Literature Review

From burnout to belonging: Creating space for grief in clinical education American Academy of Pediatrics (AAP) Journals Blog; by Rachita Gupta; 6/16/25 ... While significant progress has been made in addressing burnout and emotional distress in medicine, and in incorporating these topics into medical education, many clinicians remain hesitant and uncertain about how to address grief and distress from patient care in day-to-day clinical practice. This uncertainty exists both in terms of their own experiences and, even more so, in supporting trainees. A lack of emotional processing in these difficult situations can accelerate burnout and further disconnect clinicians from the humanism and vulnerability that are intrinsic to the privilege of practicing medicine. ... The recently published Hospital Pediatrics article by Bloomhardt et al, “Good Grief? Introducing the TEARS Framework for Educator to Support Learners Experiencing Grief,” (10.1542/hpeds.2024-008096) addresses the hesitancy many clinicians experience when assessing learners’ emotional processing during or after distressing patient cases by introducing the TEARS framework. ...Editor's Note: See a related post in today's newsletter, "“Her toes fell off into my hand”: 50 moments that changed healthcare workers forever."

Serious illness has mental health implications — palliative care can help Becker's Behavioral Health; by Dr. Simeon Kwan and Dr. Rowland Pearsall; 6/12/25 ... As health plans and providers strive to deliver whole-person, value-based care, we must recognize that treating the body is only part of the equation. Mental and emotional well-being are critical dimensions of serious illness, and they demand more focused attention. Fortunately, we have a powerful but often underutilized ally: palliative care. ... According to multiple studies, up to 40% of patients with advanced cancer experience clinical depression. Anxiety and spiritual distress are also common, particularly when facing the unknown or confronting the loss of autonomy. For those managing progressive illnesses over time, mental health concerns can erode treatment adherence, accelerate physical decline, and strain family caregivers.

Fostering a team-based approach to elevate neuro-oncology care CancerNetwork; by Sylvia Kurz, MD, PhD; 6/9/25 Sylvia Kurz, MD, PhD, spoke with CancerNetwork® about the importance of collaborating with multiple disciplines to elevate the level of care and meet the needs of patients with brain tumors.

[Singapore] An interdisciplinary approach to legacy work for a young cancer patient - A case illustrationJournal of Social Work in End-of-Life and Palliative Care; Deborah Tan, Grace Yong, Vivian Wong, Benjamin Hooi, Eng Koon Ong; 4/25An interdisciplinary approach to care is essential and crucial in the practice of end-of-life and hospice care. However, there is a lack of data on how social workers and art therapists may work together to provide psychosocial-spiritual interventions. This case study illustrates how the home hospice medical social worker and art therapist employed complementary methods to fulfill the wish of a young adult with advanced cancer through legacy work. Similar team approaches in practice may benefit other patients with similar needs.

17 "Spooky" things that happened right before terminally-ill patients passed away, according to nurses who saw it first-hand BuzzFeed Staff; by Raven Ishak; 5/31/25 "At the beginning of my shift, my patient kept pointing to a corner of the room and said to me, 'Do you see them?" ... When medical professionals work closely with patients who may pass soon, a lot of "supernatural" things may occur. So we thought to ask the BuzzFeed Community, "Nurses with dying patients, share with us the most unexplainable things you've ever witnessed." Here's what they said below: ...

I work with dying Veterans. Here's why I don't automatically thank them for their service.HuffPost Personal; by Scott Janssen; 5/26/25“'What’s it like having people thanking you for your service everywhere you go, James?' I asked. 'You might think this is an exaggeration but you asked,' he said. 'It’s an act of violence.'” ... “When you’re looking back on a life that includes the cataclysmic violence and horrific loss and grief of war, this life review process can be psychologically and spiritually complex ― even painful.”Publisher's note: An interesting reminder that care is individualized.

Primary mental health competencies for hospice and palliative medicine physicians: A Delphi studyJournal of Pain and Symptom Management; by Lisa Podgurski, Danielle Chammas, Keri O Brenner, Leah B Rosenberg, Neha G Goyal, Maria I Lapid, Sue E Morris, William F Pirl, Bridget Sumser, Benjamin W Thompson, Lindsey Wright, and Daniel Shalev; 5/20/25  Objectives: To establish and prioritize 'primary mental health competencies' for specialist hospice and palliative medicine physicians using expert consensus methods. Results: The expert panel proposed 68 competencies divided into: (A) psychological foundations of serious illness care, (B) diagnosis and management of mental health disorders in serious illness, and (C) systems-based practice. After first-round voting, 23 competencies were recirculated for a second vote. Following second-round voting, 32 competencies were included in the final list: 7 from part A, 20 from part B, and 5 from part C.

