Literature Review

Balancing work, life and whatever is in between McKnights Senior Living; guest column by Rebekah Bray, LNHA; 11/11/24 Defining our work and lives as separate entities implies that one should not affect the other. For balance, opposing forces must be equal and not influence each other. In actuality, our careers and our home lives have been begrudgingly unifying for years.  ... Late night and weekend hours somehow have become a badge of honor that demonstrates a commitment to the senior living community or long-term care facility, with the thinking that no one else will possibly be able to achieve it. Endless hours are not sustainable and, simultaneously, a baseline has been developed that tireless commitment is the bare minimum. ... [People] in leadership positions in healthcare seldom are given the luxury to unplug, mentally or physically, due to the endless cycle of problems, including staffing, changes to regulations, revenue and day-to-day operations. Many leaders consider it a sacrifice that comes with the job of leadership. ... Editor's note: Work-life balance continues to be a trend in reasons for retention, unionization, strikes, and more. More significantly--in the midst of your important work as leader--this is your life. This is your time to create and navigate relationships, work, and more. Tapping into your passion for end-of-life care, what will be your joys and regrets when you are receiving palliative and hospice care? What kinds of grief care will your family need after your death?

Kaiser Permanente mental health workers go on strike in Southern California Fox 5 - KUSI, San Diego, CA; by Danielle Dawson; 10/21/24 Thousands of mental health workers at Kaiser Permanente locations across Southern California hit the picket lines on Monday for the first day of an open-ended strike, calling for measures to reduce employee turnover and better patient care. ... The unionized mental health professionals — encompassing therapists, psychologists, social workers and psychiatric nurses — have been demanding Kaiser address issues in their next contract that have contributed to “substandard” care in Southern California. ... Last year, California behavioral health regulators flagged several of these problems when it hit Kaiser with a $50 million fine — the largest-ever penalty issued by the department — for failing to provide timely care to its patients as part of a wider $200 million settlement agreement. “Our agency could lose its Medicare license because we have five days to see our patients and, because our unsustainable caseloads, patient care is being delayed,” Elizabeth Meza, a San Diego-area hospice worker, told KUSI Monday morning. “We are only able to provide the minimum amount of care that they need.”

2,400 Kaiser mental health workers to begin open-ended strike: 6 things to know Becker's Hospital Review; by Kelly Gooch; 10/11/24 Members of the National Union of Healthcare Workers are set to begin an open-ended strike Oct. 21 at Kaiser Permanente locations in Southern California. Six things to know:

Why hospital-at-home, other providers are pressing worker safety Modern Healthcare; by Diane Eastabrook; 9/24/24 At-home care providers are testing strategies to better protect workers who are raising the alarm on workplace safety. A new survey of more than 400 home healthcare workers found more than half said they experienced or witnessed at least one act of violence or harassment in the workplace, according to Transcend Strategy Group, which conducted the poll on behalf of home care providers. The report, which echoes similar findings from a National Nurses United survey, comes as hospital-at-home programs expand and more care moves to where patients live. ... Home-based care providers are trying to address the issue because concerns about personal safety could make it harder to recruit and retain workers in a competitive job market. The concerns are also coming up in contract negotiations between unions and providers.

Providence, hospice workers agree to resolve NLRB complaint Becker's Hospital Review; by Kelly Gooch; 9/5/24 Renton, WA-based Providence and caregivers of Providence Hospice in Sonoma County, Calif., agreed to resolve allegations that workers were required to take on additional work and responsibilities without appropriate compensation. The agreement resolves allegations filed with the National Labor Relations Board in June 2023 by approximately 130 registered nurses, social workers and other staff at the hospice care provider, according to the National Union of Healthcare Workers. ... [Click here to read the terms.]  ... Both sides agreed the deal is a win for the caregivers and for hospice. "This agreement is good for us and for the families we serve because it means instead of racing in our cars from one family to another, our agency will have to staff appropriately so we can devote ourselves fully to our patients," Kristina Nauheimer, a nurse case manager at the hospice, said in the union release.

West Penn Hospital union nurses vote to authorize strike WPXI.com news, Pittsburgh, PA; by Taylor Spirito; 8/22/24 Union nurses at West Penn Hospital have voted to authorize a strike. On Wednesday, union nurses votes 99.3% in favor of authorizing their negotiating committee to send a strike notice if necessary, rejecting contract proposals from the Allegheny Health Network (AHN) as inadequate to address the region’s nurse staffing crisis. The nurses are calling for resources to recruit new nurses and retain experienced ones. They said the hospital’s nursing staff must obtain 100 more registered nurses to meet the region’s growing patient care needs, a representative from SEIU Healthcare PA said. 

Skagit Regional Health comes to tentative agreement with nurses Skagit Valley Herald; by Racquel Muncy; 7/30/24 After 14 negotiation sessions over the past five months, Skagit Regional Health and its nurses reached a tentative agreement ... The contract would affect about 600 registered nurses at Skagit Valley Hospital, its clinics and at Hospice of the Northwest. The nurses were represented in their contract negotiations by the Washington State Nurses Association. Prior to Monday’s bargaining session, there had been three major sticking points for the nurses — wages, a desire to have annual raises based on experience rather than hours worked, and retirement benefits.

