Literature Review
All posts tagged with “Clinical News | Physician & Nursing News.”
Exploring the role of AI in palliative care and decision-making
03/05/25 at 03:00 AMExploring the role of AI in palliative care and decision-making Penn Today; by Erica Moser; 2/28/25 Oonjee Oh [nursing Ph.D studen] was the lead author on the paper “The ethical dimensions of utilizing Artificial Intelligence in palliative care,” which published in the journal Nursing Ethics in November. ... The paper applies the moral principles of beneficence, nonmaleficence, autonomy, justice, and explicability to examine the ethical dimensions of three hypothetical use cases: machine learning algorithms that predict patient mortality, natural language processing models that capture the signals of psychological distress from clinical notes, and chatbots that provide informational and emotional support to caregivers.
'Shouldn't be something that's feared': She helps people face the end of life with dignity
03/04/25 at 03:00 AM'Shouldn't be something that's feared': She helps people face the end of life with dignity News Chief, part of the USA TODAY Network, Lakeland, FL; by Thomas R. Oldt; 3/2/25 Allow me to introduce a perfectly lovely person you may not wish to meet. She’s fostered rescue dogs, advocated for domestic violence victims, volunteered for foreign medical missions and worked emergency rooms throughout Central Florida. She is exceptionally empathetic, intensely focused and candid to a fault. She is also highly conversant in a subject most of us prefer to avoid. For the past seven years, Dr. Danielle Christiano has been staff physician at Good Shepherd Hospice in Auburndale where – in contrast to most other places – death is not a verboten subject. ... [Question:] What do you say or do to alleviate fears that accompany the end of life? [Answer:] It depends on your definition of hope. And it depends on what you want out of this. My general prescription is very different from most doctors because I embrace joy. I want people to seek out the things that bring them joy, ...
45% of end-of-life cancer patients potentially overtreated: 5 study notes
03/04/25 at 03:00 AM45% of end-of-life cancer patients potentially overtreated: 5 study notes Becker's Hospital Review; by Elizabeth Gregerson; 2/28/25 Almost half of all Medicare enrollees with cancer nearing end of life receive aggressive overtreatment as opposed to supportive palliative or hospice care, according to a study published Feb. 21 in JAMA Health Forum. Here are five things to know from the study:
Charges dismissed against chef accused of trying to kill his Monterey county mother
03/04/25 at 03:00 AMCharges dismissed against chef accused of trying to kill his Monterey county mother KSBW Action News-8, Monterey, CA; by Felix Cortez; 2/28/25 A popular San Francisco area chef who was arrested along with his sister and charged with trying to kill their mother more than two years ago has had attempted murder charges dismissed against him. “In over 30 years of practice, this was one of the saddest cases I have ever seen and one of the most incompetent investigations by the Monterey County Sheriff’s Department that I have ever seen,” said Juliet Peck, the attorney for James Stolich. ... The mother was terminally ill and lived on a ranch off Highway 68 outside Salinas. “James’ mother’s only wish was to die at home without pain, surrounded by her daughter, son, and pets,” Peck said. But that never happened; Tinker died about a week later in a hospice facility, never to see her children again, because an emergency protective order obtained by the sheriff’s office prevented the children from visiting their dying mother. ... According to court documents, the daughter, Whitney, was the “agent designated to make all health care decisions for her mother,” which included administering medication to help alleviate her mother’s pain. ...The original criminal complaint alleging attempted murder charges said Whitney or a co-conspirator “crushed up pills with a mallet.” A close friend of Tinker was willing to testify that Whitney had no intent to kill her mother but was simply following her mother’s “directive to provide effective and sufficient palliative care even if it hastened her death.”Editor's note: This case raises numerous issues, including but not limited to community education (including law enforcement), Advance Directives, patient and caregiver education and support, MAiD (Medical Aid in Dying) or the End Of Life Option Act (EOLOA) in California, ethics, and the dying process (note that "the mother died about a week later in a hospice facility).
Armed 60-year-old man arrested, accused of shooting at hospice nurse in Orange County
03/04/25 at 03:00 AMArmed 60-year-old man arrested, accused of shooting at hospice nurse in Orange County ABC News 12, Vidor, TX; by Scott Eslinger; 2/28/25 A 60-year-old Vidor man was arrested after a hospice nurse accused of him of shooting at her outside a patient's home. Gordon Billy Ward, 60, of Vidor, was arrested on Thursday by Orange County [California] deputies and booked into the Orange County jail. He is currently being held there on a charge of aggravated assault with a deadly weapon, according to jail records. [Click here for the related California post.]
