Literature Review

End-of-life care needs cultural humility and social justice BMJ; by Jamilla Akhter Hussain, Rekha Vijayshankar, and Mary Hodgson; 12/18/25 Death, dying, and grief are not medical events—they are profoundly social, relational, and shaped by the histories people carry into their final days. ... [A] key question is: how can end-of-life care services become more trustworthy? Too often, institutions respond with so-called cultural competency initiatives. ... What is needed is cultural humility and social justice. Cultural humility involves ongoing self-reflection and acknowledgement of bias at individual, organisational, and system levels. Palliative care must prioritise cultural humility and social justice: trust grows not through outreach alone but through shared creation of knowledge, meaning, and care—and at the end of life ...

[South Korea] Factors influencing burnout among hospice and palliative care ward nursesJournal of Hospice & Palliative Nursing; by Young-Mi Kim, Chieun Song, Jeoungmin Park; 11/25This study aimed to identify the factors influencing burnout among nurses in hospice and palliative care units. This descriptive correlational study investigated the effects of nursing practice environment, resilience, and nurses' character on burnout among hospice and palliative care ward nurses. The participants were 217 nurses working in hospice wards of 20 institutions selected from the 88 inpatient hospice and palliative care institutions designated by the Ministry of Health and Welfare in South Korea, as of 2021. The results showed that a better nursing practice environment and higher resilience were positively associated with lower burnout. Among hospice and palliative care nurses, being in their 30s and having fewer than 5 years of total clinical experience were associated with higher burnout.

25 years of progress: ELNEC and AACN transforming palliative nursing education Journal of Hospice & Palliative Nursing - JHPN / HPNA; by Cassandra Godzik, PhD, APRN, CNE, Deborah Trautman, PhD, RN, FAAN, Robert Rosseter, MBA, MS, FAAN, Pamela Malloy, MN, RN, FPCN,Jennifer DiBenedetto, PhD, APRN, Polly Mazanec, PhD, AOCN, ACHPN, FPCN, FAAN; 12/25 In the year 2000, leaders with the American Association of Colleges of Nursing joined with Dr. Betty Ferrell and her colleagues at City of Hope to address gaps in how nurses are educated to care for patients at the end-of-life and their families. ... To date, more than 1.7 million nurses have been educated with the ELNEC curriculum, and more than 1200 undergraduate and 440 graduate schools of nursing offer ELNEC training in palliative end-of-life care. The remarkable academic-practice partnership at the heart of ELNEC has dramatically changed nursing care for patients with serious illnesses and their families in the United States and globally. ... Editor's Note: As ELNEC celebrates its 25th anniversary, we honor a leadership legacy that has transformed nursing education and elevated end-of-life care worldwide. What began as a visionary collaboration between AACN and Dr. Betty Ferrell at City of Hope has become a global standard—preparing nurses for clinical excellence, compassionate presence, and interdisciplinary care. With deep appreciation, we celebrate Dr. Betty Ferrell, ELNEC, AACN, City of Hope, and the leaders who continue to champion this vital work forward.

The future of the hospice physician: HOPE, staffing & technology Maxwell TEC; podcast by Tom Maxwell with Dr. Andrew Mayo and Dr. Tiffany Richter; 12/15/25... In this episode, Tom sits down with two of the most respected clinical leaders in the country: Dr. Andrew Mayo (Chief Medical Officer, St. Croix Hospice) and Dr. Tiffany Richter (Chief Medical Officer, Agape Care Group). They break down the debate between full-time vs. contracted physicians, the "hybrid" model that is winning, and the heartbreaking regulatory gaps preventing dialysis patients from accessing hospice care. Plus, they share deeply personal stories that remind us why we do this work. 

[Europe] Muslims often don’t trust palliative care. A new charity aims to change that  Hyphen; by Weronika Stryzyzynska; 12/15/25 Al-Amal, founded by a doctor and a chaplain, is informed by the Muslim view of a good death — something they say is lacking in mainstream care. A new charity to support Muslims navigating palliative care is preparing to launch after Ramadan. As well as providing an emotional support telephone line, Al-Amal will also offer practical advice on accessing culturally and religiously appropriate care.  The Muslim view of what a good death looks like is informed by values beyond the medical. … This can affect the way Muslim patients include their families in the decision-making process or their approach to pain management.

Retirement? Not for this 80-year-old oncology nurse in Naples USA Today / The Florida Times-Union / Pressreader, Fort Myers, FL; by Liz Freeman; 12/12/25Carolyn Paget never imagined NCH Baker Hospital would throw her a birthday party for turning 80. Or that she would still be logging at least 8,000 steps during a 12-hour shift as a registered nurse in the oncology unit where she has worked for more than two decades. ... "She actually helps patients make the decision when hospice is the way to go. Patients respect her." ... According to the Bureau of Labor Statistics, ...the share of workers 75 and older is expected to grow from 9% in 2020 to nearly 12% by 2030.

