Literature Review

A day in the life: Hospice nurseDaily Nurse - The Pulse of Nursing; blog by Renee Hewitt; 4/8/24 Supporting someone with a life-limiting diagnosis or talking about death can be difficult for many people, but not for a hospice nurse. What’s it like to care for patients and their families in the end-of-life process? Maryette Williamson, RN, BSN, knows firsthand from working as a BAYADA Hospice Nurse in Fayetteville, North Carolina. We asked her about her work. What follows is our interview ... [From Maryette] ... "There was a learning curve from long-term care to hospice. The most significant difference in hospice is our focus on quality of life rather than a cure. That was the most important change for me."Editor's Note: Consider linking to this resource with your nurse recruitment tools. Hospice executives, this nurse's common transition when moving from long-term care to hospice. Ensure solid orientation/onboarding/precepting training, time, resources, support, and accountability for new hospice employees. Do not assume that they will automatically translate their years of practice into hospice principles and best practices. 

Improved onboarding process could boost worker retentionMcKnights Senior Living, by Kathleen Steel Gaivin; 4/8/24As long-term care providers navigate post-pandemic workforce challenges, they also need to improve the onboarding process, according to the results of a new survey by Viventium. ... The study detailed in the company’s 2024 Caregiver Onboarding Experience Report solicited responses from 175 administrators and caregivers in skilled nursing, assisted living, independent living, home health, home care and hospice care in November and December. The survey, Viventium said, found a “shockingly low bar for what passes as a ‘good’ onboarding experience, with strong indications that raising that bar could correlate to higher retention rates.”Editor's Note: See the article in today's newsletter, "A day in the life: Hospice nurse" for the importance of onboarding hospice nurses to to differences between long-term care and hospice care.

Optimizing RN responsibilities ‘more essential’ than staffing hours: study McKnights Long-Term Care News, by Josh Henreckson; 4/2/24 ... [New] analysis suggests that optimizing the role of registered nurses would be an even more effective way of increasing quality of care. Care quality would strongly benefit from an industry-wide focus on the responsibilities of RNs, the study’s authors said. Specifically, leaders should more actively differentiate RNs from licensed practical nurses, use a nursing practice model framework to maximize the role of RNs and provide RNs with more education in leadership and geriatric care.

Chicago area nurse gets 2 years in prison for stealing morphine from sick patientsCBS News TV 2, Chicago; by Acacia Hernandez; 4/4/24A northwest suburban nurse was sentenced in court on Thursday to two years in federal prison for stealing morphine from her patients, some of whom were terminally ill. Sarah Diamond, 31, of Woodstock, was accused of targeting the most vulnerable, including hospice patients living out their final days. In 2021, she removed liquid morphine from bottles that had been prescribed to at least five hospice patients and replaced it with saline. Prosecutors said she took the medication for her own personal use.

RNs are moving away from home health and hospice, federal survey reveals McKnights Home Care, by Adam Healy; 4/2/24 Though the number of registered nurses continues to grow, fewer are working in home healthcare and hospice compared to years past, according to the latest national sample survey collected by the Health Resources & Services Administration. In 2018, there were 179,509 RNs working in home health and hospice, representing about 6% of the nursing workforce, according to an earlier national survey. HRSA’s latest count estimated that there were 173,808 RNs in home health and hospice in 2022, or only 5% of the workforce. 

Nursa Survey finds 98% of hospital CFOs view nurse staffing as top challenge Morningstar, provided by Business Wire; 4/2/24Survey results offer insight into C-suite perspectives on workforce trends and financial impact. Nursa, a nationwide platform that exists to put a nurse at the bedside of every patient in need, today released the results of a survey with healthcare decision-makers that examines their perspectives on the evolving social contract of employment, opinions on the 1099 workforce, and reflections on what makes a nurse truly valuable to an organization. Key findings from the survey include:

Northwell hospital nurses cancel strike Becker's Hospital Review, by Kelly Gooch; 4/1/24Members of the New York State Nurses Association have called off a planned April 2 strike at New York City-based Staten Island University Hospital after reaching a tentative agreement with management on a new labor contract. The union represents 1,300 workers at the facility. ... SIUH is part of New Hyde Park, NY-based Northwell Health, a 21-hospital system with more than 85,000 employees total. ... The agreement "adds nurse staffing on units that need help"; includes an expedited process for creating staffing standards in new units; and features wage increases that total 22.12% over three years and include annual pay increases, market adjustment pay, and experience pay, the union said.

