Literature Review

CMS clarifies physician referral authority, tightens attestation requirements in proposed hospice ruleInside Health Policy; by Jalen Brown; 4/11/25... The proposed rule would explicitly allow the physician member of the hospice interdisciplinary group (IDG) to recommend patients for hospice care, addressing a gap in current regulations over which physicians have that authority. While CMS already lets IDG physicians certify that a patient is terminally ill and eligible for hospice, the existing admission rules only name the hospice medical director or physician designee as authorized to recommend admission. CMS also wants to strengthen documentation requirements for hospice recertification, ... Starting at day 180 and every 60 days thereafter, Medicare requires a hospice physician or nurse practitioner (NP) to conduct a face-to-face visit with the patient before recertifying eligibility. After the visit, the clinician must provide a written attestation confirming that the visit occurred and was used to assess whether the patient still qualifies for hospice care. Under CMS' proposal, that attestation would also need to include the clinician's signature and the date signed, submitted as a clearly labeled section or addendum to the recertification form. 

The power of film to change medical culture: A Q&A with a physician-filmmaker about her latest documentary MedPage Today; by Genevieve Friedman; 4/15/25... We spoke with Jessica Zitter, MD, a critical care and palliative care physician in California, about shifting her career beyond clinical medicine and into the world of film-making. Zitter has produced three documentaries that use storytelling to inspire healthcare providers to connect to their work with purpose, community, and compassion, and in 2022, she founded the production company Reel Medicine Media. Her latest documentary, "The Chaplain & The Doctor," explores her relationship with Betty Clark, a chaplain on Zitter's palliative care team, and the value that can grow from an unlikely partnership.

Brain activity before death: Do we see our lives flash? Time.News; interview with Dr. Eleanor Vance; 4/12/25 What flashes through our minds in the final moments of life? Could it be an intense reel of our most cherished memories or a profound sense of calm? Recent studies suggest that the brain may not simply shut down at death; instead, it could be engaged in a powerful replay of life’s most significant moments, offering a glimpse into the mysteries of consciousness and the human experience.

Hospice of Americus-Sumter County Georgia establishes nursing scholarship at GSW Georgia Southwestern State University, Americus, GA; 4/9/25 The Hospice of Americus-Sumter County Georgia has announced the creation of a new scholarship aimed at supporting students enrolled in Georgia Southwestern State University’s (GSW) Associate of Science in Nursing (ASN) program. Designed to foster local talent and address the growing need for qualified healthcare professionals, the scholarship specifically targets non-traditional students with healthcare experience or those who are first responders from Sumter County and the surrounding region. ... By prioritizing individuals already embedded in healthcare and emergency services, the fund supports career advancement and ensures that compassionate, experienced caregivers remain within the community. [Continue reading ...]

Statement by the American Nurses Association on organizational restructuring within the US Department of Health and Human Services American Nurses Association (ANA); Press Release; 4/8/25 The American Nurses Association is aware of the recent personnel changes and organizational restructuring within the US Department of Health and Human Services (HHS). These developments have sparked concerns among nurses nationwide regarding the potential impact on essential programs and services delivered by HHS in collaboration with nurses, patient advocates, and other healthcare providers. ... The association will monitor that re-structured capacity and promptly report any gaps we identify to the Administration and Congress to ensure the needs of nurses, and the public are met by our federal partners. It is imperative that Secretary Kennedy and Administration leaders ensure the uninterrupted continuation of the vital work of these agencies. Federal agencies must have the necessary staff to carry out the public health, research, quality, and operational work that the American people rely on for their health and well-being. [Continue reading ...]

You've got a friendtor in me: Innovations in peer mentoring for mid-career palliative care clinicians American Journal of Hospice & Palliative Care; April Zehm, Andrew J Lawton, Leah B Rosenberg, Sudha Natarajan, Bethany-Rose Daubman; 3/14/25 Mentoring is crucial to professional success, but little is known about the professional development needs of mid-career hospice and palliative medicine (HPM) clinicians. ... An interprofessional "friendtor" group of five HPM clinicians from three academic medical centers met monthly and for a year-end focus group. ... Several themes emerged that highlight the importance of ...