My patient was gone. I had to help his family see it: The art of medicine means sitting with families’ grief and hope Stat10 - First Opinion; by Raya Elfadel Kheirbek; 12/15/25 Bullets tore through Michael Thompson’s car at a stop sign, ending the life of a 35-year-old father in an instant. Just minutes earlier, he had dropped his 8-year-old daughter, Emma, at dance class, her pink tutu bouncing as she waved goodbye. Now, in the ICU, his young body lay tethered to machines — ... a ventilator’s hiss forcing his chest to rise. ... His family’s grief filled the room, raw and heavy, as I prepared to document our meeting. On the screen, a pop-up appeared: “Patient is deceased; do you want to continue?” Its cold bluntness paled against their pain. Michael looked alive. His chest rose and fell with the ventilator. ... Medicine isn’t just tests or machines. It is presence — sitting with families in their grief, faith, and love. Our tools should support that presence, not interrupt it with cold prompts. ... Most U.S. hospitals lack clear guidelines for these situations, leaving families and clinicians alike in limbo. They also worried about organ donation — a decision fewer than 1% of families consent to after brain death, often because the body still looks alive.Editor's Note: We thank the palliative care physicians, nurses, social workers, and chaplains who provide sensitive presence with families in the unbearable spaces between hope and loss, especially when life support decisions arise. In this season, may we pause to honor those who carry this sacred work—and remember the families who have had to accept harsh truths while machines still “breathe.”

FMOL Health doctor is spreading palliative care programming across system Catholic Health Association of the United States (CHA); by Julie Minda; 12/9/25 Dr. Mark Kantrow still remembers when it clicked for him exactly how important palliative care is in medicine.It was around 2006, and he had just attended his first conference on palliative care, at a time when the concept was new to him and to many other clinicians. ... As system medical director for palliative care, he has been integrating palliative care programming into all nine of the health system's hospitals. This work has included educating staff and patients about the approach, assembling multidisciplinary teams to deliver this type of care and building patient and family awareness of what FMOLH Health hospitals offer.

Evaluating the impact of the End-of-Life Nursing Consortium Curricula: A systematic review of assessments and outcomesJournal of Hospice & Palliative Nursing; by Olga Ehrlich, Theresa Jizba, Mariela Hristova, Christine S Davidson, Dennis C Powless, Toni L Glover; 12/25The End-of-Life Nursing Education Consortium (ELNEC) curricula prepare nurses to provide high-quality, evidence-based palliative care to patients with serious illness and their families. The original ELNEC program has been adapted to include nursing subspecialties and online learning modules, reaching nurses and students worldwide. This systematic literature review described the outcomes of nursing knowledge, attitudes, practice changes, and patient outcomes in studies that used ELNEC as a primary intervention. The findings revealed significant enhancements in knowledge of palliative care among nursing students and nurses, as well as a notable positive shift in attitudes toward caring for seriously ill and dying patients. However, findings also indicate a need for studies that apply rigorous methods using valid and reliable assessment instruments aligned with nursing competencies.

The ethical challenge of negative compassion: How excessive empathy in end-of-life care affects decision-making and patient autonomy Journal of Hospice and Palliative Nursing; by Victoria Pérez-Rugosa, Gina Lladó-Jordan, Pablo de Lorena-Quintal, Esther Domínguez-Valdés, Antonia Rodríguez-Rodríguez, Carmen Sarabia-Cobo; 12/11/25 Online ahead of print ... 3 key themes emerged: decision paralysis and emotional overload, conflicts between personal beliefs and professional responsibilities, and institutional barriers to ethical practice. Findings reveal that excessive emotional involvement can hinder the implementation of patients' documented wishes, potentially compromising patient autonomy and increasing caregiver distress. The study highlights the need for institutional policies that support emotional resilience, structured debriefing, and ethics training. ... These insights are highly relevant for palliative nursing practice, offering guidance for supporting staff and upholding patient-centered care in end-of-life settings.

Q&A: What is the relationship between AI and clinical informatics? CDW Healthcare; by Jordan Scott; 12/8/25 ... Health systems are seeking ways to address workflow inefficiencies with artificial intelligence, but if those tools aren’t implemented with a deep understanding of existing workflows and IT environments, then they aren’t likely to succeed. Clinical informaticists are well versed in health IT implementation and the change management required to ensure buy-in and adoption. HealthTech spoke with Murielle Beene, senior vice president and chief health informatics officer at Trinity Health — a large, not-for-profit health system with 92 hospitals across 25 states — about how AI is changing the field of clinical informatics. 

Ask Sheri: Overcoming fear and expressing thanks Lovin' Life; by Sheri Simpson; 12/7/25Dear Sheri, When my mother’s health began to decline, our family found ourselves standing at the edge of something we couldn’t quite prepare for. ... From the very first visit, the hospice team wrapped my mother — and our entire family — in comfort, dignity and compassion. They didn’t just care for her; they cared about her. They learned her favorite songs, listened to her stories, and treated her as the vibrant, funny, loving woman she’d always been. The nurses would hum along when she sang softly, and one even brought her a small, crocheted blanket because she noticed how much mom loved the color lavender. Hospice is not about giving up, it’s about giving more: more peace, more presence, more love. Azorna Hospice helped us see that. ...

The complex quandary over hospice relatedness Hospice News; by Jim Parker; 12/5/25 Questions over which services are deemed related to patients’ terminal diagnosis in hospice care are crucial, and physicians’ determinations of those factors may be growing more complex. ... CMS has taken a stance that essentially all the care needed by a terminally ill patient should be covered through the benefit. However, that is not always what happens in practice. ...  When considering relatedness, physicians must take a holistic approach, according to Dr. Lauren Templeton, hospice physician consultant at Weatherbee Resources and Physician Council member at The Pennant Group. ... In most cases, hospices should err on the side of considering conditions related, when possible, for the sake of their patients, Templeton indicated. “If it’s impacting the plan of care for our patients, that would make it related for us,” Templeton said.