Literature Review

From theory to practice: Collaboration shows how law and healthcare work together in real life Iowa College of Law; 5/22/24 A recent workshop collaboration between the [Iowa] College of Law and College of Nursing gave students preparing for both professions an opportunity to learn more about legal and healthcare issues surrounding end-of-life decision-making. The two-hour event, “Navigating the Intersection of Law and Healthcare: An Interactive Workshop for Future Practitioners,” brought together students from the Estate Planning and Law & Policy in Action clinics and graduate students in the College of Nursing. Topics included Medical Powers of Attorney (Medical POA), Living Wills, and other decision-making considerations for critical health issues. Elise Fenton, JD Candidate (2025), said the workshop illustrated the difference between how advance directives like Living Wills work in theory versus how they may be utilized in practice. 

Educating the future of hospice and palliative carePortage.life; by Center for Hospice Care; 5/21/24This spring students at the University of Notre Dame gained insight into the delivery of care to patients and families dealing with serious advanced illnesses. The university, in partnership with Center for Hospice Care (CHC), once again offered the course “Introduction to Hospice and Palliative Care” that was designed by Dr. Dominic Vachon, Director of Ruth M. Hillebrand Center for Compassionate Care in Medicine and Mike Wargo, COO and vice president of the Hospice Foundation. The five-week class covered a variety of topics focused on hospice and palliative care and was taught by CHC staff including physicians, social workers, chaplains, bereavement counselors and other hospice and palliative care support staff.

The human side of AI: Insights on balancing automation and empathy Innovation & Tech Today; by Enrico Palmerino; 5/20/24 ... As AI automates more tasks with clinical precision, empathy is a critical human element we cannot overlook. That intangible ability to understand and share the feelings of another isn’t just a soft skill — it’s an essential catalyst for trust, loyalty, and genuine connection. Consider the healthcare industry, where empathy is (quite literally) often a matter of life and death. Can an AI-powered diagnostic system truly grasp a patient’s fear and vulnerability when facing a serious illness? ... Finding the delicate balance between leveraging AI automation and preserving human empathy is the new challenge before us. It’s a duality that will shape how businesses operate and how we interact with technology. ... Let the machines optimize processes while we optimize the ability to connect and inspire. In this harmonious future, AI is a tool that elevates us — not replaces us.Editor's Note: Is AI a hot topic among your leaders and interdisciplinary clinicians? Often, "empathy" and "communication" are cited as key cautions and conflicts. 

Nurse resilience, decompression off balance: Press GaneyBecker's Clinical Leadership; by Erica Carbajal; 5/14/24Nurses have a hard time disconnecting from work, and may benefit from additional workplace resources that support them in doing so, according to findings from a new Press Ganey report on nurse resiliency. ... Below are four key findings from the report:

When doctors withhold futile treatments, that isn’t ‘assisted dying’ The Guardian; by Dr. James Haslam; 5/15/24 [Commentary / Letter] I write in response to Dr Jagat Aulakh’s letter (A form of assisted dying already happens in hospitals, 8 May). It must be made clear that withholding or withdrawing futile treatments is not and never has been assisted dying. Stopping – or not starting – treatments that are not wanted, are not working or are not worthwhile is good medicine and the law of the land. Whereas “assisted dying” is the modern euphemism for physician-assisted suicide and euthanasia, both forms of medicalised killing [the author's choice of words]. ... Intentions are important. ...Editor's Note: This thoughtful response puts forth ethical support against Medical Aid in Dying (MAiD), also known as "physican assisted suicide." Likely, different opinions can be inflammatory among your hospice and palliative employees, board, community, and more personally among your family and friends. As hospice and palliative leaders, we must address this issue with respectful dialogue, critical thinking, case studies, personal beliefs and values, empathy, and humanity.

Emerging leaders in hospice and palliative care AAHPM - American Academy of Hospice and Palliative Medicine; webpage source for various press releeases of individuals; 5/24AAHPM developed the Emerging Leaders in Hospice and Palliative Care program to recognize the exceptional work accomplished by the next generation of leaders and bring increased exposure to the specialty of hospice and palliative medicine. In 2014, the first class of Emerging Leaders was named. AAHPM seeks to recognize accomplished early career professionals and the next generation of hospice and palliative care leaders. This award recognizes new Emerging Leaders in recognition of their career accomplishments, involvement in the Academy, mentoring of residents and students, and participation in charitable work. [Click on the title's link for the list of 36 honorees.]Editor's Note: Do you work with or know any of these honorees? If so, please share this with them and your colleagues, along with congratulations from Hospice & Palliative Care Today! (Invite them to register for free--no strings attached--to our daily newsletter.)