What is an end-of-life doula? Psychology Today, by Cheralyn Leeby, PhD, LMFT; 3/31/24"The appellation ‘end-of-life doula’ (EOLD) is increasingly used as an umbrella term to identify lay people, primarily women, who provide a diversity of non-medical supports—social, emotional, practical, and spiritual—for people nearing the end of life, including those close to them" (Krawzik and Rush, 2020). The term doula is derived from the Greek word "doule," which means helper or maidservant. Families hire death coaches to facilitate, guide, and emotionally support the dying process.

How’s Your Soul? JAMA Network, by Daivd Vermette, MD, MBA, MHS; 3/28/24 "Brother David, how’s your soul?” The question took me by surprise. It was time for my first advisement meeting with my residency program director. In medicine, the machine runs on competence and achievement of “milestones.” Yet, as I braced for a meeting to trudge through performance evaluations and in-training exam scores, I awoke to humanity. ... Medical education has numerous models for coaching, advising, and mentoring. While these models helped develop my professional life, they missed the fundamental core of who I am: a human being. Perhaps instead we could embrace a model in medical education built on the tenets of pastoral care. ...

Death is inevitable. Doctors should be prepared to manage it appropriately. MedPageToday, by Gabrielle Kis Bromberg, MD; 3/28/24In preparation for my clinical year, my medical school instructors taught me about the importance of assessing the goals and wishes of patients at the end of life. ... [My Aunt] Daniella shared with my mom and me that she was tired of being so sick and tired of feeling stuck in the hospital's revolving door. So, I asked my aunt the questions I'd just learned in class. "What is most important to you?" "If you were sicker and could not share your own medical wishes, what would you want us to tell your doctors about your goals?" "Would you accept another ICU stay, CPR, a breathing tube?" My mom and I drove home with crystal clear instructions from Daniella. If she got sicker, she wanted to die without prolonged suffering. ... [Months later] Despite many doctors, hospitalizations, a years-long decline, and countless healthcare touch points, no one had asked Daniella how she was faring as her body failed. Why did it require a medical student -- me -- just 4 months into training, to achieve an end of life consistent with her wishes?

5 C-suite roles talent leaders are watchingBecker's Hospital Review, by Alexis Kayser; 3/21/24Becker's recently connected with HR and talent executives to learn how their health systems are strengthening leadership pipelines. When asked which leadership roles they expect to focus hiring efforts on in the coming years, these C-suite titles emerged.

Home care providers’ creative benefit packages are paying off Home Health Care News, by Joyce Famakinwa; 3/26/24 ... Amid a persistently challenging labor market, home care companies are still constantly working on configuring the best possible employee benefits package for caregivers. Companies like Right at Home San Gabriel Valley, Devoted Guardians and Family Tree Private Care have emerged as standouts when it comes to crafting impressive benefits packages. ... 

Hospice & Palliative Care Handbook: Quality, Compliance, and Reimbursement, 4th Edition McGraw Hill - Access APN; textbook by Tina M. Marrelli and Jennifer Kennedy; 3/28/24 “Hospice & Palliative Care Handbook, Fourth Edition, is an invaluable resource for timely hospice regulatory and compliance information, documentation, care planning, and case management. It provides clear guidance for hospice managers, clinicians, and interdisciplinary group members. I have utilized Tina Marrelli’s home health and hospice handbooks to support training new clinical staff and students for decades and consider these resources to be the gold standard.” – Kimberly Skehan, MSN, RN, HCS-D, COS-C, Vice President of Accreditation - Community Health Accreditation Partner