Literature Review

Sought-after physician specialty roles are taking longer to fill Modern Healthcare; by Tim Broderick; 9/24/25 The time it took to fill open positions for the most sought-after physician specialties increased to almost five months in 2024, according to new research. The nonprofit Association for Advancing Physician and Provider Recruitment, with research firm Industry Insights, examined 2024 data from more than 15,000 searches of the association’s site, 61% of which were related to physician searches. ... The analysis found the estimated median days to fill the selected jobs increased by 11.5%, to 145 days in 2024 from 130 days in 2023. Oncology positions were the hardest to fill, at an estimated median of 332 days. Cardiology positions followed with an estimated median of 248 days to fill. [Access to the full article might be limited per a paywall.] Editor's Note: Oncology and cardiology are now the two hardest physician specialties to fill. This matters for hospice care because, according to NHPCO’s Facts and Figures 2024, cancer and circulatory diseases join Alzheimer’s and other nervous system disorders as the top three hospice diagnoses—together representing nearly three-fourths of all admissions. Delays in recruiting oncologists and cardiologists risk postponing timely palliative and hospice referrals. Newly hired specialists in these fields also need focused training—and intentional relationship-building with hospice teams—to ensure patients and families receive seamless, compassionate care.

Confidential conversations in palliative care: An ethnographic exploration of trust and interpersonal relationship between nurse and patient Journal of Clinical Nursing; by Tove Stenman, Bodil Holmberg, Ylva Rönngren, Ulla Näppä, Christina Melin Johansson; 9/30/25 Confidential conversations in palliative care are grounded in fragile, dynamic trust, necessitating ongoing presence, sensitivity and adaptability from RN. To support these interactions, healthcare environments must prioritise privacy, relational continuity and communication training. Future research should investigate how organisational structures and clinical settings influence confidential conversations. ... Healthcare environments should facilitate confidential conversations by ensuring relational continuity and minimising distractions. Communication training that emphasises presence and management of silence can strengthen nurse–patient relationships, enhancing patient care and emotional support.

The effect of the Care Ecosystem Collaborative Care Model on end-of-life outcomes for people with dementia and their caregiversAmerican Journal of Hospice & Palliative Care; by Lauren J Hunt, Krista L Harrison, Rachel Kiekhofer, Jennifer Merrilees, Alissa B Sideman, Sarah Dulaney, I Elaine Allen, Kirby Lee, Winston Chiong, Sarah M Hooper, Stephen J Bonasera, Tamara L Braley, Bruce L Miller, Katherine L Possin; 8/25Collaborative care models that feature care navigation have been found to have a range of benefit for people with dementia (PWD) and their caregivers, but their effect on end-of-life (EOL) outcomes has not been robustly evaluated. Our primary objective was to evaluate the effect of the Care Ecosystem-a telephone-based collaborative care model for dementia with care navigation-on EOL outcomes for PWD and their caregivers. Compared to Usual Care, Care Ecosystem caregivers had higher ratings of caregiver self-efficacy prior to PWD death ... but caregiver's satisfaction with EOL care did not differ between groups ... Qualitative analysis revealed Care Ecosystem provided helpful emotional and practical support, but participants wanted more anticipatory guidance, more information about hospice care and earlier referral, and better coordination with the healthcare team.

Alzheimer's Association: New telenovela series highlights Alzheimer’s in Hispanic and Latino communities Alzheimer's Association, Chicago, IL; Press Release; 9/15/25In conjunction with National Hispanic and Latino Heritage Month, the Alzheimer’s Association is premiering "Memories of My Grandfather" ("Recuerdos de mi abuelo"), a five-episode mini telenovela aimed at encouraging Hispanic and Latino families to have open discussions about memory loss, diagnosis and caregiving across generations. The series, available in both English and Spanish, follows the emotional journey of a multigenerational Hispanic family in the United States after their grandfather’s Alzheimer’s diagnosis. The telenovela will be screened during two webinars hosted by the Alzheimer’s Association: one in English on Sept. 30 and one in Spanish on Oct. 7. Both webinars will feature a moderated discussion hosted by actress, film producer and Telemundo news anchor Gabi Del Moral. ... Both webinars are free and open to the public. Register for the English-language webinar or the Spanish-language webinar.

Nurse practitioner, RN shortage to hit 362,000 by 2032 Becker's Clinical Leadership; by Paige Twenter; 9/17/25 More than 1 million U.S. nurses are expected to retire by 2030 — far outpacing the projected number of new nurse graduates, according to research published Sept. 16. A study at the Georgetown University Center on Education and the Workforce, based in Washington, D.C., investigated the growing skills shortage across 561 occupations. ... Between 2024 and 2032, an estimated 18.4 million workers with postsecondary education are expected to retire, according to the report. Only 13.8 million workers will enter the labor market with equivalent education and training ... The researchers predict a shortfall of 328,100 registered nurses, 42,100 licensed practical nurses and 33,800 nurse practitioners through 2032. 

