Literature Review

The next phase in virtual nursing Becker's Health IT; by Ella Jeffries; 9/9/25 The face of a nurse now appears on a television screen in hundreds of rooms at Jackson, Mich.-based Henry Ford Jackson Hospital. From a command center down the hall, the nurse conducts safety checks, reviews charts and helps patients prepare for discharge — all without ever crossing the threshold. This new model, known as virtual nursing, is not a futuristic experiment so much as a response to an immediate crisis. Michigan is already short as many as 20,000 registered nurses, according to Eric Wallis, DNP, RN, chief nursing officer of Detroit-based Henry Ford Health, and the average nurse in the state is older than 50.

How ‘The Pitt' gets death right Hollywood Reporter; by Ingrid Schmidt; 9/8/25 Boasting 13 Emmy nominations and four recent TV Critics Association Award wins, HBO Max's breakout medical drama The Pitt has been widely lauded for its hyperrealistic portrayal of a chaotic, underfunded hospital emergency department. Among the many things the show has been credited for getting right is its nuanced depiction of death and dying. The Pitt cuts deep into the heart of harrowing end-of-life decisions and conversations faced by patients, family members and physicians, as well as the messy emotional aftermath. Editor's Note: Ira Byock, MD--pioneer palliative physician--significantly contributed to The Pitt's death stories. Explore more in our previous posts: Social Media Watch 6/20/25 and “It’s an homage”: Noah Wyle quietly sneaked in a tribute in one of the best episodes of ‘The Pitt’ . Additionally, we thank Dr. Byock for serving as a guest editor in our newsletter. 

Reducing family caregiver burden may prevent 30-day ED readmissions among community-dwelling older adults, study finds McKnights Long-Term Care News; by Foster Stubbs; 9/9/25 Alleviating caregiver burden may reduce returns to the emergency department for older adults up to 30 days after a discharge, according to research published in the Journal of the American Medical Association. The study examined 1409 dyads or duos of community-dwelling patients 65 years or older and their family caregivers. ... [Questions] included items about strain in the caregiver’s role and personal life associated with caregiving. ... "We interpret these findings as evidence that caregiver burden may contribute to a negative care transition, associated with 30-day ED revisits, ..."

Training and practice gaps in nursing home palliative care: A cross-sectional study Journal of the American Geriatrics Society (AGS); by Manali Saraiya, Molly A. Nowels, Rose L. Carlson, Jerad H. Moxley, Catherine A. Riffin, Evan Plys, M. Carrington Reid, Isabella Hastings, Taimur Mirza, Ronald D. Adelman, Daniel Shalev; 9/7/25 We conducted a cross-sectional survey of clinical employees (N = 398) at seven NHs within a single integrated health system in New York State to (1) gauge attitudes toward and knowledge about palliative care, (2) estimate the extent of engagement with advance care planning, and (3) elicit perceptions of the most valuable components of palliative care for NH residents. ... Despite support for palliative care, gaps in knowledge and clinical engagement persist and vary by discipline. Discipline-tailored training and program design may improve palliative care delivery in NHs and help ensure more consistent, value-aligned care for residents with serious illness.

The dying man who gave me flowers changed how I see care MedPageToday's KevinMD.com; by Augusta Uwah, MD; 9/2/25 Today for the first time, I got flowers from a grateful patient. And I reflect on how rough the week has been, all the things that seemed impossible and insurmountable, and everything that has brought me to this point. The patient is going on hospice, he’s going to die, yet he felt that I made a significant impact that he wanted to show his gratitude. And that almost brought me to tears. ... 

The rise of psychedelic therapeutics for end-of-life care: A new frontier in mental health and palliative medicine AI Invest; by Julian Cruz; 9/3/25 Aime Summary

Why palliative care is more than just end-of-life support MedPageToday's KevinMD.com; by Dr. Vishal Parackal; 9/1/25 ... Palliative care as a system requires strong interpersonal and cross-specialty communication for smooth functioning, as patients may require expert opinions from different fields to optimize their treatment plan. Patient education for systemic follow-ups and establishing a baseline of knowledge regarding their diagnosis and potential danger signs helps create a better environment for holistic care. While we focus on the physical aspects of care and diagnosis, we often fail to realize the psychological and mental impact that such conditions can have on the patient and their family. ... The opportunity to make a meaningful difference in patients’ lives by easing their suffering and enhancing their quality of life is profoundly fulfilling. ... Editor's Note: Excellent descriptions of palliative care.

