Literature Review

How to give physicians autonomy—and protect them from burnout American Medical Association (AMA); by Georgia Garvey; 7/1/25 Almost everyone appreciates having autonomy at work. But when physicians spend more than a decade in high-stakes and grueling medical training, only to enter practice with virtually no control over their work environment, schedule or day, it can lead to the kind of spiraling frustration that often turns into burnout or leaving the profession entirely. “It’s one of those things where the more you try to micromanage a physician’s schedule, the more a feeling of distrust you give to the physicians ...” said Jill Jin, MD, MPH, an internist and senior physician adviser for the AMA, one of the authors of the AMA STEPS Forward® “Value of Feeling Valued Playbook.” ... Though the percentages of those experiencing burnout have declined from the peak during the COVID-19 public health emergency, 43.2% of physicians still say they have at least one symptom of burnout.  ... When physicians feel valued—... as competent professionals who have devoted immense time and energy to becoming experts at their jobs—it is proven to be positively associated with lower levels of burnout.

Solvay Hospice House to temporarily pause care in Duluth during impending nurses’ strike Northern News Now, Duluth, MN; by T Kaldahl; 7/1/25  The Solvay Hospice House in Duluth will temporarily pause care and transport existing patients when union nurses walk off the job next week. The hospice house relies on Essentia Health staff to help them provide care for their patients, according to Solvay leaders. Because of the MNA’s plans to begin an open-ended strike at 7 a.m. on Tuesday, July 8, amid ongoing contract negotiations, the hospice house will be without nursing staff. 

Providence hospice workers to hold 1st strike Becker's Hospital Review; by Kelly Gooch; 6/30/25 Providence workers are set to begin a two-day strike July 2 at Hospice of Petaluma (Calif.) and Memorial Hospice in Santa Rosa, Calif. The action marks their first-ever strike and comes amid ongoing contract negotiations. The strike involves more than 100 nurses, social workers, home health aides, chaplains and other hospice workers, according to their union, the National Union of Healthcare Workers. Union-represented hospice workers have been negotiating their first contract with Renton, Wash.-based Providence since 2023, when they unionized, according to NUHW. They contend that Providence has not adequately bargained — a concern compounded by the system’s planned transition of home-based care services to Compassus through a joint venture. 

“Her toes fell off into my hand”: 50 moments that changed healthcare workers forever BoredPanda; by Dominyka; 6/18/25 When we go through traumatic events, our brain can shut out feelings and thoughts as a way to protect us from emotional or physical damage. This can make people go numb in stressful situations, so our bodies have time to figure out the best course of survival.  Healthcare workers are frequently exposed to traumatic experiences, so when they were asked what event made them go permanently numb, they shared many devastating stories. Scroll down to find them below, and don’t forget to share similar ones if you have any. 

HCS Home Care/Hospice Salary & Benefits studies underway American Health Care Association (AHCA) and National Center for Assisted Living (NCAL); by Lisa Hohenemser; 6/17/25 Hospital & Healthcare Compensation Service (HCS) has announced the 2025 Home Care and Hospice Salary & Benefits studies are now underway. The Reports are recognized as the authoritative source for comprehensive marketplace data for home health + hospice agencies. Last year’s Home Care Report contained data from 1,079 home health agencies. The Hospice Report had data from 797 hospice agencies. Both studies include questions on staffing issues, nursing turnover/vacancy rates, and sign-on bonuses used by agencies to attract new employees. The results cover salaries/bonuses and hourly/per visit rates for 60 positions, with job data reported by auspice type, revenue size, region, state, and CBSA. Also included are 19 fringe benefits, planned salary increases, productivity/caseload, and data on visit and shift differentials.  Directions to Participate in the HCS Home Care or Hospice Salary & Benefits Study: ... There is no cost to participate. 

