Literature Review

Who cares for the caregivers? The push for laws to protect nurses’ mental health Medscape; by Jodi Helmer; 2/5/25 ... More than 67% of nurses reported feeling depressed or anxious, and two thirds said they were not receiving mental health support. Nurses cite lack of time and financial resources among the reasons for not seeking treatment, but fears about losing their jobs and the impact on their nursing licenses were also top issues. ... Registered nurses (RN) and advanced practice RN (APRNs) can be required to answer invasive questions about their mental health as part of their state licensure and advanced credentialing applications. The questions can be stigmatizing and could require nurses to submit letters from their healthcare providers addressing their mental health status. ... There is a movement to urge licensing and credentialing organizations to remove invasive and stigmatizing mental health questions from their applications. The National Council of State Boards of Nursing is working on national recommendations ...

[UK - St. Christopher's Hospice] Woman with rare brain disease dances with husband for first time in yearsReposted in Daily Journal from Talker News, Tupelo, MS; by Isobel Williams; 2/20/25 This is the touching moment an elderly woman living with a rare brain disease slow danced with her husband - for the first time in years. Constance Bartholomew, 69, has progressive supranuclear palsy (PSP), a neurological condition which has left her struggling to walk. The disorder - which is estimated to affect around 4,000 people in the UK - can cause problems with balance, movement, vision, speech and swallowing. Constance began physiotherapy at St. Christopher's Hospice in Sydenham, south-east London in September last year - at which point husband Dennis, 72, joked he would pay a million pounds to dance with her again. Upon hearing the remark, rehab assistant Ralitsa Angelova ... made it her mission to make it happen.  ... “She is unable to walk, to articulate, her eyesight has failed. It’s a terrible condition. I wouldn’t wish it on anyone. But she is fully aware. There is absolutely nothing wrong with her memory or comprehension. ..." The video has been released as hospices in London come together to change perceptions of hospice care and highlight the vital importance of gifts in wills to their holistic palliative care services for adults and children in their communities. The hospices are taking part in the This is Hospice Care campaign, a national collaboration of 143 hospices across England, Scotland and Wales, brought together by Hospice UK.Editor's note: St. Christopher's Hospice--founded by Dame Cicely Saunders--is the home for modern day hospice care.  Click here for a YouTube video of Constance and Dennis. Click here for the article we posted on 2/21 about the UK's "This Is Hospice Care" initiative.

Hospices traverse the ‘new twists’ in increasingly complex auditing processes Hospice News; by Holly Vossel; 2/20/25 Auditors are raising new questions around two common issues in hospices’ Medicare claims — documentation supporting patient eligibility and the physician narrative. Program integrity issues and quality concerns have raised the bar of regulatory oversight in recent years, with auditing activity ramping up as more providers undergo multiple audits simultaneously each year. ... Claim denials most frequently occur due to insufficiently documented evidence that demonstrates a patient’s eligibility within the physician narrative explanation, Nowicki stated. Auditors have increasingly required more details to support a patient’s six month terminal illness prognosis, potentially stretching the boundaries of hospice requirements stipulated by the U.S. Centers for Medicare & Medicaid Services (CMS), he indicated. [Click on the title's link to continue reading.]

800 Geisinger nurses strike: 5 things to know Becker's Hospital Review; by Kelly Gooch; 2/19/25Members of Service Employees International Union Healthcare Pennsylvania began a five-day strike Feb. 17 at Geisinger's Luzerne County facilities in Pennsylvania, union and health system spokespeople confirmed to Becker's. Five things to know:

Improving quality of life and end-of-life care: Standardizing goals of care notes in EHRs EurekAlert! - American Association for the Advancement of Science (AAAS), Indianapolis, IN; Regenstrief  Institute, peer-reviewed publication; 2/19/25 ... A new study by researchers from Regenstrief Institute, the Indiana University School of Medicine and Indiana University Health presents the standardized goals of care note they developed, deployed and evaluated as a quality improvement initiative at IU Health, a large, statewide healthcare system. ... The study authors report:

An interview with Clinical Psychologist (retired) Johanne de Montigny, M.A.Ps. ehospice; interview between Dr. Stefanie Gingras and Johnne de Montigny; 2/14/25 Ahead of her February 19, 2025 lecture entitled “What I’ve learned about accompaniment, death and bereavement: 29 years of psychological services at the heart of an MUHC care team (1986-2015)”, part of the McGill National Grand Rounds programme, Johanne de Montigny shared her thoughts with Program Director and palliative care physician Dr. Stéfanie Gingras.Dr. Stéfanie Gingras (SG): How did you first become interested in the field of palliative care?Johanne de Montigny (JdM): It was a very profound and sudden experience where I almost died that guided me in this choice. I survived a plane crash, in which 17 people (out of 24) died. After this event, I asked myself what I was going to do with my life. For me, that meant choosing a profession that would be meaningful. After returning to school to study psychology, I chose to become a palliative care psychologist. After being confronted with sudden death, I wanted to understand how people reacted when they learned that they were going to die, that they still had time, and how to live with it. ... In those moments, I remembered that before I died – because I thought I was going to die – the young flight attendant who, in the space of a minute before the crash, had managed to help us contain the shock and give us some hope. She told us, “Whatever happens, we’re together and we’re going to get through this together.” That one relational minute made all the difference. It enabled us, I believe, to survive psychically before dying physically. She was my first carer just before she died. ... As for the family, what was most striking for me was the realization that the end of life is a time of unparalleled intimacy. Editor's note: This rich life-reflection provides powerful insights in light of many recent plane tragedies.

