Literature Review

What is the appropriate response when a colleague is not following an aid-in-dying law? American Clinicians Academy on Medical Aid in Dying - Ethics Consultation Service; posted by Jean Abbott, MD, MH; originally posted 2/2/24 and emailed 3/4/24 Outline of Ethics Question: A resource practitioner for aid-in-dying care has encountered practitioners who have not followed the requirements of the laws in that state, including eligibility, documentation, and other standard legal or medical elements of aid-in-dying care. The resource practitioner wonders what ethical responsibilities should guide their response to these concerns. Definition of “resource practitioner”: An experienced prescriber who acts as a source of information or a mentor for others prescribing or consulting for patients considering aid in dying. Their role is to advise the provider on aid-in-dying best medical practices and the process required to comply with the law.

Podcast: Dr. Robert Carolla’s reflections on life and mortality Springfield Daily Citizen; 2/28/24 Dr. Carolla, a pioneer in his field, sheds light on the delicate balance between life and mortality that oncologists navigate daily.  Through his work with the Hospice Foundation of the Ozarks and national recognition from StoryCorps broadcasts, he and his wife, Peg, have touched countless lives with their compassion and dedication. Dr. Carolla’s journey offers a profound perspective shift on life, death, grief and the human experience. 

Writing condolence cards supports nurses as well as deceased patients’ families ONS Voice, by Casey S. Kennedy; 2/29/24During extended treatment and end-of-life care, patients, their family and caregivers, and the healthcare team can form close bonds and relationships. Those ties are abruptly severed when a patient dies, leaving each party to grieve alone. For healthcare professionals, sending a condolence card can provide closure for themselves and support for a deceased patient’s family, a team of nurses reported in an article published in the December 2023 issue of the Clinical Journal of Oncology Nursing.

Many older adults don't receive palliative care before deathMedScape, by Marilynn Larkin; 2/28/24 "One of the challenges and a barrier to accessing palliative home care is the difficulty of predicting survival," Amy Hsu, PhD, an investigator at the Bruyère Research Institute in Ottawa, Ontario, Canada, told Medscape Medical News. "Clinicians are good at prognosticating when a patient might be entering their last 3-6 weeks of life, but they have a harder time predicting if someone will survive 6 months or longer."  The team developed the Risk Evaluation for Support: Predictions for Elder-life in their Communities Tool (RESPECT) to see whether access to predicted survival data could inform conversations about a patient's status and palliative care needs. The study was published online on February 26 in the Canadian Medical Association Journal.

Debate intensifies over palliative care's reach: Wootton vs. Finlay's divergent viewsThe Wall Street Journal, by Getta Pillai; 2/29/24Discover the differing perspectives of Sarah Wootton and Dr. Ilora Finlay on the effectiveness of palliative care. Gain insights into the challenges and potential solutions in end-of-life care.

Is healthcare paying enough attention to nurse leaders?Becker's Clinical Leadership, by Erica Carbajal; 2/26/24 Early this year, the American Organization for Nursing Leadership Foundation released findings from more than 2,400 nurse leaders who were surveyed in November. Thirty-five percent of respondents indicated they were considering an exit from their roles: 12% said they intend to leave and 23% said they may leave within the next six months. When asked what the top reasons were for thinking about an exit, nurse leaders pointed to work having a negative affect on their health and well-being and not having the resources to do their job — a parallel to what bedside nurses consistently point to as drivers of burnout or reasons they've stepped away from the job. 

Experiences of nursing students providing end of life care for children and young people: A focus group study Elsevier, by Clair Camara, Leah Rosengarten and Jane Callum; 2/27/24This study aims to help improve understanding of the lived experiences of children's nursing students who have cared for a patient at, during, or immediately following end-of-life. The study describes the emotions experienced by children's nursing students and explores the student nurses' perceptions of education and support needs around caring for [Children and Young People] CYP during end-of-life care.

House set to vote on bill that could give dramatic boost to nurse-aide training efforts McKnights Long-Term Care News, by Josh Henreckson; 2/28/24 A bill that could reshape how new workers enter the long-term care workforce is scheduled for a vote in the US House of Representatives this week, according to a spokesperson for House Majority Leader Steve Scalise (R-LA). If passed, HR 6585 — referred to as the Bipartisan Workforce Pell Act — would make work training programs of as short as eight weeks with a minimum of 150 hours of training eligible for the federal aid through the Pell Grant program. Previously, grants were available only to programs with a minimum of 15 weeks and 600 hours of training.

CareAcademy launches hospice care curriculum and expands offerings to serve post-acute care providers nationwidePR Newswire, news provided by CareAcademy; 2/27/24CareAcademy ... proudly announces the launch of its Hospice Care curriculum, marking a significant expansion of its offerings to support post-acute care providers. Renowned for its user-friendly platform and high-quality content, CareAcademy is broadening its focus to be a key player in the broader post-acute care landscape, serving home health, hospice and palliative care organizations.

Racial differences in shared decision-making about critical illnessJAMA Intern Med, by Deepshikha C. Ashana, MD, MBA, MS; Whitney Welsh, PhD; Doreet Preiss, PhD; et al; published online 2/26/24Question: How do critical care clinicians approach shared decision-making with Black compared with White caregivers of critically ill patients?Findings: In a thematic analysis of 39 audio-recorded clinician-caregiver meetings, racial differences were most evident in the following clinician behaviors: providing emotional support to caregivers, acknowledging trust and gratitude expressed by caregivers, disclosing medical information, and validating caregivers' treatment preferences.

How many docs are feeling burned out? Almost all of them, survey findsMedPageToday, by Joyce Frieden; 2/22/24More than half of survey participants (56%) said they've thought about either staying in medicine but no longer seeing patients, or leaving the field entirely, the poll found. Primary care doctors expressed more frustration than specialists, with a higher percentage considering leaving the field entirely (54% vs 42%). Only 30% of respondents overall said they were optimistic about the future.

From classroom to clinic: End-of-life conversations — there’s empathy in foresightThe Tufts Daily, by Deeksha Bathini; 2/21/24Palliative care physicians have conversations with families to identify patient wishes, particularly when they are facing death. These physicians are equipped with training that emphasizes empathy, comfort and patient autonomy. Freedom of choice during the dying process gives patients the power to reclaim their agency amidst a process rife with uncertainty.

Not all mourning happens after bereavement – for some, grief can start years before the death of a loved one The Conversation, by Beth Daley; 2/22/24For many people, grief starts not at the point of death, but from the moment a loved one is diagnosed with a life-limiting illness. Whether it’s the diagnosis of an advanced cancer or a non-malignant condition such as dementia, heart failure or Parkinson’s disease, the psychological and emotional process of grief can begin many months or even years before the person dies. This experience of mourning a future loss is known as anticipatory grief.Editor's Note: All clinical team members need to be equipped to tune into and validate grief that is already underway. Social workers and chaplains--especially--need to be trained to tend grief in the present, and to know how to make high-acuity referrals to bereavement counselors.