Literature Review

Best, worst states for nurses in 2025Becker's Hospital Review; by Erica Carbajal; 4/29/25Washington is the best state for nurses to practice in 2025, according to WalletHub’s annual ranking, which evaluates compensation, opportunities for career growth and working conditions. To determine the best and worst states for nurses, the financial services company evaluated all 50 states across two key dimensions: opportunity and competition, and work environment. Each state was evaluated on 20 metrics within those dimensions, including average annual salary, healthcare facilities per capita, mandatory overtime restrictions and job growth. Here are the best and worst states for nurses in 2025, per the ranking:

Healthcare employee turnover, by roleBecker's Hospital Review; by Paige Twenter; 4/25/25Generation Z workers are leaving healthcare at a 38% turnover rate, followed by a 22% rate among millennials, 14% among Generation X and 19% among baby boomers, according to a Press Ganey report. To analyze national workforce trends, Press Ganey analyzed feedback from 2.3 million U.S. healthcare employees from more than 400 health systems and 15,200 locations... Turnover rates across 11 healthcare positions between 2023 and 2024:

Disparities in end-of-life care: A retrospective study on intensive care utilization and advance care planning in the Colorado all-payer claims databaseAmerican Journal of Hospice and Palliative Medicine; Darcy Holladay Ford, PsyD, MA, LPC, RDN; Kimberly Landry, MPH; Megha Jha, MPH; Martha Meyer, PhD; 3/25Intensive end-of-life (EOL) care is emotionally and financially burdensome, disproportionally negatively impacting racial and ethnic minorities, rural residents, and lower socioeconomic seniors. ICU Stays: Hispanic/Latino, Asian, and Black members had increased ICU stays compared to Whites ... However, members without ACP [advance care planning] and rural residents had lower ICU stays ... ED Visits: Hispanic/Latino, Asian, Black members, non-dually eligible members (Medicare Fee for Service (MFFS) + Medicaid), and rural residents had increased ED visits ... Meanwhile, members without ACP or hospice care had lower ED visits ... 30-day Readmissions: Asian members and rural residents had increased 30-day readmissions ... In contrast, those on MFFS and not on Medicaid, members without ACP, and those not in hospice care had decreased 30-day readmissions ...

As the ‘Silver Tsunami’ hits the Flathead Valley, dementia diagnoses are rising while caregivers reach a breaking point Flathead Beacon, Kalispell, MT; by Maggie Dresser; 3/23/25 ... As baby boomers age and Americans live longer than previous generations, the elderly population will continue to grow and overwhelm many local resources, which includes nursing homes and memory care facilities. ... According to 2020 Census data, the national demographic of people ages 65 and over grew nearly five times faster than the total population over the 100-year period stretching from 1920 to 2020, and the population segment has recently reached 55.8 million. But Montana’s senior citizen population is disproportionately higher than many other states, ranking No. 6 overall, with 19.7% of its population considered geriatric, according to 2020 Census data.  Of this population, 9.8% of individuals in Montana suffer from Alzheimer’s.Editor's note: Click here for the national 2024 Alzheimer's Disease Facts and Figures - Special Report: Mapping a Better Future for Dementia Care Navigation.

HHS proposal slashes Medicare SHIP funds MSN; by Mary Helen Gillespie; 4/22/25 The Trump administration is proposing federal budget cuts to Medicare State Health Insurance Assistance Programs (SHIP) and seven additional elder health care safety net programs that assist older Americans. ... SHIP programs have been under the umbrella of the Health and Human Services agency Administration for Community Living. The pre-decisional budget lists funds for seven other ACL programs that would be eliminated are:

Advance care planning in the inpatient setting: The role of the hospitalistAmerican Journal of Hospice and Palliative Medicine; Nikhil Sood, MD; Rohini Garg, MBBS; Anthony D. Slonim, MD, DrPH, FCCM; 3/25Advance care planning (ACP) is critical to patient-centered health care, particularly in hospital settings where acute and end-of-life decisions often occur. As frontline providers, hospitalists are uniquely positioned to initiate and guide ACP discussions. This article explores the role of hospitalists in ACP, identifies barriers to its implementation, and highlights strategies to overcome these challenges. Key barriers include time constraints, lack of formal training, and uncertainty regarding the appropriate timing of discussions. To address these issues, hospitalists can benefit from structured communication training, integration of ACP prompts into electronic health records, and collaboration with multidisciplinary teams. While ACP has demonstrated benefits, including the alignment of care with patient preferences, reduced unnecessary interventions, and improved satisfaction for patients and families, challenges remain in ensuring consistent and culturally sensitive implementation.

Without support, seniors aging in place may elect facility-based care, study finds McKnights Home Care; by Adam Healy; 4/16/25 Older adults aging in place may rethink whether they want to receive care at home if they do not receive certain aging-in-place supports from their care providers and loved ones, according to a new study published in the Journal of the American Geriatrics Society. The researchers interviewed nearly 300 older adults receiving care at home and in long-term care facilities. ... The first theme was participants’ personal health experiences. ... Similarly, loss of health of loved ones and friends may also influence where patients want to receive care. ... The final factor influencing older adults’ aging preferences was time, the study found. 