As hospitalists’ role grows, so do the ethical dilemmas Medscape; by Donavyn Coffey; 2/17/25 Margot Eves, JD, clinical ethicist for Cleveland Clinic, was called in for an emergency consult: A man in his early 50s was asking doctors to take him off the ventilator. Just 24 hours before, the man with chronic obstructive pulmonary disease (COPD) okayed the life-saving treatment. The hospitalist over his care expected him to come off the ventilator in a few days, but 24 hours was too soon. He wouldn’t survive. With head nods and in writing the patient signaled that he was fully aware — he understood this would end his life. Eves was called in to help weigh the options: Honor the patient’s wishes or help him survive. These kinds of ethical dilemmas have become common to the burgeoning hospitalist profession. ....

The case for a 4-day workweek for nurse managers Becker's Clinical Leadership; by Kelly Gooch: 2/18/25 Four-day workweeks lead to an improved work-life balance for nurse managers, nurse leaders at Philadelphia-based Fox Chase Cancer Center argue in a new paper shared with Becker's. "A 4-Day Workweek for Nurse Leaders: Unveiling the Lessons Learned" is based on a study conducted at the 100-bed specialty cancer center. The study aims to evaluate the influence of a four-day workweek on nurse leaders' perceptions of workload and job satisfaction. Results of the study were published Feb. 17, and included 24 care delivery units and 43 nursing directors, managers and assistant nurse managers.

Center for Hospice Care's BreatheEazy Program supports patients with respiratory issues LaporteCounty.Life; by Garrett Spoor; 2/13/25 One of the toughest health challenges a person can face is the trouble of breathing. Center for Hospice Care comes across a lot of patients who experience this issue and encourages many of them to become a part of their BreatheEazy program. Dr. Karissa Misner, medical director at Center for Hospice Care, considers the BreatheEazy program to be a monumental boost for patients who might have respiratory issues. “This is a specialized pulmonary program for our patients with chronic obstructive pulmonary disease,” Misner said. “It can also be used for many other terminal diagnoses that affect the lungs. Whenever there is any type of illness that causes difficulty in breathing, we can utilize this program.”

People with depression develop long-term health conditions quicker than those without, study finds McKnights Home Care; by Kristen Fischer; 2/13/25 Adults who have experienced depression develop long-term physical conditions about 30% faster than those without depression, a new study finds. Authors of the report said depression needs to be viewed as a “whole body” condition, with treatment approaches that address mental and physical health. The report was published Thursday [2/13/25] in PLOS Medicine. Investigators evaluated the association between depression and the rate at which conditions accrued in midlife and older age.

The talk nurses don't talk about enough: Death and dying Nurse.org - Nurse Converse podcast; by "Courtney" DNP, APRN, AGNP-C; 2/11/25 ... Nursing and medical curricula extensively cover subjects such as pathophysiology, pharmacology, and anatomy, yet they often fail to provide structured training on effective communication regarding death and dying. In the podcast, the hosts recall their own educational experiences, noting that they were not equipped with the tools or frameworks necessary to engage in these sensitive discussions. One telling example from a medical course on difficult conversations revealed that when students were asked if they had received any training on the subject, not a single hand was raised. 

Rebuilding trust in medical science: How doctors and scientists can bridge the misinformation divide Association of American Medical Colleges  (AAMC); by Patrick Boyle; 2/11/25 Medical science has not fully recovered from the distrust that erupted among some segments of the public during the COVID-19 pandemic. Skepticism and misinformation about vaccines and other health matters are spreading. Can anyone help doctors and scientists build faith in medical expertise? Reed Tuckson, MD, is trying. Tuckson is cofounder and chair of the Coalition for Trust in Health & Science, a nonprofit that focuses on “ensuring that everyone is empowered to make informed and personally appropriate health decisions … based on accurate, understandable, and evidence-based information.” ...Tuckson recently spoke with AAMCNews about applying what has been learned over the past several years to responding to misinformation and distrust in medical science. ...

How to live when you know you are dying Equity Atlas; 2/11/25 Living with the knowledge of impending death is an incredibly challenging and emotional experience. Whether facing a terminal illness or a life-threatening situation, the idea of living when you know you are dying can be overwhelming. However, it is possible to find peace, acceptance, and even joy in the midst of such difficult circumstances. In this article, we will explore how to navigate this journey with grace and courage. ... How does one navigate this difficult journey? We turned to professionals in the field for their insights on how to live when you know you are dying.