Literature Review

An organ donor saved my life. But fear of unlikely botched donations hurts others.  USA Today; by Kaitlyn Wells; 9/18/25 As someone who is alive today because of an organ donation, I was alarmed by the news that Donate Life America, a nonprofit that oversees a national registry of organ donors, saw a 700% increase in donor registration withdrawals since July. That startling drop in donors followed reporting by The New York Times offering horrifying details of how in extremely rare instances, teams rushed to secure organs from patients who still showed a flicker of life. 

A nurse’s journey through advanced breast cancer: Michele’s invasive ductal carcinoma Stage 4 diagnosis Norton Healthcare, Paducah, KY; by Sara Thompson; 9/15/25 When Paducah, Kentucky, native Michele Burgess received her Stage 4 invasive ductal carcinoma diagnosis Feb. 6, 2020, she faced the advanced breast cancer the same way she approaches everything in life — head on. As a nurse manager for an inpatient hospice unit, Michele had spent years caring for others in their most vulnerable moments. Now, she would draw on that same strength for her own battle. ... Most people expected Michele to step away from her demanding career after her cancer diagnosis. After all, working in hospice while fighting breast cancer seemed like an impossible burden. But Michele saw it differently. “Why wouldn’t I continue?” she asked herself. Her work gave her purpose, and her 10-bed inpatient unit needed her steady leadership. ...

A natural segue: Retired hospice physician Ralph Caldroney ’72 turns a planned gift into immediate impact with new lecture sponsorship W&L - The Columns, Washington & Lee University, Lexington, VA; by Barbara Elliott; 9/15/25 [Dr. Ralph Caldrony, retired medical director for Hospice of Rockbridge County,] attended several Mudd Center lectures during this past year’s series: “How We Live and Die: Stories, Values and Communities.” ... Impressed by the range and quality of the Mudd Center presentations [at Washington & Lee University], Caldroney previously committed a $250,000 planned gift to the center for his 50th reunion gift in 2022. However, after such a positive experience attending this year’s lecture series, he decided to fast-track his support. For each of the next five years, his $5,000 per-year gift will sponsor an annual lecture. “It was a natural segue,” Caldroney says. “This way, I can enjoy some of the fruits of my labor while I am still alive.”

New Salem-based hospice opens with focus on nursing staff wellness Salem Reporter, Salem, OR; by Hailey Cook; 9/11/25 After 12 years working as a hospice nurse, Christie Rivelli reached her breaking point. The pressure had built since the pandemic, when her workload went from 15 patients at a time to 28. ... By opening a new, locally-owned hospice company, they’re bucking a trend. ... Solterra currently has a staff of 19, with a range of one to three decades of experience in hospice care. As a nurse herself, Rivelli said she’s prioritized her staff’s workload and benefits. Everyone starts by getting training about post-traumatic stress disorder, and she said new hires have had trouble adjusting to a slower pace of work. ... Rivelli said. “Downtime in your workday should be built in … but boy, that’s not how it’s been in hospice.” She said some companies will assign 40 patients to one nurse, which forces the nurses to do pop-in check-ups rather than getting to know their patients. It can also mean the patient will see a rotation of unfamiliar faces rather than one nurse.

‘A playbook for best practices’: ASCO and COA release updated Oncology Medical Home Standards The ASCO Post; by ASCO (American Society of Clinical Oncology); 9/10/25 ASCO and the Community Oncology Alliance (COA) have released updated standards for its Oncology Medical Home (OMH) certification program, which were initially codified and published in 2021. The 2021 systematic literature review focused on the topics of OMH model of care, clinical pathways, and survivorship care plans. Among the 2025 updates are new standards that address “just culture” and safety in oncology, multidisciplinary team management, and geriatric assessment.

Implementing education for community adult hospice nurses to expand pediatric hospice and palliative careJournal of Hospice and Palliative Nursing; by Shelly C Wenzel; 8/25Pediatric hospice and palliative patients require specially-trained clinicians to provide holistic support in areas such as disease progression, illness trajectory, and goals of care. An asynchronous online educational module, including a pre- and postmodule survey, was developed to provide education on timely pediatric quality-of-life conversations and skills for nurses who work with the adult population. Following the education module, participants reported an increase in comfort from 25% to 93.3% and willingness from 59% to 93.3%. Additionally, postmodule confidence level increased to 94%. These findings suggest an asynchronous educational module approach benefits the needs of community-based adult hospice and palliative nurses and gains learned from this module may enhance nurse skill and improve access to care.

