at the home of a patient who had been recently admitted to Hospice services. ... [Story of the patient being on a ventilator in a hospital.] This courageous and self-determined woman expressed the desire to be free from pain, suffering, and the complications and progression of her disease. Knowing that the ventilator was life-sustaining and essentially breathing for her, she made the decision to stop it. To ensure her comfort during discontinuation of the ventilator, the hospice team was present before, during, and after the procedure. Medications were used to ease shortness of breath, pain, and anxiety. ... “It’s a Wonderful Life” was playing on the TV, the Christmas tree was lit. I looked over and see the daughter wiping away her mother’s tears. Each reassured the other that everything will be OK and that they are at peace with this decision. As the medications took effect, the patient drifted off to sleep. The ventilator was stopped. Next, something happens that I will never forget. The daughter leans in and whispers to the patient, “Mom, the ventilator is off now, you are back in total control. This was profound to me on many levels. It certainly spoke to the power and importance of autonomy, the ability to make independent decisions that are aligned with one’s values and goals. ... Despite working in end-of-life care for over a decade, I still have these moments of being overwhelmed by the human spirit.

3 nurse specialties with highest, lowest pay Becker's Hospital Review; by Kelly Gooch; 1/13/25 From January through July 2024, staff registered nurses involved in direct patient care saw their median base pay increase by 2%, compared to 1.4% for those in indirect patient care. However, RNs involved in direct and indirect patient care were poised for annual increases of 3% to 4% to close out 2024. ... The survey includes six-month percentage change data from January through July 2024. It is based on data from more than 700 participating organizations, representing approximately 358,000 individuals across over 115 nursing roles, including RNs, nursing managers and licensed practical nurses. [Click on the title's link for this important data.]

Largest health care strike in Oregon history begins as thousands picket Providence Hospitals FM News 101 KXL, Portland, OR; 1/10/25 Some 5,000 hospital health care workers walked off the job Friday as they picketed all eight Providence hospitals in Oregon, in what the state health workers union described as the largest health care strike in Oregon history — and the first to involve doctors. Most of those participating in the open-ended strike are nurses. But in a rare move, dozens of doctors at a Portland hospital and at six women’s health clinics are also partaking, making it the state’s first physicians strike, according to the Oregon Nurses Association union.