Suspect armed with rifle shoots at hospice nurse, points weapon at deputies
03/03/25 at 03:00 AMSuspect armed with rifle shoots at hospice nurse, points weapon at deputies The Orange Leader, Orange County, CA; by Staff Reports; 2/28/25 A person was taken into custody after allegedly shooting at a fleeing hospice nurse and pointing a rifle at law enforcement Thursday. Orange County Sheriff’s Deputies responded to the 5600 block of Rebel Road after a hospice nurse reported to 911 that while attempting to provide care to one of her patients she was confronted by an occupant of the home. The occupant followed the nurse out of the home with a rifle, and shot at her as she fled the property. A single bullet struck the nurse’s vehicle, according to information from OCSO. Upon arrival, Orange County Deputies established communication with the suspect who remained inside the residence with the rifle. The suspect reportedly pointed the rifle toward the deputies while he remained in close proximity to the hospice patient.
The Alliance commends introduction of legislation to extend hospice telehealth flexibilities
03/03/25 at 03:00 AMThe Alliance commends introduction of legislation to extend hospice telehealth flexibilities National Alliance for Care at Home, Alexandria, VA and Washington, DC; Press Release; 2/28/25 The National Alliance for Care at Home (the Alliance) is pleased to support the reintroduction of the Hospice Recertification Flexibility Act in the House of Representatives. This bipartisan legislation, H.R.1720, would extend telehealth flexibilities for hospice face-to-face (F2F) recertification. The F2F encounter is performed by a physician or nurse practitioner to evaluate the patient and collect clinical information used in determining continued eligibility for hospice. Introduced by Representatives Carol Miller (R-WV) and Jared Golden (D-ME), the bill would extend the F2F recertification flexibility for providers until December 31, 2027. Beginning January 1, 2026, the legislation also includes important guardrails to ensure appropriate use and requires the Centers for Medicare & Medicaid Services (CMS) to create a modifier to collect data on when the F2F encounter is conducted via telehealth. The Alliance, then through its legacy organizations, worked with lawmakers to ensure continued care transformation and access to care for high-quality providers. [Click on the title's link to continue reading.]
WVU nursing faculty aim to enhance rural home care for chronically ill through NIH award
03/03/25 at 02:00 AMWVU nursing faculty aim to enhance rural home care for chronically ill through NIH award WVU Today - West Virginia University, Morgantown, WC; Press Release; 2/26/25 Three West Virginia University nursing faculty know firsthand the difficulties faced by family caregivers and their chronically ill loved ones. With a $2.7 million award from the National Institutes of Health’s National Institute of Nursing Research that is one of the largest ever for the WVU School of Nursing, the faculty researchers aim to support these families while increasing access to care in the rural reaches of the Mountain State by testing an integrated, nurse-led intervention for family home care management of end-stage heart failure and palliative care. ... Through their lived experiences, as well as their previous studies using nursing science to develop and test nurse-led interventions, the three said they hope to improve family caregivers’ and their loved ones’ overall health and well-being, including reducing depression and anxiety, and monitoring and managing end-of-life symptoms.
Montana House considers bill to put more sideboards on medical assistance in dying
02/28/25 at 03:10 AMMontana House considers bill to put more sideboards on medical assistance in dying NBC KPVI-6, Pocatello, ID; by Darrell Ehrlick; 2/26/25 ... On Wednesday, in a hearing of the House Judiciary Committee that was full of as much testimony as tears, opponents and supporters of medical aid in dying, sometimes called “physician-assisted suicide,” discussed House Bill 637, which would codify requirements for physicians to use the process. ... Demonstrating the often complex political issue that can’t be broken down by party lines, Rep. Ed Stafman, D-Bozeman, who is also a lawyer and rabbi, said he was truly conflicted on the bill, and wondered how Juras, also an attorney, viewed the proposed legislation in light of the state constitution’s right to dignity. ... Testimony from medical professionals ranged from strong support to opposition, ... [Click here for] Here's what [Montana] House Bill 637 would do ...
