Literature Review

Amid trauma and burnout, it ‘takes courage’ to reflect on mental, emotional well-being Healio; by Jennifer Byrne; 7/31/24 ... [William E. Rosa, PhD, MBE, MS] began to realize that in the stressful, devastating situations he and his colleagues faced daily, there was much to be learned from the principles of trauma-informed care. ... “This is the idea that cultivating an awareness can prevent us from re-traumatizing ourselves and others,” he said. “I think it starts with reflecting on — and telling the truth about — our mental and emotional well-being. That takes courage.” In acknowledging the emotional scars, brokenness and vulnerability that comes from tragedy and loss, individuals can begin to heal a lifetime of stored and unresolved trauma, Rosa said. “As a workforce, you and I see unacceptable rates of suicide, burnout, moral distress and attrition,” he said. “It’s time that we come to safe and supported terms with our trauma — not just as individuals, but as a collective, not only for the patients and families we serve, but for us to survive.”Editor's Note: In this article, Dr. Rosa identified "the emotional impact of taking yet another patient off the ventilator at the end of life." Recent articles we've posted in this newsletter about trauma-informed care been in our "Top Reads." While those articles focused on trauma-informed care of the persons you serve, this focuses on the persons who serve, your all-important direct patient care clinicians.

How home-based care’s leaders foster a multi-generational workforce Home Health Care News; by Joyce Famakinwa; 7/23/24 In order for the home-based care space to benefit from the demographic tailwinds coming its way, it needs to embrace emerging leaders who are bringing in fresh ideas. VNS Health, Andwell Health Partners and UVA Continuum Home Health are just a few of the companies that are throwing their support behind the next generation of leaders. ... Formerly Androscoggin Home Healthcare + Hospice, Andwell is a nonprofit operator that offers home health, hospice, palliative, behavioral health and pediatric care services. The company employs over 500 workers across all 16 counties in Maine. Along with cultivating the next crop of leaders, companies are figuring out how best to work with a multi-generational workforce.

Palliative care benefit work group Office of the Insurance Commissioner - Washington State; 7/23/24 The Washington state Legislature has directed the Office of the Insurance Commissioner, in consultation with the Health Care Authority, to convene a work group to design the parameters of a palliative care benefit and payment model for fully insured health plans. The work group must submit a report to the Legislature detailing its work and any recommendations by November 1, 2025. The work group must consider the following elements of a palliative care benefit: 

These are the most common jobs in each state in the US USA Today; by Sara Chernikoff; 7/22/24 The most common job in the U.S. is a three-way tie, according to data from the Bureau of Labor Statistics. Home health care and personal aides, retail workers and fast food counter workers ranked at the top of the list with 3.6 million workers in each occupation. ... The desire for home health and personal care aides is on the rise as the share of the elderly U.S. population grows exponentially. This occupation is the fastest growing among most states, news outlet Stacker, reported. ... Home health care aides typically assist people living with disabilities or with chronic illness. Personal care aides are often hired to care for people in hospice care, according to BLS. Advanced degrees are not required for most home health aides, rather those employed by home health or hospice agencies may need to complete formal training or pass a standardized test.Editor's Note: Federal requirements for nursing aides in hospice care are defined in the CMS Hospice of Conditions Participation §418.76 and for home health in the CMS Home Health Conditions of Participation §484.80. Additionally, extensive state laws exist, with differences between states.

End-of-life care is a profound and essential aspect of medical practice Market.US Media, New York; by Samruddhi Yardi; 7/19/24 According to End-of-Life Care Statistics, End-of-life care, also known as palliative care, refers to the comprehensive medical, emotional, and psychological support provided to individuals who are nearing the end of their lives, often due to terminal illnesses or conditions. [This article includes data on the following:]

Fallen nurses are honored by ‘guards’ in white uniforms, capes and caps Radio Iowa; by Radio Iowa Contributor; 7/17/24 A hospital in southwestern Iowa is joining a national volunteer organization that pays tribute to nurses who have died or who are in hospice care. Registered nurse Sara Beth Jones spearheaded the effort to launch a local chapter of the Nurses Honor Guard at Cass Health in Atlantic. Jones says part of their uniform is to wear a cape that’s black on one side and red on the other, much like those worn by nurses who tended to soldiers in the 1800s. ... The Nurses Honor Guard is a comprised of current and former nurses. In addition to the funerals of nurses, they attend parades, honor walks and living tributes. Besides the cape, Jones says Honor Guard participants don the traditional white uniform and cap. 