Yes, you can die from a broken heartMedscape; by F. Perry Wilson, MD, MSCE; 5/14/25 A patient comes crashing into the emergency room with severe chest pain. The EKG looks like this: A patient comes crashing into the emergency room with severe chest pain. The EKG looks like this: [graphic]. As a doctor, if you see this, you’re calling the cardiac cath lab. This is an ST-elevation myocardial infarction — the big one — indicative of a blood clot blocking blood flow to a large section of the heart. The sooner you get that blood clot out, the better chance the patient has to survive. So the patient is rushed to the cath lab, and they find… nothing. Clear coronaries. No blood clot. Further questioning reveals that the patient, an older woman, lost her husband recently. This is stress-induced cardiomyopathy, medically known as Takotsubo cardiomyopathy (TC). It’s the pathophysiologic manifestation of a broken heart. First described in 1991, Takotsubo syndrome occurs in the setting of deep psychological, emotional, or physical stress.

Exploring overlooked collaborative opportunities during end-of-life care Medical Xpress; by Institute of Science Tokyo; 5/14/25 [This study's researchers describe:] "Bereaved family members broadly recollected the mixed regretful actions and decisions that should have been taken during the end-of-life care process. Coordination and cooperation challenges that existed between health care professionals and family caregivers emerged as factors that impeded these actions at the time." [They identified three types of] unintended, percolated work (UPW). ...

Palliative and end-of-life care during critical cardiovascular illness: A scientific statement from the American Heart Association American Heart Association; by Erin A. Bohula, MD, DPhil, Michael J. Landzberg, MD, Venu Menon, MD, FAHA, Carlos L. Alviar, MD, Gregory W. Barsness, MD, FAHA, Daniela R. Crousillat, MD, Nelia Jain, MD, MA, Robert Page II, PharmD, MSPH, FAHA, Rachel Wells, PhD, MSN, and Abdulla A. Damluji, MD, PhD, MBA, FAHA on behalf of the American Heart Association Acute Cardiac Care and General Cardiology Committee of the Council on Clinical Cardiology; and Council on Cardiovascular and Stroke Nursing; 5/15/25 Abstract: Cardiac intensive care units are witnessing a demographic shift, characterized by patients with increasingly complex or end-stage cardiovascular disease with a greater burden of concomitant comorbid noncardiovascular disease. Despite technical advances in care that may be offered, many critically ill cardiovascular patients will nevertheless experience significant morbidity and mortality during the acute decompensation, including physical and psychological suffering. Palliative care, with its specialized focus on alleviating suffering, aligns treatments with patient and caregiver values and improves overall care planning. Integrating palliative care into cardiovascular disease management extends the therapeutic approach beyond life-sustaining measures to encompass life-enhancing goals, addressing the physical, emotional, psychosocial, and spiritual needs of critically ill patients. This American Heart Association scientific statement aims to explore the definitions and conceptual framework of palliative care and to suggest strategies to integrate palliative care principles into the management of patients with critical cardiovascular illness.

Team work makes the dream work for hospice veteran Veterans Administration, VA.gov; by Douglas A. Etter; 5/12/25 When Marine Corps Veteran Ivson Shelley came to the Lebanon VA Medical Center for a follow-up visit with his oncologist, Suhail Ali, MD, the staff was concerned about how much the former New York resident had declined since his last appointment. They didn’t think he could be cared for at home any longer, so a decision was made with the family to admit him to the medical center’s hospice unit Thursday afternoon. Once there, the Marine shared a heartfelt wish with the staff – he wanted to marry his lifelong love, Wanda Rivera. The couple had dated more than 50 years ago and rekindled their relationship 10 years ago. Upon hearing the Vietnam Veteran’s wish, the VA team, lead by Hospice Nurse Manager Jessica Himes, RN and Hospice Social Worker, Erin Miller, MSW, LCSW quickly came together to make it happen. Palliative care nurse Melissa Buchinski, RN began to research what the requirements were to secure a marriage license for the couple. ... [Continue reading this inspirational story.]

Advancing the primary palliative workforce: Pilot results of the Educating Social Workers in Palliative and End-of-Life Care (ESPEC) self-study programJournal of Palliative Medicine; Myra Glajchen, Cathy Berkman, Shirley Otis-Green, Russell K Portenoy; 4/25Health social workers caring for the seriously ill may lack preparation in the primary palliative skills needed for this complex task. An evidence-based, nationally scalable, multimodality training program-Educating Social Workers in Palliative and End-of-Life Care (ESPEC)-was developed to address the training needs of health social workers. Prior to completing the online training, 21.6%-50.0% of participants rated themselves as "very confident" in the clinical practice skills central to the role of the social worker in serious illness care. After completing the modules, 58.8%-81.4% rated themselves as "very confident" in both clinical and professional skills, with significant changes in nine clinical practices and four professional practices. This pilot supports the feasibility, acceptability, and educational potential of the ESPEC self-study training in increasing confidence in key practices of primary palliative care for health social workers.

What not to say to patients with serious illnesses Medscape; by Lambeth Hochwald; 4/30/25 Robert Den, MD, a radiation oncologist in Philadelphia, constantly reminds himself that while he’s in the ‘cancer world’ every minute of the day, his patients aren’t. “As oncologists, we may be meeting with the third patient that day with a newly diagnosed metastatic cancer, but for this individual, this is their first time hearing news like this,” Den told Medscape Medical News. That’s just one reason Den says words matter. ... [He identifies] "Five Things Docs Shouldn't Say" ...