Literature Review

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.”

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. 

Approaching end-of-life discussions with hospital patients Medscape; by Amanda Loudin; 12/2/25 ... Around 35% of Americans die in the hospital, which makes it particularly important that hospitalists are equipped to have end-of-life discussions with patients and their families. Yet many doctors come poorly prepared for these moments, leaving them uncomfortable when the conversations are necessary. “Most doctors receive training in how to deliver bad news surrounding a diagnosis, but that’s about it,” said Wyatt. “Doctors like cures and staving off death.” ... The issue is often compounded by the fact that patients and their families haven’t had these conversations, either, ...

The memory bear legacy, sewn with love: One woman’s heartfelt stitches continue to warm the Treasure Coast community Hometown News, Port St. Lucie, FL; by MaryAnn Ketcham; 11/30/25 Director of Volunteer Services for Treasure Coast Hospice Lisa Gunggoll recently joined Board Chairwoman and former staff member Eileen Emery at the Gardens of Port St. Lucie Senior Living Facility. There, they spent time with resident Gerry Cornell in what became a truly memorable occasion. ... Over the years, Cornell handcrafted more than 100 Memory Bears for Treasure Coast Hospice patients and families. On the day of the visit at the Port St. Lucie Gardens, Cornell proudly presented an album filled with photos of those bears, each stitched with love, care, and compassion. The album is a beautiful gift, returning a piece of her legacy that had brought comfort to so many grieving families. Editor's Note: Click here for more about Treasure Coast Hospice's Memory Bears and Pillows.

Not just a ‘soft skill’: How academic hospitals are embedding professionalism into strategy Becker's Hospital Review; by Kelly Gooch; 11/18/25 Hospitals and health systems are formalizing leadership roles focused on clinical excellence and professionalism — particularly at academic medical centers. Leaders say their institutions see the value in this approach to improve patient safety, strengthen workplace culture and support clinician well-being. ... Becker’s connected with these leaders to discuss the drivers that led their organizations to elevate this focus, how they link it to strategic goals, and examples of meaningful success. 

Can tech restore the human side of care? Becker's Health IT; by Ella Jeffries; 11/14/25 Technology has been both a promise and a problem in healthcare. When EHRs arrived in hospitals, they were heralded as a revolution — bringing order to messy paper charts and standardizing how care was documented. But soon after, clinicians found themselves staring more at screens than at the patients sitting in front of them. Now, nurse leaders say the very systems that once distanced them from patients could hold the key to rebuilding that connection.

Letters without limits: Jesse Tetterton The Johns Hopkins News-Letter; by Omkar Katkade; 11/22/25 Letters Without Limits, founded by students at Johns Hopkins and Brown University, connects volunteers with palliative care and hospice patients to co-create “Legacy Letters.” These letters capture memories, values and lessons that patients wish to share, preserving stories that might otherwise be lost. By honoring these voices and preserving legacies, Letters Without Limits hopes to affirm the central role of humanism in medicine, reminding us that every patient is more than their illness and that their voices deserve to be heard.

Shepherd’s Cove Hospice: Children’s Activity Garden Sand Mountain Reporter, Albertville, AL; by Mary Bailey; 11/22/25 Shepherd’s Cove Hospice in Albertville lives by the words of community, compassion and connection. On Tuesday morning they opened the doors of the community room for a free breakfast and then held a ribbon cutting for their new “Children’s Activity Garden” located at their facility. With one in nine children in Alabama experiencing a loss of a parent or sibling by age 18, Shepherd’s Cove Hospice saw a need and wanted to help. The Children’s Activity Garden is space where children and teenagers can come to deal with their emotions but also have the freedom and space to still be a child and play. 

Unique ethical dilemmas occur in long-term care settings: Staff need ethics resources  Medical Ethics Advisor; by Stacey Kusterbeck; online ahead of print 12/1/25 issue ... “The position paper was developed in response to concerns from our members about the ethical challenges of the changing environment in long-term services,” says Jason M. Goldman, MD, MACP, president of the American College of Physicians. ... Discharge disposition, communication issues (either among the clinical team or between clinicians and parents), behavior problems, and goals of care were the top ethical issues reported. Lack of caregiver support was another frequent unique ethical concern. Editor's Note: Your hospice is in a unique role to provide ethics trainings for end-of-life care, and thus building trust, clinical best practices, and referrals. The CMS Hospice Conditions of Participation require: Hospices That Provide Hospice Care to Residents of a SNF/NF or ICF/MR (§ 418.112) (f) Standard: Orientation and training of staff. Finally, this rule requires a hospice to assure the orientation of SNF/NF and ICF/MR staff caring for hospice patients. Staff orientation must address the following topics: hospice philosophy; hospice policies regarding patient comfort methods, pain control, and symptom management; principles about death and dying; individual responses to death; patient rights; appropriate forms; and record keeping requirements.

Consciousness and meaning at life’s end: How the study of dying deepens our understanding of everyday presencePsychology Today; by Alexander Batthyany, PhD; 11/15/25Sergei Rachmaninoff lies dying in his Beverly Hills home. Family and friends surround him, the room suffused with that particular stillness that often accompanies life's final hours. Then something unexpected occurs. The composer opens his eyes and asks those present: "Can you hear this beautiful melody? The enormously beautiful music?" The response from those at his bedside is immediate: "No, there's no music here." ... I share this story with all those who wish to participate in our work as mandatory reading, simply because I want to prevent us from making the same error—saying "No, there's no music" instead of asking "What do you hear?" ...

UofL oncology social work expert leads national effort to transform cancer patient support The Lane Report, Louisville, KY; by Holly Hinson; 11/17/25 ... Tara Schapmire, an associate professor in the University of Louisville (UofL) Department of Medicine, Division of Palliative Medicine, and an associate professor at the UofL Kent School of Social Work and Family Science, has worked decades to help individuals and families impacted by cancer. Schapmire was recently awarded a five-year, $1.6 million grant from NCI to lead a national training initiative aimed at transforming psychosocial and palliative care in oncology. The grant will support an intensive training and mentorship program, and 50 social workers from across the U.S. will be competitively selected each year to receive fully funded palliative oncology training and structured mentorship.

Leveraging electronic health record tools and social work to improve advance care planning documentation in older adults with cancerJCO Oncology Practice; by Lauren Reed-Guy, Julianne Ani, Keshav Raghavendran, Charlotte Zuber, Molly Collins, Meghan Kennedy, Noah Goldman, Carolyn Cahill, David Dougherty, Peter Gabriel, Aditi Singh, Leland Boisseau, Ramy Sedhom; 10/25 We conducted a quality improvement pilot in a community oncology practice targeting patients age 65 years and older with a documented geriatric assessment. An electronic health record (EHR) dashboard was used to flag patients without ACP [advance care planning] documents on file. We implemented a default offer of an ACP-focused social work visit during already-scheduled oncology visits. Over 9 months, the proportion of patients with any ACP documents on file increased from 32% to 65%. AD completion increased from 21% to 53%, POLST completion increased from 15% to 31%, and patients with an ACP note on file increased from 17% to 23%. Assistant Editor's note: This study highlights the incredible value of social work interventions in a variety of care settings.