Literature Review

Palliative care nurses see us in our final hours — these are the life lessons they've learnt ABC News; by Iskhandar Razak; 6/29/24 Anne Myers was once confused and shaken by death. After more than a decade as a nurse, including in hospital ICUs, her mother died. "I'd seen a lot of deaths in my nursing life, but it was the closest human to me that had died," she said. "It kind of sent me down a 'oh my god, I don't know what's happening to me', this grief I'm experiencing." Soon afterwards, she became a palliative care nurse. "I ended up just going down the path of 'what is death, what is death and dying all about?'" she recalled. More than 15 years later, here's what she and other palliative care nurses have discovered on how to die well and live well.

In a 1st at ChristianaCare, physicians vote to unionize Becker's Hospital Review; by Kelly Gooch; 7/1/24 Physicians at ChristianaCare locations in Delaware and Maryland voted to join the Doctors Council, an affiliate of the Service Employees International Union. ... The decision marks the first attending physician union in Delaware, the first union at ChristianaCare, and the largest union of private sector physicians in the U.S., according to the Doctors Council. Union representatives said the physicians' decision is a response to ongoing concerns about corporatization and their professional autonomy.

[Four-day workweeks:] A flexibility trend gaining steam in nursing Becker's Clinical Leadership; by Erica Carbajal; 6/26/24 A growing number of health systems are embracing  four-day workweeks for nurse leaders — a strategy that has helped some boost recruitment, retention and staff engagement. Over the past year, the needs and well-being of nurse managers have come into focus, with hospitals and health systems taking a closer look at how to best support them in addition to bedside nurses. Survey findings have indicated nurse managers have a hard time fully disconnecting from work, and they crave much of the same work environment factors that front-line nurses do, such as the ability to take time off when needed and work-life balance support. As such, four-day schedules have increasingly become part of the conversation at many hospitals and health systems. 

The best staff retention strategies: Poll Becker's Hospital Review; by Mariah Taylor; 6/24/24 Increased schedule flexibility remains one of the most effective strategies for staff retention, a recent Becker's poll found. The poll, posted on LinkedIn in mid-June, asked participants to vote on which of three options would have the greatest effect on staff retention at their organization. Becker's has no insights into respondents' organizations or roles. Of 832 votes received, 62% of respondents said increased schedule flexibility, 29% said hiring more staff, 4% said wellness initiatives and 6% said other. 

Penn Health CEO on piecing together the healthcare hiring puzzle Becker's Hospital Review - Leadership & Management; by Madeline Ashley; 6/17/24 ... Penn Medicine has introduced programs to students and young people that will not only inspire them to join the healthcare industry, but prepare and train them for the opportunities that lie ahead. "I think the world needs mission oriented people," Kevin Mahoney [CEO of Philadelphia-based University of Pennsylvania Health System] told Becker's. "You've got to believe in where you're working, otherwise you're just punching the clock." In late May, the health system partnered with Heights Philadelphia, an organization that connects middle schoolers and up with career and college opportunities, and Philadelphia City Council majority leader Katherine Richardson to hold a career event. ... "By introducing students to the field, we’re creating a pathway to careers that enrich lives and make a difference in others. Encouraging careers in health care also helps to strengthen the field overall, ensuring a pipeline poised to answer the needs of the future." [Click on the title's link to read more of this innovative solution, and other student-oriented programs.] 

A palliative care curriculum may promote resident self-reflection and address moral injury The Journal of Surgical Research; by Shruti Koti, Lyudmyla Demyan, Danielle Deperalta, Sophia Tam, Gary Deutsch; 6/22/24 online ahead of print Introduction: There is a lack of formal palliative care education for surgical trainees, and the demanding nature of surgical training and exposure to challenging clinical scenarios can contribute to moral injury. We developed a palliative care curriculum to promote self-reflection, aiming to address moral injury in residents.Conclusions: The described palliative care curriculum accomplishes several goals as follows: it educates residents on palliative care topics, teaches communication tools, encourages self-reflection, and provides space for building peer relationships. The ease of implementation makes this curriculum applicable across various types of institutions, offering the potential to positively impact surgical training on a national scale.

