Literature Review

My husband almost died. When I asked his doctor for help, I was appalled by the insensitive response. HuffPost; by Carrie Severson; 1/13/25 ... The physician’s assistant came in and looked at Gavin [the author's husband]. As soon as she took her seat, I told her I wanted to schedule him for a feeding tube, expecting her complete understanding and compassion. Instead, she laughed. “I recommended a consult for a feeding tube last week, and you declined it,” she said sharply. “Now I have to start over from scratch and reach back out to the GI team to see how we can get him in.” My mouth dropped open. I stared at her, bewildered. “I wasn’t ready last week. I’m ready now,” Gavin mumbled, barely audible. “What did he say?” the physician’s assistant snarled. I very calmly repeated what Gavin said, my heart breaking for him and rage racing through my body. “Well, you certainly have made my job harder. And now I’ll have to see what I can do for you. You’ll hear from me about your next steps, and you better follow them. It might be too late because of your attitude,” she barked. I leaned in, looked at her straight on, meeting her nasty tone, and said, “No. Your attitude has made this harder. And it’s very much not appreciated right now. He’s in pain, and your job is to help us. In fact, you took an oath to do no harm, and what you’re doing in this room is harmful.” ...

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.

How agilon health trains primary care physicians to provide palliative care Hospice News; by Jim Parker; 1/8/25 The senior care company agilon health (NYSE: AGL) has scaled a palliative care education model for its physician partners throughout most of the markets they serve. ... A 2023 study published in the Journal of Pain and Symptom Management found that the primary care-led, integrated approach to palliative care that agilon employs were two-thirds less likely to die in a hospital and on average spent five more days at home near the end of life. Hospice News sat down with agilon’s CMO, Dr. Karthik Rao, to talk about the ways the company prepares physicians to provide palliative care to their most seriously ill patients. [Key goals include:]

Managing clinical care after M&AHealthleaders; by Christopher Cheney; 1/6/25Coping with the challenges of mergers and acquisitions has become an essential responsibility for CMOs.

Hospice workers share the foods that bring patients comfort till the end: Plus, they reveal how families can support their loved ones with scents, small bites and shared memories HuffPost; by Julie Kendrick; 12/30/24... We all live, we all die and we all enjoy food along the way. The memory and meaning of food, along with the bliss of being able to savor a cherished flavor, are still present in our lives, even as we head toward a last meal, a soothing sip of water or a final bit of sustenance. “Food often plays an emotional role in the last stages of life,” said Dr. Kurt Merkelz, the chief medical officer at Compassus, a home-based care company. “Some patients may reminisce about favorite meals or foods that connect them to fond memories and loved ones. There are instances where patients crave a specific dish that reminds them of their family or heritage, even if they can’t eat much.” ... People often ask for things like mashed potatoes, ice cream and chicken soup, according to Gail Inderwies, the founder and president of KeystoneCare, a hospice and home health provider in Pennsylvania. ... Sometimes, those comforts are part of a culinary heritage.

As a hospice nurse, Jaffrey's Nancy Folsom helps make the journey easier The Keene Sentinel, Keene, NH; by Elijah de Castro; 12/28/24 Nancy Folsom has been working around death since she was a teenager in her family’s funeral home, where she was an embalmer apprentice. From there, she took a step back, pursuing a career as a home hospice nurse in the Monadnock Region, where she helps those who are dying confront death. “Death is never easy, at any age or any time,” Folsom said. “We want to make it as human as possible. I’ve always been comfortable with death.” ... Folsom, 62, of Jaffrey, “has never had a boring day” on the job. When she’s not out in the community working, she’s in the Peterborough office of Home Healthcare, Hospice and Community Services, a local nonprofit provider of home health services that also has offices in Keene and Charlestown. ... Over the years, Folsom has gained experience in how to best read a situation when she gets a new patient. Building trust between a hospice nurse and a patient, Folsom said, takes time, something many of her patients don’t have. Folsom resolves this dilemma by first making sure she is comfortable herself and cultivating a calm, abiding presence. ...

Muslim community-engaged research highlights Muslim Americans' end-of-life-healthcare gaps and needs WisconsinMuslimJournal.org; by Sandra Whitehead; 12/20/24 Few Muslim Americans use hospice care, despite its posited benefits. A multi-sectoral team of academicians and community leaders in southeastern Wisconsin decided to find out why. ... Muslims are one of the fastest-growing religious communities in the United States, numbering between 3 to 5 million, with projections it will double by 2050. “With an aging Muslim population, there is a growing need for specialized healthcare services like hospice and palliative care,” the team’s research explains. ... Through a qualitative descriptive study with a Muslim patient and 10 family caregivers, the research team identified their perceptions of hospice care, ethical concerns and experiences. Among their varied perceptions, many saw it as useful only in the last hours of life. Participants also had ethical concerns about the use of sedative medication and with cessation of feeding terminally ill patients. Some had concerns about how hospice care might lead to unnecessary interventions or even hasten death. ...  The team is developing an informational resource, Islamic Bioethical Considerations for the End of Life: A Guide for Muslim Americans, to help Muslims who struggle when thinking about death and dying. 