What do physicians want at the end? An international qualitative study on physicians’ personal end-of-life preferences and what influences them Palliative Care and Social Practice; by Sarah Mroz, Frederick Daenen, Sigrid Dierickx, Freddy Mortier, Ludovica De Panfilis, Luca Ghirotto, Toby Campbell, Kenneth Chambaere, and Luc Deliens; 7/4/25 Research Results: ... Most physicians prefer to avoid aggressive and life-prolonging treatment, physical and mental suffering, and being a burden. They prioritize being in a peaceful environment and communication with loved ones. Various factors influence preferences including cultural, social, and religious beliefs, and legislative environment, but most significant are the deaths of loved ones and clinical practice. Death and dying become normalized the more they are reflected upon and discussed, and this process can also provide personal growth which helps physicians provide better care to patients and families.

Why physician strikes are a form of hospiceKevinMD; by Patrick Hudson; 8/24/25I have only recently started thinking about strikes. They seemed like something other people did: railway workers, bus drivers, teachers, dockworkers. People with contracts. People who clocked in and out. Not doctors. Not surgeons. Certainly not me. You and I were supposed to absorb and adapt. To advocate from within. And we did, for a long time. We bent ourselves into shapes that did not fit. Worked around all the broken processes. Made phone calls after hours. Took the extra shift. Rewrote the notes to satisfy a system that did not understand the work. Until, eventually, some of us stopped. Not because we wanted to burn it all down, but because we could not keep pretending. And that is what a strike is, sometimes. Not rebellion. Not rage. Just a line and a refusal. And an end to the performance. Is it not strange how long you can work inside a system that is eating itself? ... You do not strike because you have stopped caring. You strike because you remember when it mattered.Publisher's note: An interesting analogy for our fractured healthcare system...

RN median hourly pay, by stateBecker's Hospital Review; by Kelly Gooch; 8/19/25Median hourly base pay for registered nurses varies across states, with RNs in California earning the most, according to SullivanCotter’s “2025 Health Care Staff Compensation Survey Report.” The survey, released in July, covers nearly 2.5 million healthcare employees across over 2,660 participating organizations, including more than 800,000 individual RNs, licensed practical nurses and nursing managers. Here is the median per-hour base pay for RNs, by state, according to survey data shared with Becker’s [see article for all states]:

Why more doctors can't make ends meetAxios; by Tina Reed; 8/12/25America's doctors are working harder and getting paid less. And that could soon translate into less access for some patients. The big picture: A new report from consultancy Kaufman Hall shows primary care physicians and specialists are delivering more services since the pandemic. But they're not making more money because of stagnant reimbursements from public and private insurers and inflation. The data helps explain why medical practice bankruptcies hit a six-year high last year — and why some providers are shifting to pricey procedures for cash-paying customers to boost their bottom lines.

Flu, COVID-19 vaccination rates falling among health care workers WWLP, Springfield, IL, originally Boston, MA; by Alison Kuznitz; 8/14/25 The rate of Massachusetts health care workers vaccinated against the flu and COVID-19 is declining, despite state officials pushing for the vast majority of providers to get their shots in order to stunt the spread of illnesses. The Department of Public Health’s goal is to achieve an annual flu and COVID immunization rate of 90% or higher among eligible health care personnel at all licensed facilities and emergency medical services. ... During the 2024-25 respiratory virus season, an average of 83.5% of providers in acute care hospitals were vaccinated against the flu, ... That compares to ... 52.3% in nursing homes, 68.7% in rest homes, 52.2% in adult day health programs, 21.2% in EMS and 65.4% in hospice. Editor's Note: Is 65.4% high enough for health care workers who consistently tending many of the most vulnerable persons receiving health care? What are the vaccination rates for your organization? 

Guest Voice: What ‘It’s a Wonderful Life’ teaches us about living with MS Multiple Sclerosis News Today; by Donald Kushner, MD; 8/15/25 Donald Kushner, MD, is a retired physician, board certified in internal medicine and hospice and palliative care. He has been living with multiple sclerosis (MS) for more than 20 years and draws on his dual perspective as both doctor and patient to explore illness, identity, and adaptation. He’s writing a book about how people with chronic illness and their support systems can better understand — and talk to — each other.