Literature Review

Attitudes and beliefs regarding Pain Medicine: results of a national palliative physician survey Journal of Pain and Symptom Management; by Daniel K Partain, Wil L Santivasi, Mihir M Kamdar, Susan M Moeschler, Jon C Tilburt, Karen M Fischer, Jacob J Strand; 4/25/24 online ahead of print Objectives: To evaluate referral rates, co-management strategies, and beliefs of palliative physicians about the value of Pain Medicine specialists in patients with serious illness. Conclusion: This study shows that Palliative Care physicians have highly positive attitudes toward Pain Medicine specialists, but referrals remain low. Facilitating professional collaboration via joint educational/clinical sessions is one possible solution to drive ongoing interprofessional care in patients with complex pain.

Palliative care nursing: Podcast with Betty Ferrell about ELNECGeriPal Podcast; by Alex Smith, Eric Widera, and Betty Ferrell; 4/26/24As Betty Ferrell says on our podcast today, nurses play an essential role in care of people with serious illness. Who spends the most time with the patient in the infusion center? Doing home care? Hospice visits? In the ICU at the bedside? Nurses. ELNEC (End-of-Life Nursing Education Consortium) celebrates it’s 25th anniversary in 2025. We talk today with Betty Ferrell, who has been a nurse for 47 years, and is the founder and PI of ELNEC.

Across the nation, the fight’s on to protect physician-led careAmerican Medical Association - AMA; by Kevin B. O'Reilly; 4/25/24After helping state medical associations and national specialty societies defeat more than 100 bills to inappropriately expand nonphysicians’ scope of practice in 2023, the AMA is again relentlessly joining its allies in organized medicine to continue the fight for physician-led, team-based care in this year’s legislative session. This intensive and effective advocacy effort has ranged across the country, as the AMA has helped battle scope creep in Alaska, Connecticut, Georgia, Oklahoma, New Hampshire and elsewhere.

Beyond compensation: Culture as a benefit HR Daily Advisor; by G Hatfield; 4/24/24 Compensation is not the only factor that nurses consider when choosing a health system. Benefits packages, workplace culture, safety, and flexibility all play a role in the decision-making process. CNOs should take a look at their health system’s offerings to make sure they are attractive to new nurses and that they are staying competitive in the industry. During the HealthLeaders’ Nurse Labor and Compensation NOW Summit, Robin Steaban, Chief Nursing Officer at Vanderbilt University Hospital, spoke about  innovative perks to attract and keep nurses, and how workplace culture and safety play a role as benefits alongside compensation.

Nurses protest AI at Kaiser Permanente Becker's Health IT, by Giles Bruce; 4/22/24 Hundreds of nurses gathered April 22 to protest the use of artificial intelligence at Oakland, Calif.-based Kaiser Permanente. The California Nurses Association held the demonstration at Kaiser Permanente's San Francisco Medical Center to coincide with the beginning of KP International's Integrated Care Experience conference. "It is deeply troubling to see Kaiser promote itself as a leader in AI in healthcare, when we know their use of these technologies comes at the expense of patient care, all in service of boosting profits," said Michelle Gutierrez Vo, BSN, RN, a president of the California Nursing Association and registered nurse at Kaiser Permanente Fremont (Calif.) Medical Center, in a statement. ...

Psychosocial distress screening among interprofessional palliative care teams: A narrative review Journal of Social Work in End-of-Life & Palliative Care, by Chelsea K Brown and Cara L Wallace; 4/23/24With increased need for palliative care and limited staffing resources, non-social workers are increasingly responsible for screening for urgent psychosocial distress. The National Consensus Project guidelines call for all palliative care team members to be competent in screening across domains. ... Although an abundance of validated screening tools exists for outpatient oncology-specific settings, there is minimal guidance on psychosocial screening tools intended for specialty palliative care. The most oft-cited tools have been met with concern for validity across diverse palliative care populations and settings. ...  

Behind the stethoscope: Exploring nursing ethics Noozhawk, Santa Barbara County, by Green Shoot Media; 4/22/24 The American Nurses Association developed a Code of Ethics for Nurses in the 1950s. It has been revised over the years to respond to technological advances and changes in society and the nursing field. Gallup takes a poll every year asks how the public ranks various professions for having high honesty and ethics. For 22 straight years, nurses come in as the most respected in terms of honesty and ethics. In 2024, 78% of the poll takers perceived them as honest.

Primary and specialty palliative care utilization at a regional Burn center Oxford Academic / Journal of Burn Care & Research; by Zoe Tao, MD, Alexandra Hoffman, BS, Anna Stecher, MD, Niknam Eshraghi, MD, FACS; 4/20/24There is little research informing appropriate specialty palliative care consultation over primary palliative care practice, or the ability of the burn surgeon to perform skills such as effective goals of care discussions. ... There is bias in diverting both primary and specialty palliative care resources toward acutely ill patients and those with less immediate projected mortality may need additional attention.

Terminally ill pediatric patients and the grieving therapist Psychotherapy.net, by Sara Loftin, LPC-S, RPT-S; 4/18/24 A pediatric clinician shares the rewards and challenges of working with terminally ill children and their families. When asked about the favorite aspect of my (dream) job, I could talk for hours. I feel passionate about working in a pediatric hospital setting with chronically ill children and their families. Each day brings new challenges. ... Experiencing the death of a child is the most painful part of my job, and it will never make sense to me although logically, I know this happens. On the other hand, I feel honored to be a small part of the most vulnerable time in a family’s life, and to walk alongside them in their journey of grief and loss. ... It has been impossible for me to not be deeply impacted working in this arena. [This article includes:]

Hospice handoffs may lower odds of Medicare denials Medscape, by Lara Salahi; 4/29/24Clearer communication between primary care clinicians and hospice providers may decrease the number of denied Medicare approvals for end-of-life treatment, according to a small study presented on April 18 at the American College of Physicians Internal Medicine Meeting 2024. Tyler Haussler, MD, acting medical director at  Brookestone Home Health & Hospice in Carney, Nebraska, said he conducted the study. ... CMS requires a "face-to-face encounter" between a physician and hospice caregiver to communicate clinical findings and determine the patient's terminal status. Missing or incomplete documentation of a patient's medical condition remains one of the main reasons the agency denies hospice coverage. 

5 steps to cutting the red tape that adds to doctor burnout American Medical Association (AMA), by Sara Berge, MS; 4/16/24 ... Reducing burnout is essential to high-quality patient care and a sustainable health system. The AMA measures and responds to physician burnout, helping drive solutions and interventions. ... Dr. [Kevin] Hopkins identified the five steps below to get rid of regulatory make-work that interferes with patient care and contributes to physician burnout.

Health care system eats away at the doctor-patient relationship The Boston Globe; updated 4/17/24... The system economically rewards throughput (the number of patients seen per unit time) and procedures rather than the time needed to develop an open and communicative doctor-patient relationship. While a good physician might understand the tests and evaluations that are indicated by a presenting medical problem, the excellent clinician knows which tests and evaluations should not be done. This is primarily ascertained by delving into details of the patient’s physical, psychological, social, family, and economic history. This process, as James highlights, can lead to collaborative and more effective care. ...Editor's Note: This article highlights "Dr. Thea James’s remarkable work at Boston Medical Center in addressing structural inequity in medical care as a means of enhancing outcomes brings up an underlying structural problem across the entire medical care system (“Her health equity message being heard,” April 13, 2024.)