UVM Medical Center reaches new contract for nursing employees, 23% wage hike VB Vermont Biz; by The University of Vermont Medical Center; 7/22/24 Nurses employed by University of Vermont Medical Center who are part of the Vermont Federation of Nurses and Health Professionals (VFNHP) voted to ratify a new three-year contract for nursing staff this past weekend. The contract includes a 23% wage increase for nurses over the next three years.

Asheville nurse strike? Mission/HCA 'gave some ground'; groups support nurses with fund Asheville Citizen Times; by Joel Burgess; 7/22/24 A nurse union negotiator has said HCA HealthCare, the owner of Mission Health, has "given some ground" on key issues — but nurses are still preparing for a potential strike over staffing numbers at Western North Carolina's biggest hospital. Local activists including WNC Workers Assembly, meanwhile, are rallying residents and raising money to help nurses in case of a strike. Mission nurses unionized in 2020, a year after HCA — a for-profit Tennessee corporation and the biggest hospital company in the country − bought the nonprofit Mission for $1.9 billion. Editor's Note: Mission/HCA provides hospice, palliative, and PACE care.

Anxiety and resilience in palliative medicine physicians BMJ Supportive & Palliative Care; by Cristhian Alexis Velásquez Marín, Carlos Javier Avendaño-Vásquez; 7/2/24, online ahead of printTo identify the relationship between the degree of anxiety and the capacity for resilience in palliative care physicians ..., [we] included 42 Colombian Palliative Care Physicians and administered a sociodemographic questionnaire, the Zung Anxiety Scale and the Resilience Scale. Results: 42 palliative care physicians with an average age of 41 participated in the study. Anxious symptoms were present in 100% of the physicians evaluated. Mild or moderate anxiety was identified in 93.7% of the population and 6.3% of people with severe anxiety symptoms. ... Our results reflect that the population of palliative care physicians has a higher risk and exposure to developing anxiety and its adverse outcomes. We found higher anxiety levels compared with other studies so this population requires greater vigilance and intervention in treating and preventing mental health difficulties.Editor's Note: Executive leaders for palliative care services, use this research to be aware of possible stress-related tolls on your palliative physicians and team members. Ask. Generate dialogue. Do not assume that this applies, but rather use it to tune into and improve the support your physicians need. While this research was in Columbia, it resonates a U.S.recurring trend of the unionization of physicians, often related to burnout and stress overload.

Story Rounds inspires real talk by doctors about their toughest work Standford Medicine - SCOPE Beyond the Headlines; by Mark Conley; 6/27/24 Jay Shah, MD, took a deep breath as he stood on the Berg Hall stage and looked out across the crowd. It was made up of 150 of his Stanford Medicine peers, some of them longtime mentors and collaborators. ... Shah had been chosen to lead off the latest rendition of Story Rounds, the WellMD and WellPhD and the Medical Humanities and Arts Program (MedMuse) co-sponsored live storytelling program -- a safe place for MDs, clinical students and residents to share with their colleagues. ... Shah's tale was an impassioned 13-minute story of metamorphosis: Of going from a doctor determined to trudge forward without self-reflection, watching it destroy his marriage and spiral his mental health, to one who recognized the harm in not processing the difficult situations and emotions that come with the job -- such as the pain, guilt and loneliness of losing a patient and feeling like it was all his fault. His was the first of five stories that evening, delivered in a personal storytelling format inspired by Public Radio Exchange's podcast The Moth. It encapsulated a growing movement toward doctors talking openly about burnout, stress and mental health -- and trying to support one another, whether they're a wide-eyed first-year resident or a veteran health care leader like Shah.

'I don't ever trust Epic to be correct': Nurses raise more AI concerns Becker's Health IT; by Giles Bruce; 6/14/24 Nurses continue to voice concerns about artificial intelligence and its integration into EHRs, saying the technology is ineffective and interferes with patient care. Nurses from health systems around the country spoke to National Nurses United, their largest labor union, for a June 5 story about issues with such programs as automated nurse handoffs, patient classification systems and sepsis alerts. Multiple nurses cited problems with EHR-based programs from Epic and Oracle Health that use algorithms to determine patient acuity and nurse staffing levels. "I don't ever trust Epic to be correct," Craig Cedotal, RN, a pediatric oncology nurse at Kaiser Permanente Oakland (Calif.) Medical Center, told the nurses' union. "It's never a reflection of what we need, but more a snapshot of what we've done." ... Hundreds of nurses protested AI at Kaiser Permanente San Francisco Medical Center in April.

3,000+ nurses at 6 Providence facilities to strikeBecker's Hospital Review; by Kelly Gooch; 6/10/24 Members of the Oregon Nurses Association are set to begin a three-day strike June 18 at six Providence facilities, in what the union deems the largest nurses' strike in the state's history. The union represents more than 3,000 nurses at the following facilities, according to an ONA news release: