Literature Review

Nurse leaders can take the lead in promoting civility in the workplace Oncology Nurse Advisor; by Susan Rux, PhD, DNP, RN, FACHE; 2/28/25 Civility, the act of respecting others, especially in situations where disagreement or disparity may arise, occurs by intentionally displaying kindness and empathy. These behaviors help people to understand differences as well as uphold common ground across all social contexts. A stable foundation, afforded through civil actions, serves as a catalyst in achieving environments that promote diversity, equity, and inclusivity — the underpinnings of a culture of belonging. Nurse leaders can play a key role in creating this culture. Contrary to civility, in the healthcare setting, acts of incivility lead to increased levels of staff disengagement and turnover. Researchers have noted that a civil nursing workplace provides a safeguard against numerous professional issues, including but not limited to increased turnover rates, burnout, job dissatisfaction, and stress.

Qualitative analysis through the lens of minority nurses American Nurse; by Sonya Moore, PhD, RN, CRNA; Carolyn Still, PhD, RN; and Siobhan Aaron, PhD, RN; 3/4/25 Many argue that experiences of discrimination, racism, and microaggression (intentional or unintentional) serve as key barriers to the recruitment and retention of diverse nurses. Iheduru-Anderson, who interviewed 30 Black nurses, noted that despite an increase in the number of Black nurses in the U.S. workforce over time, they remain significantly underrepresented in leadership and faculty positions. The study identified several themes that contribute to lack of advancement, including maintaining White comfort, distrust, lack of role models and representation, expectations about leadership roles, and the ineffectiveness of advanced degrees in securing advancement. 

Bayada Home Health Care introduces first Director of Veterans Affairs HomeCare, Pennsauken Township, NJ; 2/28/25  As part of its ongoing commitment to U.S. veterans and their families, BAYADA announced the appointment of U.S. Army Veteran Ally O’Neal to director of Veterans Affairs, BAYADA Hospice. BAYADA created this new position, with the help of O’Neal, to ensure its hospice services are tailored to meet the unique physical, emotional and psychological needs of veterans and their families. As BAYADA director of Veterans Affairs, O’Neal will work collaboratively with clinicians, clinical educators, service providers, community organizations and veteran service agencies to enhance the quality of care and support provided to veteran patients and their families, something dear to O’Neal's heart. 

Forget perks—leadership starts with asking employees what they need Forbes; by Benjamin Laker; 2/25/25 Employee well-being isn’t just a perk—it’s a business imperative. As organizations struggle with high turnover, burnout, and shifting workforce expectations, leaders must rethink how they engage and support employees. Research consistently shows that investing in well-being leads to measurable gains in productivity, retention, and performance. A recent study published by BMJ Leader examined how a structured, data-driven approach to improving workplace culture can yield transformative results—using the well-being initiative at Royal Free Hospital as a case study. ... The program, which was the focus of the BMJ Leader study, incorporated systematic conversations based on the Joy in Work Framework, identifying key challenges and implementing targeted solutions. Following implementation, workplace satisfaction surged by 76%, highlighting the significant impact of addressing staff concerns directly. Employees became more engaged in organizational initiatives, fostering a culture of active participation rather than passive compliance. 

‘Global problem’: Numerous factors, biases contribute to overtreatment at end of life Healio; by Josh Friedman; 2/26/25 Nathan I. Cherny, MD, has worked all around the world. At every stop — from Australia to Israel, and Memorial Sloan Kettering Cancer Center in between — he has seen people with cancer receive overly aggressive treatment at the end of life. ... In a review published in ESMO Open, Cherny and a cohort of multinational colleagues highlighted numerous reasons why overtreatment occurs among patients approaching the end of life, ... They listed more than 20 contributing factors, including desire for control of the cancer, denial and anger, family pressure and hope preservation. The two factors that contribute most to overtreatment are optimism bias and the “counterphobic determination to treat,” which involves clinicians having a difficult time introducing the suggestion of palliative care revert to offering further treatments, Cherny said. ... Responsibility for decisions does not need to fall solely on oncologists, Cherny added. Palliative care physicians, social workers, chaplains and others can be part of a team to assist patients with their choices. ... The number of patients who are overtreated differs at each institution. “Each institution has its own culture of care,” Cherny said. Editor's note: This article puts forth significant insights for all palliative and hospice clinicians, interdisciplinary teams, and palliative/hospice executive leaders. Apply Cherny's to your referral sources: "Each institution has its own culture of care." Apply these findings to your own palliative and hospice services. 