Wishing that your patient would die: Reasons and reactions
02/28/25 at 03:00 AMWishing that your patient would die: Reasons and reactions Psychiatrist.com - Rounds in the General Hospital; by Yelizaveta Sher, MD; Filza Hussain, MD; Benjamin J. Hoover, MD; Matthew Gunther, MD, MA; Daniel O. Fishman, MD; Mira Zein, MD; Jose R. Maldonado, MD; Theodore A. Stern, MD; 2/25/25 Have you ever had a patient suffer so much that you wanted them to die? Have you wondered whether such thoughts and feelings are acceptable? Have you been uncertain about how you could manage your guilt over such thoughts? Have you been unsure about how to best advocate for a patient whose medical care is futile? If you have, the following case vignette and discussion should prove useful. ...
Home health patients, caregivers lack understanding of palliative care, researchers find
02/27/25 at 03:00 AMHome health patients, caregivers lack understanding of palliative care, researchers find McKnights Long-Term Care News; by Adam Healy; 2/25/25 Home healthcare patients, caregivers and clinicians have significant knowledge gaps surrounding palliative care, which are contributing to poorer health outcomes for sick patients, according to a new study published in Home Healthcare Now. ... Healthcare providers, including home care agencies, are partially responsible for this limited public awareness, according to the researchers. The majority of survey participants agreed that it is the responsibility of doctors and nurse practitioners to inform seriously ill patients about palliative care. However, Medicare policy may be at the heart of this issue, Ashley Chastain, the study’s lead author, said.
North Texas doctor helps parents facing infant loss deal with the unimaginable
02/27/25 at 02:00 AMNorth Texas doctor helps parents facing infant loss deal with the unimaginableCBS News - Texas; by Andrea Lucia, Lexi Salazar, Katie Standing; 2/25/25[Background story for parents Yvette and Thoms Ngo upon dealing with the news that their in-utero baby girl Zoe was diagnosed with Trisomy 13, would likely miscarry, or die soon after birth. Dr. Terri Weinman, their neonatologist offered rich palliative care interventions and support.] "When we met Dr. Weinman and her team the first time, she would say things like, 'So, what are we going to do when Zoey is here,' which changed my mindset completely," Yvette Ngo said. ... For the first time, the Ngos began to consider what Zoey's life, short as it might be, could look like. "It made us more comfortable with the situation, I mean as comfortable as you can be," Thomas Ngo said. "She just gave us hope." Zoey was born on April 18, 2024. She met her parents, her siblings and her grandparents. She was baptized. "They made us little crafts and mementos for us to take home, like footprints, really ways to help cherish Zoey's life," Yvette Ngo said. "They took her heartbeat and recorded it for us. Little things that we wouldn't necessarily think of." Zoey even had a chance to go home. But after 36 hours of life, Zoey passed away in her father's arms. The perinatal palliative care Zoey received remains rare. But for families like the Ngos, it provides a small sense of control when it's needed most. "Being able to plan so much in advance and think about all the different scenarios and how we wanted it," Yvette Ngo said. " I think, looking back on our time with Zoey..." "We wouldn't have done anything differently," Thomas Ngo said. Editor's note: Pair this with "Improving knowledge, confidence, and skills in perinatal bereavement care through simulation in baccalaureate nursing students," posted 2/24/25.
‘Global problem’: Numerous factors, biases contribute to overtreatment at end of life
02/27/25 at 02:00 AM‘Global problem’: Numerous factors, biases contribute to overtreatment at end of life Healio; by Josh Friedman; 2/26/25 Nathan I. Cherny, MD, has worked all around the world. At every stop — from Australia to Israel, and Memorial Sloan Kettering Cancer Center in between — he has seen people with cancer receive overly aggressive treatment at the end of life. ... In a review published in ESMO Open, Cherny and a cohort of multinational colleagues highlighted numerous reasons why overtreatment occurs among patients approaching the end of life, ... They listed more than 20 contributing factors, including desire for control of the cancer, denial and anger, family pressure and hope preservation. The two factors that contribute most to overtreatment are optimism bias and the “counterphobic determination to treat,” which involves clinicians having a difficult time introducing the suggestion of palliative care revert to offering further treatments, Cherny said. ... Responsibility for decisions does not need to fall solely on oncologists, Cherny added. Palliative care physicians, social workers, chaplains and others can be part of a team to assist patients with their choices. ... The number of patients who are overtreated differs at each institution. “Each institution has its own culture of care,” Cherny said. Editor's note: This article puts forth significant insights for all palliative and hospice clinicians, interdisciplinary teams, and palliative/hospice executive leaders. Apply Cherny's to your referral sources: "Each institution has its own culture of care." Apply these findings to your own palliative and hospice services.
