Literature Review

Managing oncology nurse burnout through peer support, emotional intelligence Oncology Nursing News; by Pattie Jackel, MN, RN, AOCN; 3/28/25 Debriefing after patient loss, supporting patients at the end of life, and finding outlets outside of work can help oncology nurses avoid burnout. ... Pattie Jakel, MN, RN, AOCN, spoke with Oncology Nursing News® about burnout in oncology nursing and ways to avoid it while providing palliative care to patients. ... You have to have a strong network and support. And my husband is…an architect, so medicine is not his thing, and in the beginning, he’d be like, “Pattie, I can only hear one sad story a week because I can’t hear all your sad stories.” ... "Working in acute care, I saw some horrific death and dying that occurred for our patients. We would definitely debrief afterwards, bring the group together 5 minutes. Sometimes we did longer ones." [Continue reading ...]

Honoring a young girl’s love of nature on her final dayMayo Clinic News Network; by Mayo Clinic Staff; 3/27/25 On a Saturday evening in September of 2024, Mae Helgeson arrived at Mayo Clinic in Rochester, her small body reeling from the trauma of a life-threatening accident. Although she was intubated and sedated, it didn't take long for the care team to learn what made this little girl special. ... "I often ask parents to tell me about their child. Is there anything you think is important or that I should know about your family?" says Paige Dighton, one of the Child Life specialists who partnered with Mae's family. "This allows them to share the special things — those unique qualities that make them a family. You learn more than just what's in their chart." ... It was only a couple of days later that Mae's family was faced with the devastating decision they'd hoped to avoid. ... The question shifted from "Can we save her?" to "How do we say goodbye?" Following their lead, the team began focusing on end-of-life care. "Dr. Schiltz gave us the space to think and process our emotions — it didn't feel rushed," says Matt. 

Hospital workers share 26 deathbed regrets they’ve heard that changed their lives Boredpanda; by Ruta Zumbrickaite; 3/28/25 While painful, regret can also be a motivator for learning and growth, encouraging us to avoid repeating past mistakes and make better decisions in the future. We guess that’s why self-help author Debbie Ford once said, “Pain can be our greatest teacher.” Someone on the web asked hospital workers, “What regrets do you hear from dying patients?”, and folks who’ve been there in people’s last moments shared the words that hit them the hardest. Here’s a list of some of their most profound responses.  

Hidden battles: Keeping cancer secret Harvard Health Publishing - Harvard Medical School; by Maureen Salamon; post is dated 4/1/25, retrieved from the internet 3/25/25 Some people choose to conceal their diagnosis and treatment. Here's why — and reasons that approach can sometimes backfire. ... [In addition to privacy motives, Cristina Pozo-Kaderman, a senior psychologist at Harvard-affiliated Dana-Farber Cancer Institute] says cancer patients may also wish to:

Hastening death by stopping eating and drinking: Hope Wechkin, Thaddeus Pope, and Josh Briscoe GeriPal Podcasts; by Hope Wechkin, Thaddeus Pope, and Josh Briscoe Eric and Alex have featured discussions about complex bioethical concepts around caring for people at the end of life, including voluntarily stopping eating and drinking (VSED), and multiple episodes about the ethical issues surrounding medical aid in dying (MAID). Recently, discussion has emerged about how these issues intertwine in caring for patients with advancing dementia who have stated that they would not want to continue living in that condition: for those with an advanced directive to stop eating and drinking, how do we balance caring for their rational past self and their experiential current self? Should these patients qualify for medical aid in dying medications? And is there a middle path to provide some degree of comfort while also hastening the end of life?

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.]

End-of-life conversations: ‘When they open the door, you have to go in’ Oncology Nursing News; by Pattie Jakel, MN, RN, AOCN; 3/13/25Oncology nurses have a unique relationship with patients that allows for difficult but essential end-of-life conversations, says expert Patricia Jakel, MN, RN, AOCN. Jakel, one of the editors in chief of Oncology Nursing News, emphasized that following up with patients and ascertaining what answers and support they need comes with the close bonds that oncology nurses form with patients with cancer. ... [Jakel describes:] We play a really important role. And sometimes patients ask us difficult questions, and we have to be prepared for it. I remember a lovely young patient I had, she had 2 little girls, and she was very sick. And things weren’t going well for her in the hospital, and she just—she looked up at me and she said, "Am I dying today?" And I thought, "She’s opening the door. She needs to have this conversation.” And I said, “It’s not going to be today, but I think it’s going to be soon.” And she kind of chuckled, because her sister was at the bedside, and she said to her sister, “I need my makeup done. I want my makeup on today, if today’s not the day.” And that took us to a whole conversation about what dying would look like for her.Editor's note: Read and share this significant, sensitive video/article from its source, Oncology Nursing News. What communication education and support do you provide for your nurses? Explore this similar article from Oncology Nursing News, "APPs, Oncologists Work Together for End-of-Life Discussions," 11/2/24.