Most people pursue a toxic type of purpose in life—but if you do this instead, ‘there is no way to fail’ CNBC Make It; by Dr. Joran Grumet, contributor/hospice medical director; 4/4/25 It took me many years and quite a bit of emotional heartache to realize a life-changing fact: When it comes to purpose, bigger is not better. Most of our anxiety stems from what I call “big P” Purpose, which is overly focused on the outcome or destination. ... [Dr. Grumet describes what he calls "big P" Purpose vs. "little P" Purpose.] I’ve found that most people end up pursuing the former, toxic type of purpose. It’s the easiest kind to choose, because it means meeting society’s expectations and following in the footsteps of the herd. The harder decision by far is to do the internal work to discover what really lights you up — and find a way to pursue it in the world. This all takes effort, but it’s worth it. ... Little P purpose embraces an abundance mentality. There is room for everyone — I mean everyone — to pursue that which brings them inner joy and happiness. This pursuit will never rely on whether someone else is succeeding or failing. ... [Continue reading ...]

Nurse honor guard hoping to grow in South Dakota Sisseton Courier, Sisston, SD; by Brenner Cariveau; 4/4/25Nurse Honor Guard is a national organization which aims to honor the life of a nurse in funeral services. Traveling home, health and hospice nurse Laura Frankenhoff said the ceremonies help highlight the career of the nurses and is a way to ensure they are recognized for the work they have done as a nurse. Nurse Honor Guard has been performing ceremonies to honor the lives of nurses nationwide since their inception in the 1980s, Frankenhoff said. Regarding the honor guard, the base is made up of volunteers, according to Frankenhoff. "It's a volunteer chapter. You can make a chapter anywhere." Editor's note: Especially for pioneer hospice organizations--typically non-profits but definitely not all--do you honor those who laid the foundations for the work you're able to do now? If not, how can you? While nurses are absolutely core, how might you also honor your aides, social workers, chaplains, grief counselors, executives, office staff, and others who invested their talents and years in hospice care? May we remember. May we humbly thank and honor them.

Are hospitalists becoming de facto PCPs for patients with complex illness? Today's Hospitalist; by Colleen Peggenburg, MD, MS; April 2025 Key takeaways:

Palliative care in the intensive care unit: An integrative review of intensive care unit health care professionals' views and experiences Dimensions of Critical Care Nursing (DCCN); by Berit Lindahl and Susan Kirk; May-Jun 2025 ... Our findings suggest there is variation in how palliative care in the ICU is conceptualized and interpreted. Intensive care unit professionals need enhanced competencies and training to develop their confidence in providing palliative care and improve role clarity. Such training should focus on serious illness conversations with patients/families and interdisciplinary teamwork. Integration of palliative consultants into the ICU could be further developed.

Managing oncology nurse burnout through peer support, emotional intelligence Oncology Nursing News; by Pattie Jackel, MN, RN, AOCN; 3/28/25 Debriefing after patient loss, supporting patients at the end of life, and finding outlets outside of work can help oncology nurses avoid burnout. ... Pattie Jakel, MN, RN, AOCN, spoke with Oncology Nursing News® about burnout in oncology nursing and ways to avoid it while providing palliative care to patients. ... You have to have a strong network and support. And my husband is…an architect, so medicine is not his thing, and in the beginning, he’d be like, “Pattie, I can only hear one sad story a week because I can’t hear all your sad stories.” ... "Working in acute care, I saw some horrific death and dying that occurred for our patients. We would definitely debrief afterwards, bring the group together 5 minutes. Sometimes we did longer ones." [Continue reading ...]

Bioethics Artificial Intelligence Advisory (BAIA): An Agentic Artificial Intelligence (AI) framework for bioethical clinical decision support Cureus; by Taposh P. Dutta Roy; 3/12/25 Healthcare professionals face complex ethical dilemmas in clinical settings in cases involving end-of-life care, informed consent, and surrogate decision-making. These nuanced situations often lead to moral distress among care providers. This paper introduces the Bioethics Artificial Intelligence Advisory (BAIA) framework, a novel and innovative approach that leverages artificial intelligence (AI) to support clinical ethical decision-making. The BAIA framework integrates multiple bioethical approaches, including principlism, casuistry, and narrative ethics, with advanced AI capabilities to provide comprehensive decision support.