ONA Leadership Column: The next level
02/26/25 at 03:00 AMONA Leadership Column: The next level State Nurses Associations - Oklahoma Nurses Association; by Dean Prentice, DHA, MA, BSN; 2/24/25 What is it going to take to raise the leadership ability of your staff to the next level? One of the many roles you play for your staff is encouraging their professional development. ... The future of nursing will require a well-rounded skill set that goes beyond traditional clinical training. Emotional intelligence, cultural competence, data-driven decision-making, ethical leadership, and resilience are all critical to meeting the challenges of tomorrow’s healthcare landscape. By developing these skills, nurses will not only improve patient outcomes but will also contribute to the evolution of the nursing profession, ensuring it remains relevant, compassionate, and effective in an increasingly complex world.
5 tips to determine how tech can support your physicians
02/26/25 at 03:00 AM5 tips to determine how tech can support your physicians American Medical Association (AMA); by Georgia Garvey; 2/25/25 ... Margaret Lozovatsky, MD, vice president of digital health innovations at the AMA, recently shared five important considerations—among them establishing a governance model and agreeing on shared priorities—in designing technology to support clinical practice. Dr. Lozovatsky’s presentation was part of a two-day AMA training event to help physicians eliminate unnecessary work and free up more time to focus on what matters most—patient care. ...
Leading early conversations about ICD [implantable cardioverter defibrillator] use in end-of-life cancer care
02/26/25 at 03:00 AMLeading early conversations about ICD [implantable cardioverter defibrillator] use in end-of-life cancer care Cancer Network; by Megan Mullins, PhD, MPH; 2/21/25 Earlier and more frequent talks about disabling ICDs with patients receiving end-of-life care and their families may help avoid excessive pain. ... Regarding implantable cardioverter defibrillators (ICDs) in those with fatal cancers, it is critical that patients know what having a device means and how it impacts end-of-life care, according to Megan Mullins, PhD, MPH. CancerNetwork® spoke with Mullins, assistant professor in the Peter O’Donnell Jr. School of Public Health, the Harold C. Simmons Comprehensive Cancer Center, and the Department of Internal Medicine at UT Southwestern Medical Center, about how ICD deactivation prior to end-of-life care could impact clinical practice in patients with advanced cancers. ... She emphasized that device deactivation would allow the body to undergo the natural dying process without unnecessary painful shocks associated with the use of the device.
Interdisciplinary strategies for establishing a trusting relation as a pre-requisite for existential conversations in palliative care: a grounded theory study
02/26/25 at 03:00 AMInterdisciplinary strategies for establishing a trusting relation as a pre-requisite for existential conversations in palliative care: a grounded theory study BMC Palliative Care - Part of Springer Nature, Open Acces; by Annica Lagerin, Christina Melin-Johansson, Bodil Holmberg, Tove Godskesen, Elin Hjorth, Lena Junehag, Carina Lundh Hagelin, Anneli Ozanne, Johan Sundelöf & Camilla Udo; 2/19/25... This study aimed to gain an in-depth understanding of healthcare professionals’ (HCPs) experiences of existential conversations with patients with PC needs and their next-of-kin by generating a theoretical model. ... To emphasize the importance of ethical competence for quality patient care, particularly in PC, a combination of care ethics, clinical proficiency, relational skills and effective communication is essential. ... The potential obstacles we identified that require attention include the need for managers ... to support HCPs by allowing time for reflection, developing new routines, and providing education focused on existential conversations in PC. However, the main contribution of this study is the description of the interdisciplinary strategies HCPs used to establish meaningful, existential conversations by maintaining presence, as this paved the way for trusting conversations with patients and next-of-kin. Editor's note: Pair this with today's article "Why being trustworthy is a leadership hack that drives success."
