Literature Review

[Ireland] Palliative care nurse specialists’ perspectives on spiritual care at end of life—A scoping reviewJournal of Hospice & Pallaitive Nursing; Dunning, Bronagh MSc, PGCert, BSc, RGN, RNT, FHEA; Connolly, Michael PhD, MSc, BA, RGN, RNT; Timmins, Fiona PhD, FAAN, MSc, BA (Open), BSc (Open), BNS, FFNRSCI, RNT, RGN; June 2025The purpose of this scoping review was to explore and to summarize the published literature on palliative care nurse specialist’s perspectives of spiritual care at end of life. The research demonstrates that specialist palliative care nurses perceive spiritual care as an important element of holistic care at end of life; however, these nurses also agree that spiritual care is lacking. This deficiency results from a lack of education in spirituality; experience of the nurse; the nurses’ own spiritual and religious beliefs and values, fears, and difficulties in communication; and the nurse-patient relationship. The findings demonstrate the necessity to increase the level of spiritual care education in nurse programs, educating nurses on the provision of spiritual care, and how to deal with conflicts in spiritual and religious beliefs.

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."

‘Because I Knew You’: OHSU pediatric physician’s memoir reveals how treating kids helped him healOregon Public Broadcasting (OPB), Portland, OR; by Geoff Norcross, with Robert Macauley; 6/10/25 About 200 pages into Robert Macauley’s memoir, he takes up the big question of why God — if there is one — allows kids to suffer and die. “The best answer I’ve come up with — with three graduate degrees in theology from places like Oxford and Yale, followed by three decades as a physician-priest—is…” The next two pages are blank. This is what he writes next. “In other words, I don’t know. I don’t know why God lets such terrible things happen, which even someone as tragically flawed as me would make absolutely sure to prevent, given a pinch of omnipotence and a nanosecond to act.” Macauley deals with dying kids for a living. He’s a pediatrician at OHSU, and one of the few in the country certified in hospice and palliative care. He’s also an ordained Episcopal priest. His new memoir is called “Because I Knew You: How Some Remarkable Sick Kids Healed A Doctor’s Soul.” He spoke with OPB’s “All Things Considered” host Geoff Norcross. 

Hospice chaplain provides comfort in life's final moments Central Florida Public Media, Orlando, FL; by Bryan Gozalez and Claire Macchiarola; 6/4/25 The hum of an oxygen machine fills the room as Mary Durkin is helped from her bed and slowly takes a seat on her couch. As someone under home hospice care, the goal of her caretakers is to ensure the comfort of their patient as she nears the end of her life. And one of those caretakers is Vishisho Awomi, known to her patients as Chaplain Avika. She sits beside her, clasping Durkin’s small hands in her own for their weekly visit. Durkin is one of roughly 150 patients that fall under Avika’s spiritual care. As a hospice chaplain with VITAS Healthcare, it is Avika’s job to comfort, pray, or just be present with all of her patients. “I get to build that personal relationship and build that connection, I get to know that person from beginning to end,” Avika said. ...

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: ...

MLN Fact Sheet: Creating an efffective Hospice Plan of CareCenters for Medicare & Medicaid Services, Medicare Learning Network (MLN); 5/10/25 The hospice plan of care (POC) maps out needs and services given to a Medicare patient facing a terminal illness, as well as the patient’s family or caregiver. CMS data shows that some hospice POCs are incomplete or not followed correctly. This fact sheet educates on creating and coordinating successful hospice POCs. The primary goal of hospice care is to meet the holistic needs of an individual and their caregiver and family when curative care is no longer an option. To support this goal:

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.

[Taiwan] Spiritual well-being of terminally ill patients and next-of-kin caregivers in hospice care: A quantitative and qualitative approachPalliative and Supportive Care; Er-Jung Hsueh, Shu-Chun Tsai, Jun-Hung Lai, Chi-Yu Lu, Tsai-Wei Huang, Made Satya Nugraha Gautama; 4/25Terminal cancer patients often endure significant distress, impacting their quality of life. Spiritual well-being provides peace and meaning during this challenging period. This mixed-methods study included 30 terminally ill patients and 17 next-of-kin caregivers in hospice care. Spiritual well-being was assessed using the Functional Assessment of Chronic Illness Therapy - Spiritual Well-Being Scale (FACIT-Sp-12), and symptom distress with the Edmonton Symptom Assessment Scale. Patients showed a significant improvement in spiritual well-being over time, ... [and] symptoms such as shortness of breath ... , drowsiness ... , and anxiety ... were negatively associated with spiritual well-being. Caregiver spiritual well-being positively influenced patient scores, especially with female caregivers ... Qualitative findings supported these results, revealing themes of spiritual adjustment, the impact of physical symptoms on spiritual well-being, and the crucial role of caregivers in providing emotional and spiritual support.

What is it like to die? University of Minnesota’s VR experience offers some answers. The Minnesota Star Tribune; by Richard Chin; 5/2/25 Our reporter returned from the Embodied Labs experience with some thoughts on what he’d like his last hours to look like. When the University of Minnesota offered to let me experience what it’s like to die, naturally I said yes. Aren’t we all morbidly curious about the undiscovered country, as Hamlet put it, from which no traveler returns? Except this time, happily, I would get to return because it would be a virtual death, an experience in a VR studio that’s part of the university’s Health Sciences Library system.

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). ...

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.]

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" ...