Experiencing and enduring patient distress: the distress of palliative care patients and its emotional impact on physicians in trainingBMC Medical Education; by Andréa Tarot, Maxence Pithon, Ashley Ridley, Virginie Guastella, Virginie Guastella, Morgane Plancon, Régis Aubry, Helène Vaillant Roussel, and Axelle Maneval; 6/26/24The extreme vulnerability experienced by patients in palliative care may result in significant distress. These patients require appropriate care while not pathologizing their natural distress. ... [The] aim of this study was to explore how professionals in training feel when confronted with the distress of patients undergoing palliative care. ... The interviews revealed the following five themes:

'We may not ever be fully staffed': Health system C-suites plan for the future Becker's Hospital Review - Leadership & Management; by Laura Dyrda; 6/24/24 After the pandemic, most healthcare leaders experienced a "great resignation" as workers left for other service industries and ever since health systems have been dealing with a lack of skilled labor to backfill the vacancies. "As we have realized we may not ever be fully staffed to the degree we were pre-COVID, we now must augment our existing workforce with technology that extends their capabilities," said Mark Moseley, MD, president of USF Tampa General Physicians and executive vice president of Tampa General Hospital. "This is a two-part challenge. First, we need to deploy technology thoughtfully with sound blocking and tackling, which is expensive in both time and capital. Second, we must train our workforce to use these new technologies to aid them in their daily responsibilities in a manner that does not diminish the ethos of why many of us went into healthcare: the interactions with patients and members of the healthcare team." Physicians and nurses can fall on a wide spectrum of excitement or distaste for incorporating technology into their practice. Some may find it impersonal and challenging to understand while others see it as a tool boosting their capacity. ... [Click on the title's link to continue reading.]

Lawmakers remain committed to passing hospice workforce bill Hospice News; by Jim Parker; 6/24/24 Federal legislators plan to continue to work on passing a bill designed to bolster the hospice and palliative care workforce. The Palliative Care and Hospice Education Training Act (PCHETA) has come before Congress several times but has not yet been passed. The bill’s most recent development occurred in July 2023, when it was reintroduced by Sens. Tammy Baldwin (D-Wisc.) and Shelley Moore Capito (R-W.Va.). Capito has indicated that the senators are not giving up on the legislation as they seek to ensure that hospice and palliative care providers are able to meet growing demand. ... The legislation would establish fellowships through new palliative care and hospice education centers to provide short-term, intensive training, as well as incentivized award programs across all the relevant disciplines. It also would support programs to develop career paths within the field.

The 9 biggest challenges physicians face in daily practice: Survey Becker's Hospital Review; by Ashleigh Hollowell; 6/20/24 ... The following challenges are the ones physicians most often ranked as very or somewhat significant as they relate to their day-to-day work:

Psychological health in Palliative Care: Thematic analysis of a psychiatrist's and an art therapist's clinical reflexive journals Palliative Medicine; by Wen Phei Lim, Roxanne Jia Yu Chew, Clare O'Callaghan; 6/19/24 online ahead of print Aim: This study aims to describe how patients receiving palliative care experience psychological health, explore the meaning of a palliative care clinician's work and contribute to the understanding of psychological health in palliative care through the reflexive and visual journals of clinicians.

Palliative care nurses share precious lessons learnt after decades working with the dying News.com.au [Australia]; by Jessica Wang; 6/16/24 After taking care of terminal patients who are facing death for 35 years, Sydney nurse Cindy Grundy has learnt a lesson or two about living. Her most cherished is to “guard your time” and treat it like the invaluable commodity that it is, says the palliative care nurse, who works in an inner-city public hospital. “To me, time is everything. It’s so precious,” the 59-year-old said. “You need to learn how to prioritise things and let go of the things that don’t matter. I appreciate the smaller things in life from working in this job but time is a big thing for me.” ... At the heart of what she does, and other palliative care nurses do, is make sure patients can get the most out of the last few hours, days, weeks or months of life – whether that’s through managing their symptoms or fulfilling their last wishes. “They’re dying but they’re still alive and that’s a chance for laughter, love and new experiences,” says fellow Sydney-based nurse Steven Turk.