Hospice caregiver spends days with family during Arkansas winter storm
02/25/25 at 03:30 AMHospice caregiver spends days with family during Arkansas winter storm NBC News KARK - Maumelle, AR; by Neal Zeringue; 2/20/25 In icy conditions, many would not risk going up and down the steepest hills, but in-home care workers have. One in Maumelle even stayed away from home for days to be with a family on top of a dangerous hill. ... [Nelda] Michael’s husband has dementia and has had in-home care for 15 months. He needs constant attention. Because of the ice, nurses with Arkansas Hospice could not see him Wednesday, but on Thursday they were determined to give him care. However, Morgan Bartley and Michelle Kelley’s cars slid down the hill on one side of the road the Michaels live on top of. KARK 4 News found them stuck and helped them up from the other end of the road. “We were prepared to park our vehicles at the bottom and hike a mile up. Anything to get to him and to her,” Bartley said. [Click on the title's link to continue reading.]
How OU Health's Professional Practice Model is defining nursing excellence
02/25/25 at 03:00 AMHow OU Health's Professional Practice Model is defining nursing excellence Health Leaders; by G Hatfield; 2/24/25 This model enables [Oklahoma University] OU Health to elevate nursing education, practice, and outcomes, says this CNE. ... Stefanie Beavers, DNP, RN, NEA-BC, chief nurse executive at OU Health, and HealthLeaders Exchange ... The Concept: A professional practice model, according to Beavers, is an evidence-based practice that aligns organizational values with a framework driven by research and outcomes. The goal is to elevate nursing excellence and patient outcomes, but also to solidify the identity of the organization's teams. The OU Health Nursing Professional Practice Model was developed based on the Joanne Duffy Quality Caring Model, so that the organization could take caring behaviors and integrate them into OU Health’s values.
Patients without family or health care proxies face overtreatment or limbo in hospitals
02/25/25 at 03:00 AMPatients without family or health care proxies face overtreatment or limbo in hospitals WHYY - PBS; by Maiken Scott; 2/24/25 A program matches unrepresented patients with volunteers who can make care decisions for them during health care crises. ... [Intensive care physician David] Oxman says unrepresented patients are a small, but growing group. Some have outlived their family members, or are estranged from them. Maybe they’ve moved a lot, sometimes substance use or homelessness plays a role. The situation is especially complicated with patients who have dementia, or who can’t communicate their wishes for other reasons. ... Most states have provisions where medical guardians and medical decision makers can be appointed by a court, but that takes a long time. In the meantime, a search for relatives begins. David Sontag, director of ethics for Beth Israel Lahey Health in Massachusetts, ... created a matching program where health care professionals volunteer to represent patients, not within their own hospital systems because that could cross ethical boundaries, but at other hospitals. “This is an opportunity for us to help some of the most vulnerable members of our communities, those who have nobody to speak for them when they can no longer speak for themselves. And that allows us to respect their autonomy throughout their lives,” he said.
Who cares for the caregivers? The push for laws to protect nurses’ mental health
02/24/25 at 03:30 AMWho cares for the caregivers? The push for laws to protect nurses’ mental health Medscape; by Jodi Helmer; 2/5/25 ... More than 67% of nurses reported feeling depressed or anxious, and two thirds said they were not receiving mental health support. Nurses cite lack of time and financial resources among the reasons for not seeking treatment, but fears about losing their jobs and the impact on their nursing licenses were also top issues. ... Registered nurses (RN) and advanced practice RN (APRNs) can be required to answer invasive questions about their mental health as part of their state licensure and advanced credentialing applications. The questions can be stigmatizing and could require nurses to submit letters from their healthcare providers addressing their mental health status. ... There is a movement to urge licensing and credentialing organizations to remove invasive and stigmatizing mental health questions from their applications. The National Council of State Boards of Nursing is working on national recommendations ...
Hospice workers in Tampa experience what it feels like to live with dementia
02/24/25 at 03:00 AMHospice workers in Tampa experience what it feels like to live with dementiaFox 13 Tampa Bay, FL; by Kailey Tracy; 2/19/25 Keosha Simmons says her father, who died in 2018, was a hard worker and an amazing man. ... "He did live with dementia. It was an early onset of dementia. He ended up with cancer, and it was a later stage when we found out about it, and that's when he came under the care of Empath Health Suncoast Hospice," Simmons said. Simmons is now the Director of Empath’s Community Engagement team. On Wednesday, Simmons and her team did a different kind of training. It was a hands-on simulation to experience what someone with dementia feels. [From this article's "The Brief" Summary.]
