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As the field of hospice care continues to grow, in-house residency programs to recruit and train staff are expanding, according to an article in Hospice News (Parker, 2022). Additionally, the nursing shortage has impacted staffing for hospice organizations, and hospice agencies recognize that most nurses interested in hospice care need training.


Healthcare workers are seeking more mentorship and time to learn the specialty, explained Stephanie Pattel, CEO of hospice provider Care Dimensions in Massachusetts (Parker, 2022). Care Dimensions' in-house residency program began a few years ago; they're able to train new hires according to the company's policies and procedures, and the program is a nurse recruitment tool.


Separate residency tracks for new graduates and experienced nurses are offered at some agencies. Hospice administrators say nursing school graduates have not received much, if any, exposure to hospice or palliative care in school (Parker, 2022).


Calvary Hospital in New York launched a 12-month program in 2022 to train both new graduates and experienced registered nurses (RNs) for in-hospital and community hospice settings (Donahue, 2022). Certification in palliative care will be offered through the Hospice and Palliative Nurses Association, according to program director Betty Nelson, PhD, RN.


Donahue M. (2022). Calvary launches groundbreaking RN residency program. Calvary Hospital.[Context Link]


Parker J. (2022, June 28). Hospices develop nurse residencies to stem labor pressures. Hospice News.[Context Link]



As refugees enter the United States in large numbers, the trauma many refugees and asylum seekers have experienced has created greater mental health problems: post-traumatic stress disorder (PTSD), depression, and anxiety (AlRefaie & Dowrick, 2021). These displaced individuals are 10 times more likely than the general population to confront mental health conditions due to PTSD (AlRefaie & Dowrick, 2021).


Unfortunately, accessing mental health care is significantly more difficult for refugees. Multiple factors present barriers, including the confusion and complexity of accessing the U.S. healthcare system, language differences, and the shortage of mental health care providers (Zurek & Rocha, 2022). Resettling in rural places is another reason for a scarcity of mental health care. When they do find a provider with whom they can communicate, refugees still encounter clinicians who are culturally uninformed and unable to provide effective care. Persons of other nationalities also face the stigma of mental health problems that keeps them from seeking help.

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Some healthcare institutions and organizations are piloting peer intervention programs that can reduce the anxiety and stress of seeking care. Training refugee women to serve as lay therapists with people of their own culture is another valuable aid (Zurek & Rocha, 2022).


AlRefaie A., Dowrick C. (2021). Causes and risk factor of post-traumatic stress disorder in adult asylum seekers and refugees. Psychiatry International, 2(4), 410-423.[Context Link]


Zurek E., Rocha A. (2022, September 18). Many refugees dealing with trauma face obstacles to mental health care. Kaiser Health News.[Context Link]



Elisabeth Elliot, missionary, twice widowed, and an author/speaker, offers straightforward counsel about coping.


What shall we do with difficulties? First, I would say that if we come to God with an empty cup, asking Him to reveal His will and help us to do the right thing, no matter what it costs, He will certainly show us. Second, we have the promise, "I can do all things through Christ who strengthens me" (Philippians 4:13, NIV). God never gave a command for which He will not supply the power to obey.


Third, we know that we have been created with the will to choose. We may choose to do what we ought to do, and God will help us. If we wish that God has not sent this difficulty, let's be straightforward with God, confess the truth, and submit to his Word as an obedient servant. Obedience always leads finally to joy. (p. 3)


From The Elisabeth Elliot Newsletter, July/August 1990. The Elisabeth Elliot Foundation.