Literature Review

Let us never consider ourselves finished nurses ... we must be learning all of our lives. - Florence Nightingale, 1820-1910Editor's Note: Executive leaders, what ongoing learning do you provide for your nurses? Do you simply give directives (which are important) or do you also foster the individual's curiosity, confidence, and increased competence? Whatever your hospice and palliative role, discipline, and education, may we ALL be learning, all of our lives. Celebrating National Nurses Week, May 6-12, 2024

Highlighting Nurses Week: Best, worst states for nurses in 2024 Becker's Hospital Review; by Erica Carbajal; 4/30/24 WalletHub has deemed Washington the best state for nurses to practice in 2024 — a recognition based on an analysis of earnings, job growth and working conditions. For the annual ranking, the financial services company compared 50 states across two key dimensions: opportunity and competition, and work environment. Twenty metrics were grouped into those two dimensions, ... Here are the 10 best and worst states for nurses in 2024, per the ranking:  ...

How Mass General Brigham provides emergency care at home Becker's Health IT; by Giles Bruce; 5/6/24Somerville, MA-based Mass General Brigham now treats patients needing emergency or urgent care at home. The health system's patients can request referrals to the Home Hospital Emergency Care program through their primary care providers, who decide if patients are stable enough to be treated at home. If they are, a nurse talks to the provider and schedules a home visit, where a paramedic completes a physical exam joined virtually by an emergency medicine physician. Editor's Note: Pair this article with others in today's newsletter: "Stranded in the ER, seniors await hospital care and suffer avoidable harm" (in our Post-Acute Care section), and "[Australia] Palliative patients can die peacefully at home with paramedic support, claims proposed framework" (in our International section). 

National Nurses Week 2024: RN reflects on the state of the profession, calls for change USA Today / Columbia Daily Tribune; by Julia Gomez, USA Today; 5/6/24 Monday, May 6 kicks off National Nurses Week, and it gives folks an opportunity to show their love and appreciation for the people who take care of the sick, injured and dying. From neonatal nurses who help welcome newborns into the world to hospice nurses that provide peace and comfort to their dying patients, nurses play a crucial role in the medical industry. ... Catherine Kennedy, a registered nurse and the Vice President of National Nurses United, told USA TODAY that there needs to be systemic change on the federal level to give nurses the best chance to care for their patients. A study published by the National Library of Medicine states that in 2021, nurses would work an average of "8.2 hours of paid overtime and 5.8 hours of unpaid overtime per week that year — making up the equivalent of more than 9000 full-time jobs." ... 

Workers at two Essentia Health facilities file for union representation Minnesota Nurses Association (MNA); by Sam Fettig and Lauren Bloomquist; 5/2/24 Registered nurses at Essentia Miller Hill Surgery Center and nurses and other healthcare workers at Essentia Solvay Hospice House announced this week that they have filed for an election with the National Labor Relations Board to form a union represented by the Minnesota Nurses Association ... because they want a voice in their workplace to improve both working conditions and how care is provided to their patients. ... At Essentia Solvay Hospice House, workers across the board, including Registered Nurses, Licensed Practical Nurses, Nursing Assistants, Administrative Assistants, Environmental Services workers, and Cooks, filed for a union election.

Highlighting Nurses Week: Tidewell Foundation raising the next generation of hospice nurses Observer; by Tidewell Foundation; 5/2/24 ... Serving Charlotte, DeSoto, Manatee, and Sarasota counties [Florida], the Tidewell Foundation provides the philanthropic support needed to ensure all who need the world-class care of Tidewell Hospice ... funds the only accredited non-profit Nurse Residency program in the United States. Tidewell began its Nurse Residency Program in 2018 to combat the nursing shortage in our region. Now, 6 years later, it is the first hospice to be accredited by the American Nurses Credentialing Center (ANCC), joining a network of 264 nurse residency programs across the nation.

Curricular reform in serious illness communication and palliative care: Using medical students' voices to guide change  Academic Medicine: Journal of the Association of American Medical Colleges; by Jennifer A Reidy, Kate Brizzi, Stephanie H Chan, Hollis Day, Scott K Epstein, Melissa Fischer, Priya S Garg, Anna Gosline, Carolina Jaramillo, Emma Livne, Suzanne Mitchell, Sarah Morgan, Molly W Olmsted, Patricia Stebbins, Isabella Stumpf, Tamara Vesel, Irene M Yeh, Megan E Young, Roberta E Goldman; 5/1/24 Purpose: To gather and leverage the voices of students to drive creation of required, integrated palliative care curricula within undergraduate medical education in Massachusetts, which is lacking in a majority of U.S. medical schools. Conclusions: This study confirms long-standing themes on students' experiences with SIC and palliative care topics, including feeling inadequately prepared to care for seriously ill patients as future physicians. Our study collected students' perspectives as actionable data to develop recommendations for curricular change.