800+ California nurses to receive 22.5% pay hike Becker's Hospital Review; by Kelly Gooch; 5/10/24Members of the California Nurses Association have approved a new labor contract with Washington Hospital Healthcare System in Fremont, Calif. The four-year agreement covers roughly 840 nurses, according to a union news release. It was approved by union members May 3 and by the Washington Township Health Care District board of directors May 8. ... According to the CNA, the new deal includes a 22.5% across-the-board increase in wages over four years. It also includes "precedent-setting standard expanding infectious disease protocols and workplace violence protections"; language that protects union members' ability to take meal and rest periods; and protections for part-time positions, according to the union.Editor's Note: These new terms reflect nationwide trends of healthcare/nurse strikes and reasons for leaving their jobs, ie., pay, patient safety, workplace violence, work/home life balance, and more.

Nurse practitioners improve skilled nursing's dementia care outcomes, but regulatory barriers remain: studyMcKnights Long-Term Care News; by Josh Henreckson; 5/13/24[Nurse pracitioners'] NPs’ involvement can significantly improve end-of-life care outcomes for residents with Alzheimer’s disease and related dementias (ADRD), according to the results of a new study in JAMA Health Forum. ... Those benefits, however, were shrunk by state regulations on the scope of care NPs are allowed to provide. ...  Elizabeth White, PhD, assistant professor of health services, policy and practice at Brown University [describes,] “For example, when a state restricts NPs from signing Do Not Resuscitate orders, that can serve as a barrier to advance care planning and could contribute to unnecessary hospitalizations at the end of life.” Editor's Note: We posted this JAMA Health Forum article on : Nurse Practitioner care, scope of practice, and end-of-life outcomes for nursing home residents with dementia. 

Top 5 AI concerns for nurses Becker's Health IT; by Giles Bruce; 5/8/24Nurses have been expressing concern about healthcare artificial intelligence lately, with some even marching in protest against the technology. But what are their main qualms with AI? [According to a recent study:]

Nurse Practitioner care, scope of practice, and end-of-life outcomes for nursing home residents with dementia JAMA Health Forum - JAMA Network; by Cyrus M. Kosar, PhD; Bishnu B. Thapa, MPA, PhD; Ulrike Muench, RN, PhD; Christopher Santostefano, RN, MPH; Emily A. Gadbois, PhD; Hyesung Oh, MA, MBA; Pedro L. Gozalo, PhD; Momotazur Rahman, PhD; Elizabeth M. White, APRN, PhD; 5/10/24 Question: Is nurse practitioner (NP) care associated with end-of-life outcomes for nursing home residents with Alzheimer disease and related dementias (ADRD), and do these associations differ between states with full vs restrictive NP scope of practice regulations? Findings: The results of this cohort study including 334 618 US nursing home residents with ADRD indicated that decedents with greater NP involvement at end of life had fewer hospitalizations and higher hospice use. The adjusted differences in outcomes between decedents with extensive vs minimal NP care were larger in states with full scope of practice regulations than in states with restrictive regulations.

Impact of implementing serious illness conversations across a comprehensive cancer center using an interdisciplinary approach The American Journal of Hospice & Palliative Care; by Karen Guo, Garrett Wasp, Maxwell Vergo, Matthew Wilson, Megan M Holthoff, Madge E Buus-Frank, James J Perry, Amelia M Cullinan; 5/10/24Objectives: (1) Increase Serious Illness Conversation (SIC) use across oncology teams via an interdisciplinary quality improvement (QI) approach and (2) assess patient reported shared decision making (SDM) experiences with clinicians engaged in SIC implementation.Results: Oncology teams screened a total of 538 patients, identified 278 eligible patients, and completed 144 SIC conversations. The teams improved the proportion of documented SIC among eligible patients from near 0% to a collective frequency of 52%.

What nurses really need is better staffing: The common strategies to raise nurse morale need an updatePenn LDI - Leonard Davis Institute of Health Economics; by Karen Lasater, PhD, RN, and Jane Muir, PhD, APRN; 5/10/24Pizza. Coloring books. Goody bags. They could be activities at a 5-year-old’s birthday party. But they’re not: These are many employers’ attempts to lift the morale of nurses on the frontlines of chronically understaffed organizations. What nurses really want are better working conditions so they can deliver the best care possible to their patients. As researchers at the University of Pennsylvania School of Nursing, we asked thousands of nurses why they are leaving their profession. Their answers are straightforward — short staffing is so rampant that the public’s health care is at risk. The playbook of corporate health care asks nurses to do much with little, but nurses aren’t willing to skimp on quality and safety. There isn’t a nursing shortage — it’s nurses’ refusal to be part of a system that puts profits before safety.