Literature Review

How to give physicians autonomy—and protect them from burnout American Medical Association (AMA); by Georgia Garvey; 7/1/25 Almost everyone appreciates having autonomy at work. But when physicians spend more than a decade in high-stakes and grueling medical training, only to enter practice with virtually no control over their work environment, schedule or day, it can lead to the kind of spiraling frustration that often turns into burnout or leaving the profession entirely. “It’s one of those things where the more you try to micromanage a physician’s schedule, the more a feeling of distrust you give to the physicians ...” said Jill Jin, MD, MPH, an internist and senior physician adviser for the AMA, one of the authors of the AMA STEPS Forward® “Value of Feeling Valued Playbook.” ... Though the percentages of those experiencing burnout have declined from the peak during the COVID-19 public health emergency, 43.2% of physicians still say they have at least one symptom of burnout.  ... When physicians feel valued—... as competent professionals who have devoted immense time and energy to becoming experts at their jobs—it is proven to be positively associated with lower levels of burnout.

Clinicians’ perceptions about institutional factors in moral distress related to potentially nonbeneficial treatmentsJAMA Network Open; Teva D. Brender, MD; Julia K. Axelrod, BA; Sofia Weiss Goitiandia, MA, MSc; Jason N. Batten, MD, MA; Elizabeth W. Dzeng, MD, PhD, MPH; 6/25In this qualitative study, we described institutional factors that may exacerbate, prevent, or mitigate the influence of societal factors contributing to moral distress related to potentially nonbeneficial LST [life-sustaining treatments]. Health systems should consider how health care consumerism influences patients’, families’, and clinicians’ expectations regarding potentially nonbeneficial LST, particularly at hospitals with advanced technological interventions (eg, organ transplantation, extracorporeal membrane oxygenation, salvage chemotherapies). Future studies should explore the societal and institutional factors contributing to moral distress for clinicians at lower-resourced hospitals, such as inaccessible advanced treatments and barriers to transferring patients for higher levels of care. While some institutions lacked sufficient structures to support clinicians’ efforts to de-escalate potentially nonbeneficial treatments, policies empowering clinicians across the medical hierarchy, as well as conflict resolution and emotional support resources (eg, palliative care) might prevent or mitigate moral distress.

Sky Harbor program teaches TSA to help passengers with dementia. It's the 1st of its kind in U.S. 91.5 KJZZ Phoenix; by Kathy Ritchie; 6/17/25  For the first time anywhere in the U.S., Transportation Security Administration officers at Sky Harbor Airport are learning how to help travelers living with dementia. "So during this simulation, we're going to be wearing sunglasses, headphones, and both pairs of gloves," said Calli Carlson with Hospice of the Valley during a recent training session. "It's going to be about an 8-minute experience.  So those headphones are going to tell you what to do with your blue bag. Do the best that you can." She’s leading the agents in a simulation so they experience what it's like to have dementia. "So this interactive Dementia Moments training is one of the first trainings that has been provided to TSA agents." This simulation uses special glasses that impair vision, headphones to mimic audio distortion and gloves which affect dexterity.Editor's Note: Bravo! Do you provide any similar type of training for your employees and volunteers, designed to simulate contexts and interactions with persons with dementia? Surely, you can! 

Celebrating Father’s Day when Dad is on hospice Roze Room Hospice, Culver City, CA; retrieved from www.rozeroom.org on 6/12/25Father’s Day is often synonymous with backyard cookouts, gifts, cards and large family gatherings. Honoring your father or a father figure means celebrating the role this important person has played in your life. It can be a sentimental day where we slow down and consider the gift this person has been in our lives. But if your father is in hospice care, Father’s Day can take on even more significance. You may believe the day will be filled with sadness and unease. But truly capturing this day will be a gift to your dad and all those who love him. Here are five ways to celebrate Father’s Day when your dad is on hospice.

Hawai'i Pacific University alumni join forces to build a pioneering palliative care team for student excellence Special to The 'Ohana - HPU's Daily News, Honolulu, HI; 6/3/25 A group of HPU alumni from the nursing, social work, public health and business administration programs ... will be working towards steering a newly established palliative care team at HPU to assist nursing students, social workers and public health students to play an important role in understanding palliative care, hospice and communication with family and survivors. The team will play a role in setting up clinical placements in the community at St. Francis Palliative Care Units and Hospice, to give our nursing students invaluable hands-on experience in providing compassionate care for patients with serious and life-limiting illnesses. HPU Assistant Professor Joy Bliss, Ph.D., will also be designing simulations for “effective listening and communication skills,” to enhance student’s performance and skills in grief and this specialty of nursing. ... This initiative is not only an opportunity to strengthen the clinical training of nursing students, but also an essential step forward in improving the availability and quality of palliative care in Hawaiʻi. 