Breaking the silence: The mounting need for trauma-informed hospice care Hospice News; by Holly Vossel; 5/3/24Traumatized and abused hospice patients and providers often experience an array of lingering physical, emotional and psychological effects that can fall into a silent abyss of unmet needs. ... Many seniors have experienced some form of trauma or abuse in their lifetime. ... More data has become available in recent years around the prevalence of different types of abuse and trauma. Roughly 10% of seniors 65 and older nationwide are victims of some type of abuse each year, the U.S. Department of Justice (DOJ) reported. Caregiver neglect represents 5.1% of these cases, with psychological and physical abuse impacting 4.6% and 1.6% of seniors, respectively. ...Editor's Note: This article highights interviews with Dr. Ashwin Kotwal, assistant professor at the University California San Francisco; Carole Fisher, president, National Partnership for Healthcare and Hospice Innovation (NPHI); Dr. Cameron Muir, chief innovation officer, NPHI; Andrea Devoti, executive vice president at the National Association for Home Care & Hospice (NAHC); Lindsey Owen, executive director of Disability Rights Vermont.

Substance use disorders in hospice palliative care: A narrative review of challenges and a case for physician interventionCambridge University Press; by Lauren Rudy and Emilie Lacroix; 2/29/24Objectives: Substance use disorders (SUDs) are frequently encountered in hospice palliative care (HPC) and pose substantial quality-of-life issues for patients. However, most HPC physicians do not directly treat their patients’ SUDs due to several institutional and personal barriers. ...Results: ... Recommendations for physicians and training environments to address these challenges include developing familiarity with standardized SUD assessment tools and pain management practice guidelines, creating and disseminating visual campaigns to combat stigma, including SUD assessment and intervention as fellowship competencies, and obtaining additional training in psychosocial interventions.

What's in the Black Box of a successful nurse and social worker team palliative telecare intervention (ADAPT)? (RP317)Journal of Pain and Symptom Management; by Lyndsay DeGroot, PhD, RN, CNE; Kevin Wells; Brianne Morgan, BSN; Michelle Upham, MSW, LICSW; David B. Bekelman, MD, MPH; 5/24Key Message: A nurse and social worker palliative telecare team provided structured symptom management, psychosocial care, and individualized medical changes to improve quality of life, depression, and anxiety for patients with COPD, HF, and ILD. Impact: A nurse and social work palliative telecare team used collaborative care to tailor recommendations to the unique needs and symptoms of each patient, thereby improving quality of life.

Shocked at end-of-life: An educational video for hospice workers about Implantable Cardioverter-Defibrillators Journal of Pain and Symptom Management; by Sarah Godfrey, MD, MPH; Christine L. Chen, MD; Melanie S. Sulistio, MD; Sharika Kumar, MD; and Kelley Newcomer, MD; 2/24 Introduction: Hundreds of thousands of patients with implantable cardioverter-defibrillators (ICDs) die yearly. Though ICD shocks can be lifesaving, they can also be severely painful. One third of ICD patients are shocked in the last day of life irrespective of DNR status. Over 97% of hospice programs admit patients with ICDs, yet only 10% have deactivation policies and less than 50% of hospice patients have their ICD deactivated. ...  Conclusion: Hospice personnel have limited knowledge about ICDs, prohibiting best care of patients with these devices at EOL. A short educational video increased knowledge and may serve as a helpful tool. Improving ICD knowledge amongst hospice personnel is essential to ensuring the unique needs of hospice patients with ICDs are met.

More legislation in Illinois deals with ending a person’s life The Center Square - Illinois; by Kevin Bessler; 5/1/24 Another bill has been introduced in Springfield dealing with end of life options for the terminally ill. Illinois state Sen. Julie Morrison’s Senate Bill 2644 would establish a statewide electronic registry that would contain Physician Orders for Life Sustaining Treatment (POLST) forms, which detail what type of medical treatment a critically ill patient does and does not want. “How much or how little treatment a person receives at the end of their life should be up to each individual instead of the one-size-fits-all approach,” said Morrison, D-Lake Forest, during a news conference Wednesday. “This measure will enable physicians to access forms detailing patients wishes in a single, accessible location.” 

Nurse pleads guilty to 22 counts of patient murder, attempted murder Becker's Hospital Review; by Mariah Taylor; 5/2/24 Heather Pressdee, a Pennsylvania nurse, pleaded guilty to three counts of first-degree murder and 19 counts of attempted homicide, the Pittsburgh Post-Gazette reported May 1. Ms. Pressdee pleaded guilty on May 2 in an ongoing hearing that is expected to go until May 3. She was given three consecutive life sentences and 380 to 760 years consecutively. Ms. Pressdee, 41, was first charged in May 2023 in connection with the mistreatment of three nursing home patients while working at Quality Life Services in Chicora, Pa., including two counts of homicide and one count of attempted murder. In November, she was charged in connection with the mistreatment of 19 additional patients that were in her care at five different facilities since 2020.