[UK - St. Christopher's Hospice] Woman with rare brain disease dances with husband for first time in years
02/24/25 at 03:00 AM[UK - St. Christopher's Hospice] Woman with rare brain disease dances with husband for first time in yearsReposted in Daily Journal from Talker News, Tupelo, MS; by Isobel Williams; 2/20/25 This is the touching moment an elderly woman living with a rare brain disease slow danced with her husband - for the first time in years. Constance Bartholomew, 69, has progressive supranuclear palsy (PSP), a neurological condition which has left her struggling to walk. The disorder - which is estimated to affect around 4,000 people in the UK - can cause problems with balance, movement, vision, speech and swallowing. Constance began physiotherapy at St. Christopher's Hospice in Sydenham, south-east London in September last year - at which point husband Dennis, 72, joked he would pay a million pounds to dance with her again. Upon hearing the remark, rehab assistant Ralitsa Angelova ... made it her mission to make it happen. ... “She is unable to walk, to articulate, her eyesight has failed. It’s a terrible condition. I wouldn’t wish it on anyone. But she is fully aware. There is absolutely nothing wrong with her memory or comprehension. ..." The video has been released as hospices in London come together to change perceptions of hospice care and highlight the vital importance of gifts in wills to their holistic palliative care services for adults and children in their communities. The hospices are taking part in the This is Hospice Care campaign, a national collaboration of 143 hospices across England, Scotland and Wales, brought together by Hospice UK.Editor's note: St. Christopher's Hospice--founded by Dame Cicely Saunders--is the home for modern day hospice care. Click here for a YouTube video of Constance and Dennis. Click here for the article we posted on 2/21 about the UK's "This Is Hospice Care" initiative.
Hospices traverse the ‘new twists’ in increasingly complex auditing processes
02/24/25 at 03:00 AMHospices traverse the ‘new twists’ in increasingly complex auditing processes Hospice News; by Holly Vossel; 2/20/25 Auditors are raising new questions around two common issues in hospices’ Medicare claims — documentation supporting patient eligibility and the physician narrative. Program integrity issues and quality concerns have raised the bar of regulatory oversight in recent years, with auditing activity ramping up as more providers undergo multiple audits simultaneously each year. ... Claim denials most frequently occur due to insufficiently documented evidence that demonstrates a patient’s eligibility within the physician narrative explanation, Nowicki stated. Auditors have increasingly required more details to support a patient’s six month terminal illness prognosis, potentially stretching the boundaries of hospice requirements stipulated by the U.S. Centers for Medicare & Medicaid Services (CMS), he indicated. [Click on the title's link to continue reading.]
Improving knowledge, confidence, and skills in perinatal bereavement care through simulation in baccalaureate nursing students
02/24/25 at 03:00 AMImproving knowledge, confidence, and skills in perinatal bereavement care through simulation in baccalaureate nursing studentsState Nurses Associations - Kansas State Nurses Association; by Shelby True, MSN, RN; Libby Rosen, PhD, RN, IBCLC; Ashley Seematter MSN, RN; Jeri Harvey & Karly Lauer, MSN, RN; 2/20/25Many baccalaureate nursing programs throughout the United States thread concepts of bereavement and end-of-life care throughout their curriculum. However, a standardized education program for nursing students that increases the knowledge, confidence level, and application of skills a nurse must possess when providing perinatal bereavement care is often absent from the curriculum (Sorce & Chamberlain, 2019). Perinatal loss can have a profound impact on parents and their loved ones, leading to emotional, psychological, physical, and spiritual trauma that deeply affects the lives of those involved. The nursing care each parent receives at the time of the loss may be remembered for years to come and is crucial to determining the nature of the grieving process (Sorce & Chamberlain, 2019). ... To improve the knowledge, confidence, and skill level of nurses providing perinatal bereavement care, a role-play perinatal bereavement simulation was developed and implemented in two Midwestern universities’ baccalaureate nursing programs in the maternal/newborn courses. Editor's note: Having served our hospice's Pediatrics Team for four years, the grief of parents, grandparents, siblings affected me deeply. I remember vividly a young mom unable to physically leave her baby's body with the hospital's nurse. Gently, we held her baby together. Over the course of about 15 minutes, the mother gradually shifted the weight of holding her baby over to me, before the hardest task of her life--leaving the hospital without her child. (It was Christmas week. I bawled when I got home.) Visiting them at the funeral home and after in their home, I experienced horrible, disenfranchised comments and attitudes from others (especially a local preacher). Leaders: tune into your pediatric hospice and palliative team members. What specialized support and education do they need? And, we never know what personal stories of perinatal bereavement those around us continue to carry.