Perspectives of hospice medical directors on challenges and solutions for improving care for persons living with dementias (PLWD) and their caregiversAmerican Journal of Hospice and Palliative Care; by Taeyoung Park, Abhay Tiwari, Elizabeth Luth, Yongkang Zhang, Simone Prather, Micah Toliver, Giancarlo Chuquitarco, Veerawat Phongtankuel; 8/25A larger proportion of PLWD [persons living with dementia] outlive the 6-month hospice eligibility requirement compared to other terminally ill patients, which leads to high rates of hospice live discharge. Hospice medical directors (HMDs) are physicians with unique insights into both the clinical aspects of care and the administrative and regulatory guidelines of hospice care delivery. To address these challenges, HMDs suggested (1) establishing a dementia-specific hospice program, (2) extending hospice benefit availability for PLWD, and (3) creating a step-down service for families experiencing live discharge from hospice. HMD participants suggested providing additional supports and/or reforming the current Medicare hospice benefits to better address end-of-life care for PLWD, who may require prolonged and intensive end-of-life support.

The tangled web of nurse education Becker's Clinical Leadership; by Mariah Taylor; 8/29/25 In the last few years, hospital leaders have been faced with a tangled web of needs: easing nurse shortages, retaining nurses, and helping all pursue their career dreams. Their solutions all come down to nurse education. Health systems have been taking a more active role in providing, supporting and building out nurse education programs in universities and as part of employee benefits. However, they still face a number of complex issues.  Editor's Note: What types of career ladder systems and support to you have in place, especially for your aides to move into nursing and to grow nurses into leadership roles? What universities or online education systems can you utilize? What personalized educational assessments and plans to you include in your employees' regular Performance Reviews? For nonprofits, what donor/grant-driven programs do you have, or might you start to support career ladders for your clinical employees?

Caregiving under the Medicare Hospice Benefit JAMA Internal Medicine - Viewpoint Agind and Health; by Helen P. Knight, MD; Richard E. Leiter, MD, MA; Harry J. Han, MD; 9/8/25 As palliative care physicians, we frequently refer patients to hospice care. When we do so, we often worry about them. How will they and their families manage custodial care—the day in, day out, physical and financial demands of caregiving—on top of navigating the inherent challenges of end of life? We know that high-quality hospice agencies provide patients and their families with invaluable support for symptomatic, emotional, and spiritual needs. But in the US, due to constraints of Medicare reimbursement, hospice agencies provide only limited custodial care support; this lack of assistance often is an unwelcome surprise to our patients and families and profoundly shapes their end-of-life experience.

The next phase in virtual nursing Becker's Health IT; by Ella Jeffries; 9/9/25 The face of a nurse now appears on a television screen in hundreds of rooms at Jackson, Mich.-based Henry Ford Jackson Hospital. From a command center down the hall, the nurse conducts safety checks, reviews charts and helps patients prepare for discharge — all without ever crossing the threshold. This new model, known as virtual nursing, is not a futuristic experiment so much as a response to an immediate crisis. Michigan is already short as many as 20,000 registered nurses, according to Eric Wallis, DNP, RN, chief nursing officer of Detroit-based Henry Ford Health, and the average nurse in the state is older than 50.

Training and practice gaps in nursing home palliative care: A cross-sectional study Journal of the American Geriatrics Society (AGS); by Manali Saraiya, Molly A. Nowels, Rose L. Carlson, Jerad H. Moxley, Catherine A. Riffin, Evan Plys, M. Carrington Reid, Isabella Hastings, Taimur Mirza, Ronald D. Adelman, Daniel Shalev; 9/7/25 We conducted a cross-sectional survey of clinical employees (N = 398) at seven NHs within a single integrated health system in New York State to (1) gauge attitudes toward and knowledge about palliative care, (2) estimate the extent of engagement with advance care planning, and (3) elicit perceptions of the most valuable components of palliative care for NH residents. ... Despite support for palliative care, gaps in knowledge and clinical engagement persist and vary by discipline. Discipline-tailored training and program design may improve palliative care delivery in NHs and help ensure more consistent, value-aligned care for residents with serious illness.

The dying man who gave me flowers changed how I see care MedPageToday's KevinMD.com; by Augusta Uwah, MD; 9/2/25 Today for the first time, I got flowers from a grateful patient. And I reflect on how rough the week has been, all the things that seemed impossible and insurmountable, and everything that has brought me to this point. The patient is going on hospice, he’s going to die, yet he felt that I made a significant impact that he wanted to show his gratitude. And that almost brought me to tears. ... 

Update on malpractice claimsLinkedIn; by Elizabeth Hogue; 9/3/25New analysis by Claggett, Sykes and Garza Trial Lawyers shows that registered nurses (RNs) and physicians continue to top the list of health professions most likely to be sued for malpractice... While the total number of malpractice suits has decreased by almost 20% in ten years, the severity of claims has risen... Home care nurses, including those providing hospice and palliative care, were the most vulnerable to professional liability claims of all nursing specialties... [The article includes factors that may contribute to increases in claims against home health nurses and strategies that nurses can use to protect themselves from malpractice claims.]