How hospice chaplains improve patient outcomes Hospice News; by Jim Parker; 9/19/25 Patients may seek spiritual guidance from a number of places, but hospice chaplains remain essential. Hospice chaplains receive specialized training in caring for patients at the end of life that clergy in the larger community may not have. They are trained in active listening and to address the intricacies and sensitivities of end-of-live conversations with patients and families. Nearly 8,000 hospice chaplains are working in the United States, according to a study in the journal Work, Employment and Society. About 66% of these chaplains identify as men, and 20% are members of the LGBTQIA+ community. Close to 72% are white, 10.8% are Black and 8.5% are Latino. Nearly 42% of hospice chaplains have a bachelor’s degree, an equal percentage have masters degrees and 7% hold a Ph.D., the study indicated. Editor's Note: Hospice chaplains are often misunderstood or underestimated. Their role is not simply to pray or read Scripture, but to offer skilled, sensitive spiritual support—often through life-review, family conflict, presence, words and actions that honor diverse beliefs. Effective chaplains know when not to pray, how to avoid imposing religious language, and how to remain aware of their own biases while creating space for another’s faith or worldview. Their contributions can profoundly shape the patient and family experience at the end of life. When hiring, look for credentials such as BCC, BCCI, or BCC-PCHAC and learn more through the Association for Professional Chaplains. 

Health systems should empower their primary care physicians to deliver better palliative and end-of-life care Medscape - Family Medicine; by Edward L. Burns, MD, MA; 9/17/25 Primary care physicians (PCPs) play a pivotal role in managing the overall well-being of their patients. However, when it comes to palliative and end-of-life care, many health systems do not train or empower their PCPs to manage this important part of their patients’ lives. ... By systematically training PCPs in palliative care principles and communication skills, health systems can simultaneously deliver significantly higher quality, patient-centered care that aligns with families’ values and wishes, while reducing unnecessary hospitalizations, ICU admissions, and aggressive interventions that may not align with patients’ wishes. 

Top ten tips palliative care clinicians should know about intentionally interprofessional collaboration Journal of Palliative Medicine; by Michelle M Milic, DorAnne Donesky, Naomi Tzril Saks, Rebecca Cammy, Constance Dahlin, Susan DeSanto-Madeya, Tracy Fasolino, Seiko Izumi, Amanda Kirkpatrick, Joshua R Lakin, Vickie Leff, Kashelle Lockman, Jennifer Walter, William E Rosa, Cara L Wallace; 9/9/25 This article supports individuals to practice at the top of their education, clinical training, and scope of practice while maximizing the functionality of the palliative care team as a whole. We intentionally use the term interprofessional rather than interdisciplinary to clarify that we are focused on collaboration of team members who represent multiple professions or occupations that require specialized training and meet ethical standards (e.g., nursing, chaplaincy, social work, medicine, and pharmacy) rather than interactions among specific fields of study (e.g., cardiology, nephrology, and oncology).

Holistic nursing in BSN programs: A patient-centered approach Nevada State University; 9/9/25 ... Holistic care in nursing reflects a broader vision, encouraging nurses to see patients as whole people rather than conditions to be managed. Bachelor of Science in Nursing (BSN) programs are responding by weaving holistic care into both coursework and clinical experiences. From teaching cultural sensitivity and ethics to encouraging self-care, these programs prepare nurses to build stronger relationships with patients while promoting healing on multiple levels. The result is a patient-centered approach that benefits individuals, families, and communities alike.

Are we growing leaders? Exploring leadership training in hospice and palliative medicine fellowshipJournal of Pain & Symptom Management; by Lynn A Flint, Greg Wallingford, Paul Tatum, Julie Bruno, Helen Fernandez, Elise C Carey; 8/25The purpose of this study was to characterize the current state of leadership curricula in HPM fellowships and understand which leadership topics fellowship program directors (PDs) consider to be most important to include in a leadership curriculum for fellows. Respondents rated leadership topics as important for training, yet many topics are not included in fellowship curricula. Six topic areas related to communication and self-management were rated as having great need or were included in existing curricula by more than 60% of respondents. PDs identified ten topics to be of great need for fellows, all but one of which were included in at least 40% of programs' curricula. Negotiation was the exception being included in only 20% of programs' curricula.

Benefits and burdens of research participation: A mixed methods systematic review in palliative and end-of-life careJournal of Hospice and Palliative Nursing; by Cara L Wallace, Stephanie P Wladkowski, Ruaa Al-Juboori, Anna Wingo, Kathryn W Coccia, Rebecca Hyde, Verna Hendricks-Ferguson; 8/25Research participation of hospice and palliative care patients and family caregivers is essential to develop and test best practices. Yet, healthcare professionals are often hesitant to ask patients and caregivers to participate in research, fearing it is too intrusive or unethical during a sensitive time. This review focused on the motivating factors, benefits, and burdens of research participation for patients with serious illness and their family caregivers. For clinicians and researchers, connecting patients and caregivers to palliative and end-of-life research may be both beneficial as a contribution to scientific literature and as an additional source of ongoing 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?