Patient-centered communication drives supportive care needs in incurable cancer Oncology Nursing News; by Kristie L. Kahl; 4/16/25 The Primary Palliative Care Communication Intervention (PRECURSOR) may improve the psychosocial experiences of patients with incurable gynecologic cancer and their caregivers in the outpatient setting, according to results of a pilot study presented at the 50th Annual ONS Congress. ... Currently, most of the conversation around supportive care is provider-driven, and clinical tendency is to insert palliative care in the terminal setting. However, the study investigators aimed to integrate supportive care across the cancer continuum.

“I Don’t Know What to Say”-A multimodal educational and environmental intervention to improve bedside nursing communication at end of lifeJournal of Hospice & Palliative Nursing; Wolownik, Gregory DNP, AGPCNP-BC, ACHPN; Wholihan, Dorothy DNP, AGPCNP-BC, ACHPN, FPCN, FAAN; 4/25... research shows inpatient medical-surgical nurses are not adequately trained to deliver end-of-life (EOL) care. This lack of foundational learning leads to gaps when communicating with patients and families and negatively impacts quality of care. A literature review and staff interviews identified barriers to communication, such as lack of formal education and experience; personal, cultural, and emotional challenges; and high workload. A multimodal intervention focusing on improving staff nurse communication skills was designed ...[including] environmental cues, engaging pocket cards, and an education module on communication techniques. Nurses demonstrated increased confidence and competence immediately following the education session, enduring at 4 weeks. Innovative, clinically relevant interventions can positively impact communication skills without requiring increased time commitments or high cost.

The cost of nurse turnover in 24 numbers | 2025 Becker's Hospital Review; by Molly Gamble; 4/7/25 Nurse shortages and mounting labor costs are among health system CEOs’ top concerns, and a new survey puts numbers to the financial risks hospitals face from nurse vacancies and churn. The 2025 NSI National Health Care Retention & RN Staffing Report features input from 450 hospitals in 37 states on registered nurse turnover, retention, vacancy rates, recruitment metrics and staffing strategies.  It found the average cost of turnover for one staff RN grew from January through December 2024 to $61,110, among other dollar figures and statistics that are helpful to understand the financial implications of one of healthcare’s most persistent labor disruptions. Here are 24 numbers that illustrate the cost of nurse turnover, according to the most recent edition of the report, which is available in full here. [Continue reading ...]

Perioperative integration of palliative care and urology for patients with serious urologic illness: A qualitative need finding inquiryJournal of Pain and Symptom Management; Bhagvat J Maheta, Nainwant K Singh, Jonathan Bergman, Cati G Brown-Johnson, Alekhya Gunturi, Nickolas Interrante, John T Leppert, Karl A Lorenz, Isabella G Raspi, Karleen F Giannitrapani; 3/25Many urologic serious illnesses are treated with surgical procedures, which may put patients at a further risk of diminished quality of life. [We] purposefully sampled urologists, palliative care physicians, and clinical team members at fourteen geographically distributed Veteran Health Administration sites. We identified one general overall theme, to "change culture" so that PC [palliative care] is not a "last resort" ... Utilizing telehealth and team member role expansion when discussing the initial diagnosis, with surgery as a potential treatment option, allows for multiple conversations ... Creating a process to ensure goal of care conversations occur, since "urologic procedures can have complications that significantly impact quality of life" ... [and] during the pre-operative visits, interdisciplinary input and evaluation of the patient prior to surgery allows the patient to "have a sort of joint meeting with us and the urologist."

Federal legislation would mandate hospice education upon hospital discharge McKnights Home Care; by Adam Healy; 4/2/25 A bill under consideration in Congress would require hospitals to educate patients about hospice care options upon discharge. HR 2437, introduced Thursday by Rep. Erin Houchin (R-IN), would amend Medicare policy to mandate that hospitals “provide information on available hospice programs to certain individuals upon discharge,” according to the bill. Although hospitals are not necessarily required to provide patients with information on available hospice programs upon discharge, they are encouraged to do so. [Continue reading ...]

What’s next for COOs? Becker's Hospital Review; by Kelly Gooch; 3/26/25 The health system C-suite continues to evolve, as organizations streamline leadership by eliminating or combining roles, and by restructuring leadership teams amid industry headwinds. Against this backdrop, the COO role is also changing, with leaders taking on more strategic responsibilities while continuing to oversee day-to-day operations across their systems. In conversations with Becker’s, Eric Stevens, COO of Roseville, Calif.-based Adventist Health, and Rick Majzun, president and COO of Palo Alto, Calif.-based Stanford Medicine Children’s Health, discussed how they are balancing this growing scope and where the COO role fits in the modern C-suite. [Continue reading ...]