7 strategies to reduce workplace incivility, bullying in hospitals Becker's Hospital Review; by Kristin Kuchno; 6/6/25 Workplace incivility and bullying have persisted in healthcare since their uptick during the COVID-19 pandemic. As the healthcare landscape continues to evolve, so do the challenges teams face, according to Brian Reed, vice president and chief human resources officer for Indianapolis-based Indiana University Health’s east region. ... Here are seven strategies to reduce workplace incivility among healthcare teams:

State of the nursing workforce: 14 trends to know Becker's Clinical Leadership; by Mariah Taylor; 5/14/25 In 2025, the nursing workforce has stabilized compared to prepandemic numbers and is expected to grow. However, there are still several nursing challenges systems are facing. Here are 14 trends to know about the nursing workforce in 2025:

Roughly 40 percent of nurses plan to leave profession within 5 years, survey finds McKnights Home Care; by Adam Healy; 5/13/25 The nursing workforce today is more stable than it was during the height of the COVID-19 pandemic, but a significant share of nurses still plan to leave the profession behind in the next five years, according to the 2024 National Nursing Workforce Survey published in the Journal of Nursing Regulation. ... Approximately 40% of RNs, LPNs and LVNs surveyed said that they planned to leave nursing sometime in the next five years. In 2022, roughly 26% of nurses said the same. The most common reasons nurses cited for wanting to leave their jobs included retirement, stress or burnout, workloads and pressures caused by understaffing, the report noted.

Experiences of hospice staff beyond the frontlines during COVID-19: A qualitative secondary analysis study Journal of Palliative Care and Social Practice; by Thanga Harini Sundaramoorthy, John I MacArtney, Abi Eccles; 4/12/25Three main themes were identified: (1) Blurred margins: Participants discussed facing difficulty separating work and home life and taking stresses and thoughts about work home. (2) Isolation, loneliness and social interactions ...  (3) Disruption to family and personal commitments: Some staff felt unable to see or support their parents, partners and children during the pandemic subsequently impacting their psychological and emotional well-being. Conclusion: Hospice staff compromised aspects of their personal life and family responsibilities during the pandemic to carry out their role at work. Workplaces and organisations should aim to support hospice staff more broadly to help with managing work-related pressures and balancing personal commitments in future emergency periods.Editor's note: Use this evidence-based research with your Emergency Disaster Preparedness Plans. Click here for the CMS.gov Emergency Preparedness Rule. Click here for Wisconsin's CMS Emergency Preparedness Rule Toolkit: Hospices.

From heroes to burnout: How we failed our frontline health workers MedPage Today's KevinMD.com, and excerpt from Health Care Nation; by Tom Lawry; 3/15/25 Of all the lessons learned from fighting a pandemic, none was more frightening or important than discovering how dependent the system is on how we treat our doctors, nurses, and frontline caregivers.  They were already in short supply, with burnout on the rise, when the pandemic hit. As multiple waves of COVID-19 variants washed over us, frontline health workers stepped in at great risk and personal sacrifice to care for highly infectious patients. ... Some witnessed more deaths on a double shift than they did in a normal year. They delivered the bad news to families and managed end-of-life care. They were often the last face and warm voice a COVID-19 victim saw and heard. In the end, they not only saved lives but saved the system from total collapse. ... We called them heroes. And we promised to do better in how we treated them once the COVID-19 crisis passed. Promises made should be promises kept. While we continue to talk about workforce burnout using polite terms with concern in our voices, let us be clear: A system with a mission of healing continues to harm in record numbers the very people in short supply who are there to take care of the rest of us. ... [Click on the title's link for more.]

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.

Relaxing licensing, training requirements during pandemic didn’t improve nursing home staffing: study McKnights Long-Term Care News; by Zee Johnson; 2/24/25 A new study of more than 15,000 nursing homes found no link between relaxed certified nurse aide training and licensing protocols during the pandemic and improved staffing levels. During COVID-19, 19 states loosened their training requirements (the “treatment” group), and 31 states did not (“control” group). However, both recorded nearly the same CNA hours per resident per day, according to the study by researchers at the University of Iowa. ... During the pandemic, direct caregivers were at extreme risk for contracting the deadly virus, which killed more than 200,000 nursing home residents and workers. But more often than not, they were left without basic benefits such as paid sick leave, Mehboob said.