Keeping cool when debate turns hot: Inaugural global Ethics Center conference features scholarship, presentations on fostering civil, productive dialogue The Harvard Gazette; by Christy DeSmith; 2/24/25 Americans today are wrestling with how to turn down the heat when discussing politically and morally charged topics. Students, professors, and education professionals from around the globe assembled at Harvard this month to chart their way to more productive discussions — and better relations. The inaugural Challenging Barriers to Civil Discourse conference, hosted by the Edmond and Lily Safra Center for Ethics, featured scholarship on fostering open, honest exchanges across deep divides. ... [Dr. Julia] Kolak told of mediating clashes that arose ... when the family of a critically ill patient ... resisted end-of-life care. She works to unearth the principles guiding all parties, without elevating those with medical expertise. “When we treat others as capable of dialogue,” she offered, “it really changes the affective grip of conflict. ... [Jeffrey Dunn] raised the critical question: “What is the long-term goal of this work?” ...

ONA Leadership Column: The next level State Nurses Associations - Oklahoma Nurses Association; by Dean Prentice, DHA, MA, BSN; 2/24/25 What is it going to take to raise the leadership ability of your staff to the next level? One of the many roles you play for your staff is encouraging their professional development. ... The future of nursing will require a well-rounded skill set that goes beyond traditional clinical training. Emotional intelligence, cultural competence, data-driven decision-making, ethical leadership, and resilience are all critical to meeting the challenges of tomorrow’s healthcare landscape. By developing these skills, nurses will not only improve patient outcomes but will also contribute to the evolution of the nursing profession, ensuring it remains relevant, compassionate, and effective in an increasingly complex world. 

Hospice Insights Podcast - Controlling the narrative: A new tactic for auditors and ALJs JD Supra; by Bryan Nowicki and Meg Pekarske; 2/19/25 Hospices that have gone through audits are familiar with certain recurring reasons why auditors deny claims. Two common reasons are the lack of support for a six-month prognosis and the insufficiency of the physician narrative. In this episode, Husch Blackwell’s Meg Pekarske and Bryan Nowicki discuss a new twist on these kinds of denials, and how hospices can strengthen their documentation to try to avoid them.

Home health, hospice CEO average pay tops $400K: report McKnights Home Care; by Adam Healy; 2/19/25 The Hospital & Healthcare Compensation Service’s newly released 2024-2025 Multi-Facility Corporate Compensation Report offered an in-depth look at home health  and hospice executives’ average earnings. The average CEO salary at a multifacility home health and hospice firm was $403,000, with the top 10% earning $603,000 and the bottom 10% making $278,000. Average salaries varied among other C-suite executives, with chief operating officers earning $247,000, top financial executives earning $265,000, and chief medical officers earning $285,000, on average, according to the report. 

New tech, new problems: Why application development needs a big-picture view Software Development Times (SD Times); by Sharul Sangl; 2/19/25... [Many] organizations have approached [technology] innovation without a comprehensive strategy or holistic view of their applications, simply focusing on adding the latest features or trendy tools. As a result, they are facing challenges related to application performance, scalability, efficiency, and security. To ensure the success of application innovation, enterprises must maintain a big-picture view of their applications.  ... When approached strategically, organizations are in a prime position to capitalize on current technologies to truly innovate. ...

Hospice finance 101 and the gift of mortalityPost Independent; by Peter Schoomaker, Homecare & Hospice of the Valley CFO; 2/19/25... [Practical information about hospice expenses, like labor and mileage reimbursement with. "For our agency, we estimate our clinicians will drive more than 250,000 miles in 2025, slightly more than the distance from the Earth to the Moon."] And now a more personal note … I am grateful for the last seven years of my career working in hospice care. Most importantly, I am grateful for the opportunity to integrate into the clinical experience of hospice. When I shadow an admission visit or attend the hospice interdisciplinary meeting, I am reminded that hospice is a world of YET (You’re Eligible Too). The only thing that separates me, and our hospice patients, is time. My relative physical strength will eventually shrink. My mental faculties will fade. And there is a large possibility, at some point in my life, that I will depend almost entirely on others to help with most activities of daily living. This is true for all of us. ... ... Recognizing this truth opens a path to humility. A path to step away from the ego, even for a moment, and really let go. ... When I reflect on this, I realize what a gift our mortality is. To know that our choices matter because we never know much time we have left. A sincere thank you to all our hospice, homecare and private duty clinicians — and our administrative teams that support them. It is genuinely noble work.Editor's note: "A sincere thank you" to Peter Schoomaker, Homecare & Hospice of the Valley CFO

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. ....