Sarcopenia in terminally ill patients with cancer: Clinical implications, diagnostic challenges, and management strategies Journal of Hospice & Palliative Care; by Se-Il Go, Myoung Hee Kang, and Hoon-Gu Kim; 3/1/25 Sarcopenia, characterized by progressive loss of skeletal muscle mass and strength, is a prevalent but often overlooked condition in patients with cancer who are terminally ill. It contributes to functional decline, increased symptom burden, and reduced quality of life, yet remains underrecognized in palliative care. Diagnosing sarcopenia in this population is challenging because conventional imaging techniques are often impractical. Instead, alternative assessments, such as the Strength, Assistance with walking, Rise from a chair, Climb stairs, and Falls questionnaire (SARC-F), anthropometric measurements, and bioelectrical impedance analysis offer feasible options. Management should focus on symptom relief, functional preservation, and patient comfort, rather than on muscle mass restoration.

Leverage collaboration, detailed notes to improve end-of-life care Home Helath Line; by MaryKent Wolff; 3/13/25 Educate your hospice staff on monitoring symptoms that could indicate a patient is nearing the end of life. Agencies that manage these symptoms early and take the time to prepare and comfort caregivers and families for the transition could see these successes reflected in their CAHPS Hospice survey scores. [Subscription required for more content.]

My Stories program preserves cherished memories of patients in hospice The Alpena News, Alpena, MI; by Reagan Voetberg; 3/8/25 The Hospice of Michigan in Alpena preserves the stories of patients, not in a book or photo album, but on a flashdrive. It’s called the My Stories program. Patients in hospice are given the opportunity to video record their stories and memories for their loved ones to hear once they’ve passed. Patients do not have to pay a dime to record their life stories. Alpena’s Hospice of Michigan Volunteer Program Coordinator Kristie Lukes talked about how meaningful the My Stories project is to patients and their families. Lukes coordinates volunteers to help patients with their recordings. Lukes explained further what My Stories is. “It’s a recording of the patient’s life and the stories that they want to share with family and patients,” she said. “So it becomes kind of a legacy project.” 

Here’s to Laura Ptucha-Skoog, hospice nurse YubaNet.com; by Timothy May; 3/10/25 “I’m not sure I’d say much at all, not at first. I would just try to listen.” This in response to the question of how a hospice nurse should respond if patients or family members make demands that seem unreasonable, unwise, or downright impossible. ... Laura Ptucha-Skoog should know; she has been an R.N. for decades and a nurse at Hospice of the Foothills for the last nine years. She loves her job, including the challenge of facilitating communication. Her ability to talk frankly with terminally ill hospital patients and families drew her to a career in hospice. “Often,” Laura explains, “the human elements are as challenging as the medical ones. Things like asking the right questions and listening to responses; making sure your patient and their caregivers understand what you are doing and why; verifying that everyone understands where you are in the process; listening to their responses with patience and empathy.” ... 

Report finds those with Parkinson’s have unmet hospice needsMcKnights Long-Term Care News; by Kristen Fischer; 3/6/25 Hospice use varies depending on whether a person has Parkinson’s disease, Lewy body dementia or Alzheimer’s disease and those with Parkinson’s may have more unmet needs, a new study finds. Researchers evaluated data on 11,327,324 Medicare beneficiaries enrolled in hospice between 2010 and 2020 as part of their study, which was published Tuesday in JAMA Network Open. ... Hospice enrollees who had Parkinson’s disease and dementia with Lewy bodies were less likely to be disenrolled from hospice due to extended prognosis compared to those with Alzheimer’s disease. People who had Parkinson’s disease but not dementia with Lewy bodies were more apt to have longer stays over 180 days and turn hospice away compared to those with Alzheimer’s disease. (Short stays were defined as those less than seven days.)