Palliative care, mental health services underutilized in pancreatic cancer Healio; by Jennifer Byrne; 12/19/24 Individuals with pancreatic cancer underutilized palliative care and mental health services, according to a retrospective analysis. ... Researchers from Saint Louis University used electronic health record data from Optum’s Integrated Claims-Clinical Data set to identify 4,029 patients with newly diagnosed pancreatic cancer. The investigators then used ICD-9/10 codes to identify subsequent diagnoses of anxiety and depression, as well as palliative care consultations. ... Results showed higher prevalence of anxiety (33.9% vs. 22.8%) and depression (36.2% vs. 23.2%) among patients who had palliative care consultations than those who did not have documented consultations. ... Healio: Did any of your findings surprise you? Divya S. Subramaniam, PhD, MPH: It was unexpected to see that palliative care consultations, despite identifying higher levels of anxiety and depression, did not increase treatment rates for these mental health conditions. This suggests mental health might not yet be a central focus in palliative consultations, which often concentrate on managing physical symptoms.

How UCSF Health is rebuilding an 'instrumental' management layer Becker's Hospital Review; by Kelly Gooch; 12/17/24Middle managers have long played a crucial role in industries across the U.S. However, a November article from global management consulting firm Korn Ferry describes "a disappearing layer of middle management," particularly among professional-service firms that are "delayering" to improve flexibility and responsiveness. ...  [Data] shows that in 2023, middle managers accounted for 31.5% of all layoffs, with an average of 22% between 2018 and 2022. While Mitul Modi, Korn Ferry senior client partner in the firm's global healthcare services practice, said layoffs of managers have occurred at various health systems in 2024, he told Becker's he is not seeing this occur with patient-facing roles. Instead, he has observed an increased emphasis on developing middle managers. ... One example of this is San Francisco-based UCSF Health. ... UCSF Health's efforts center around investing in a management core training program.[Click on the title's link to continue reading.]

States ranked by nurse communication Becker's Hospital Review; by Mackenzie Bean; updated 12/13/24 Hospitals in Louisiana, Minnesota, North Dakota, Nebraska and South Dakota have the highest nurse communication scores, while hospitals in the District of Columbia have the lowest, CMS data shows. CMS collects and publicly reports data on nurse communication as part of its HCAHPS survey data. The nurse communication measure assesses the percentage of patients who reported that their nurses "always" communicated well. The data was collected in 2023 and published in CMS' Provider Data Catalog Oct. 30. Nationwide, 80% of patients reported nurses always communicated well, up one percentage point from the year prior, according to CMS data. [Click on the title's link for this ranked list.]

Characteristics of patients enrolled in hospice presenting to the emergency department American Journal of Emergency Medicine; by Kayla P Carpenter, Fernanda Bellolio, Cory Ingram, Aaron B Klassen, Sarayna S McGuire, Alisha A Morgan, Aidan F Mullan, Alexander D Ginsburg; 12/9/24, online ahead of print Emergency Departments (EDs) frequently care for patients with life-limiting illnesses, with nearly 1 in 5 patients enrolled in hospice presenting to an ED during their hospice enrollment. This study investigates the reasons patients enrolled in hospice seek care in the ED, the interventions they receive, and their outcomes. ... Patients enrolled in hospice most frequently presented to the ED for trauma [36%; with 15% for pain, 12% for catheter/tube malfunction]. Most received laboratory studies and imaging. Nearly half of patients were admitted to the hospital and short-term mortality was high, particularly for patients enrolled in hospice for needs for ED care? Ie.,

University of Michigan Health-Sparrow nurses authorize strike as contract negotiations continue CBS News, Detroit, MI; by Elle Meyers; 12/12/24 Union officials representing the University of Michigan Health-Sparrow nursing staff have been working for months for an improved contract, but leaders say they're not close to a deal. "The hospital so far is not making offers that are going to keep up competitive. It's not going to allow us to make sure we maintain our level of care or quality of care," said Jeff Breslin, a registered nurse and the president of the Professional Employees Council of Sparrow Hospital. The University of Michigan bought Sparrow last April. Bresil says he was hopeful for positive change. "They had promised to come in and build new facilities, improve other facilities that we have, which is great, but you've got to take care of the people as well, and frankly, I'm disappointed that this is the direction things are taking," he said. Breslin said contract negotiations between the nurse's union and the hospital began last August. Their contract expired in October, and they still haven't reached a deal. He says nurses want to see more competitive pay, better staffing levels and an improved health plan.