"You're next": People are sharing the last words they heard someone say as they were dying, and they're not all inspiring BuzzFeed; by Mike Spohr; 5/21/25There's so much we don't understand about the end of life. Recently, we shared a post where Quora users shared their experiences being present for the final moments of someone's life...and hearing their last words. Well, as it turns out, BuzzFeed's readers wanted to share their experiences hearing someone's last words too, so we rounded them up here:

The best leaders ask the right questions Harvard Business Review On Leadership, Episode 110; podcast by Arnaud Chevallier; 5/14/25 Few leaders have been trained to ask great questions. That might explain why they tend to be good at certain kinds of questions, and less effective at other kinds. Unfortunately, that hurts their ability to pursue strategic priorities. Arnaud Chevallier, strategy professor at IMD Business School, explains how leaders can break out of that rut and systematically ask five kinds of questions: investigative, speculative, productive, interpretive, and subjective. He shares real-life examples of how asking the right sort of question at a key time can unlock value and propel your organization. With his IMD colleagues Frédéric Dalsace and Jean-Louis Barsoux, Chevallier wrote the HBR article “The Art of Asking Smarter Questions.”

[June 12-18, 2025] Why celebrating CNA Week is a big deal ShiftMed; by Sarah Knight; 4/23/25 National Certified Nursing Assistant (CNA) Week, which kicks off on the Thursday of the second full week of June, is an annual tribute to the dedicated individuals who form the backbone of our healthcare system. So, as we approach CNA Week 2025, we must recognize their tireless efforts and unwavering commitment. ... CNA Week 2025 kicks off on Thursday, June 12 and runs through Wednesday, June 18. This year’s theme, “We Are the Champions,” celebrates CNAs as the unsung heroes of frontline care—professionals who ensure patients feel seen, heard, and truly cared for every single day. ...

Honey, Sweetie, Dearie: The perils of elderspeakKFF Health News, originally published by The New York Times; by Paula Span; 5/9/25 A prime example of elderspeak: Cindy Smith was visiting her father in his assisted living apartment in Roseville, California. An aide who was trying to induce him to do something —  Smith no longer remembers exactly what — said, “Let me help you, sweetheart.” “He just gave her The Look — under his bushy eyebrows — and said, ‘What, are we getting married?’” recalled Smith, who had a good laugh, she said. Her father was then 92, a retired county planner and a World War II veteran; macular degeneration had reduced the quality of his vision, and he used a walker to get around, but he remained cognitively sharp. People understand almost intuitively what “elderspeak” means. “It’s communication to older adults that sounds like baby talk,” said Clarissa Shaw, a dementia care researcher at the University of Iowa College of Nursing ... “It arises from an ageist assumption of frailty, incompetence, and dependence.” Its elements include inappropriate endearments. “Elderspeak can be controlling, kind of bossy, so to soften that message there’s ‘honey,’ ‘dearie,’ ‘sweetie,’” said Kristine Williams, a nurse gerontologist at the University of Kansas School of Nursing ...

Why did you choose to become a nurse?Yuma Sun, Yuma, AZ; by James Gilbert; 5/5/25 In honor of National Nurses Week, the Yuma Sun is proud to celebrate the dedicated nurses who serve our community with compassion, strength and resilience. ... To mark this special week, we asked nurses from across Yuma a simple but powerful question: Why did you choose to become a nurse? Their answers reflect the heart of the profession—stories of inspiration, personal sacrifice and a deep commitment to caring for others.

5 things every leader can learn from Pope Francis  Inc., by Suzanne Lucas; 4/21/25 He led the world’s largest organization with humility and a willingness to engage with different groups and hear different viewpoints. ...  [Pope Francis' death marks] the end of a papacy that influenced far more than just the Catholic Church. In his 12 years as pope, he led with a style that offers enduring leadership lessons for anyone in a position of authority, especially in business. ... While I’m not Catholic, I have followed his work in the 12 years he’s served as pope, and there are plenty of things you can learn about his leadership of the Catholic Church and apply in your life and business.

Prayer for patients? Readers and ethicists respondMedscape; by Alicia Ault; 4/24/25 ... In a recent Medscape column, Andrew N. Wilner, MD, related the story of a physician offering to pray for his wife at the conclusion of a routine visit. She had no previous relationship with the clinician and only a minor complaint. Wilner found the physician’s action disturbing and wrote in his column that while there might be situations where prayer would be appropriate, his wife’s visit did not fit in that category. Some readers took issue with Wilner’s response. ... He thinks there are a lot of considerations to weigh before a doctor should ask. “Prayer is very personal, and religious beliefs are very, very personal,” said Wilner, adding that “For some people, they’re profound.” Others might be agnostic, and it is not likely possible to know all of this if there is no prior patient-doctor relationship, said Wilner.

For AYAs with advanced cancer, study finds serious communication gaps about their care National Cancer Institute; by Daryl McGrath; 4/15/25 Many adolescents and young adults (AYAs) with advanced cancer don’t have discussions with their clinicians about how they want to approach palliative care until the final weeks of life, a study of medical records of nearly 2,000 young patients showed. ... Talking about care and treatment near the end of life is one of the most challenging aspects of caring for AYAs with advanced cancer, said Ashley Wilder Smith, Ph.D., M.P.H., of NCI’s Healthcare Delivery Research Program and co-leader of NCI’s Adolescent and Young Adult Oncology Working Group. ... “When a young person is faced with a disease that may lead to an early death, it’s vitally important to give them the opportunity to think about what’s most important to them and what happens to them in terms of care in the time they have left,” she said.