In response to ‘Garnet lays off 26 people citing cost saving Warwick Advertiser, Letters to the Editor; by Ethel Hemsi; 7/15/24 For the past seven years I have been a volunteer with the Palliative Care team at Garnet Health Hospital. The whole team has been laid off to save costs. The article says it can be replaced by the hospitalist team of internal medicine providers. In my opinion this team can in no way be replaced by other doctors. Palliative care is a very complex and respectable practice in itself with specially trained doctors and nurses. It does much more than manage a patient’s pain. The palliative care providers are focused on helping patients and their families understand the patient’s condition and come together to make important decisions that patients with serious illnesses face. This includes weighing the pros and cons of various medical treatments as they pertain a patient’s quality of life. ... 

Mayo Clinic Minute: How extreme heat, humidity affect your health News Tribune; by Tribune News Service; 7/16/24 Many parts of the U.S. continue to grapple with oppressive heat and humidity. This can prevent the body from cooling down, increasing the risk of heat cramps, exhaustion and heatstroke. Dr. Jesse Bracamonte, a Mayo Clinic family medicine physician, said the extreme heat and high humidity can be a dangerous mix. "High heat and high humidity can place one at risk for serious illness if people aren't careful. The heat can affect people's bodies by increasing the core body temperature and ability to sweat, and cause dehydration that can cause further medical problems and ensuing issues, and eventually can lead to heat exhaustion, in some cases, severe heat illness, known as heatstroke," Bracamonte said. Editor's Note: What information and support are you providing for your clinicians who travel between visits and for your patients who might be affected by extreme heat and humidity? What simple, practical adaptations might you create, like disposable water bottles for staff as they leave your building (with a sign of support and basic info)?

Keeping staff members safe and sound by optimizing security technology Security; by Paul Sarnese; 7/12/24 Nobody wants to invest in technology, only to have it go the way of the stationary bike that sits unused in the corner of a room. That holds true for healthcare organization leaders who are looking to invest in staff safety alarm systems that can help avert potentially dangerous situations. With workplace violence against caregivers increasing 115% since 2021, many healthcare organizations are, indeed, looking to protect workers from harm — and to shield their organizations from resultant financial distress.Editor's Note: Workplace violence and staff safety continues to trend as a root cause for nursing and other healthcare strikes across the nation. Examine your organization's Incident Reports and QAPI initiatives. What needs to be addressed?

Rosewood nursing home staff demands experience pay, free coverage Times Union, Rensselaer, NY; by Jim Franco; 7/11/24 A group of Rosewood Rehabilitation and Nursing Center workers, represented by a national health care union, is demanding a new contract with higher wages for more experienced workers and a union-provided health insurance plan that would be fully paid by their employers. ... The workers, members of 1199SEIU United Healthcare Workers East, say a contract with the experience pay and no-cost health care coverage would help address staff shortages at the facility. The union, which has an office in East Greenbush, cites federal Department of Health and Human Services data showing total nursing staff turnover at the facility is 61.8 percent, higher than the national average of 52 percent and the New York average of 44.7 percent.Editor's Note: The reasons identified for this staff strike are consistent with other nursing/healthcare strikes across the nation: pay, benefits, staff shortages. Additionally, this facility's nursing staff turnover of 61.8 percent likely impacts--negatively--patient safety, another key factor for recent nursing strikes.

How to overcome the cumulative effects of change Healthcare IT Today; by guest author Maura Koehler-Hanlon; 7/5/24 Healthcare IT organizations are currently undertaking major initiatives to enhance patient engagement, streamline processes, ensure regulatory compliance, and more. This extensive workload can overwhelm employees, leading to burnout due to the sheer volume of changes. ... In this environment, it becomes critical for leaders to understand change saturation and build change resilience. Here’s what leaders need to know and do to move forward:

Senior care experts detail how to build a coveted ‘destination workplace’ McKnights Home Care; by Josh Henreckson; 6/27/24 Faced with today’s complex array of financial, staffing and regulatory challenges, senior care operators need to rely on a broad range of workplace solutions, a panel of experts said. ... Providers should be actively listening to their employees’ needs and trying to meet the evolving desires of the labor market, they emphasized at McKnight’s “Meeting of the Minds” thought-leader discussion. This must take place whether they’re pursuing recruiting strategies, trying to improve staff retention, integrating new technological advances or investing in new benefits and professional development. “The one area that’s going to undergird everything for your success is paying attention to the most important capital, which is human capital,” said Navin Gupta, CEO at software provider Viventium. “Pay attention to the caregiver experience from recruitment … to retention to recognition and development — the entire journey."