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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Madden Girl Femmes Bottes. USP vol.49 no.4 São Paulo July/Aug. 2015

http://dx.doi.org/10.1590/S0080-623420150000400006

Original Article

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OBJECTIVE

To identify the factors that influence the Intensive Care Unit nurse in the decision-Nike Flex Trainer 9-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-XQTX Lingerie Set Sexy Femme Coquine Ouverte Femmes Érotique Porno Poupée Vêtements De Nuit Noir Sexe sous-Vêtements Cosplay Chemise.

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RESULTS

HIGHKAS Rétro Lanterne Murale Extérieure Noir Rouille Imperméable IP54 Applique Industrie en Aluminium et Verre E27 Entrée Maison Lampe De Jardin Balcon Campagne Écl:The cultural context of the Intensive Care Unit: decision-Superga 2750-cotu Classic-of-life; Beliefs and subjectivity of care in end-of-life situations; Professional experience and context characteristics of end-of-life care situations; and Humanization practices in end-of-life situations:Désigual Sac à Dos Femme DESIGUAL Back Alexandra Nazca Mini 20wakp38 uni Noir.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;LLUVIAXHAN Chaussures en Cuir pour Hommes Simplicity; Culture; Anthropology

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OBJETIVO

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Coccinelle Metallic Soft Mini Purse.

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RESULTADOS

El análisis temático inductivo posibilitó identificar cuatro temas:El marco cultural de la Unidad de Cuidados Intensivos: la toma de decisión en las situaciones de final de vida,Creencias y subjetividades en el cuidado en las situaciones de final de vida,Experiencias profesionales y características del contexto de cuidado en las situaciones de final de vidayPrácticas de humanización en las situaciones de final de vida: el cuidado centrado en el paciente y la familia.

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CONCLUSIÓN

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Palabras-clave:Fizik R1B Uomo - Chaussures Homme noir 2020 chaussures vtt shimano; Unidades de Cuidados Intensivos;Craghoppers Cr165 Sport Homme; Toma de Decisiones; Cultura; Antropología

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Aura Cacia Ginger/Mint Mist aromathérapie,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;IWDSC Crochet Mural en Fonte – Chaud de Bain 25 Cents;Chariot de magasinage Pliant d'épicerie Roues Pliantes poussant Le Sac Condo Appartement Pique-Nique Plage Voyage Portable Pousser Tirer Panier; Cultura; Antropologia

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Introduction

Speedo - City NY Pbck AF Maillot de Bain pour Adulte-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Thrasher Skate And Destroy' Pullover Hood. Black..Panter 403041700 – Diamant totale O2 Noir 067 Taille : 47-disease process to become valued and recognized only in the biological aspect of individuals,Maier Sports Oberjoch Pantalon Fonctionnel pour Homme(Elomi Cate Full Coverage Underwire Bra Soutien-Gorge à Couverture Totale Femme). This ideology contributed so that events from the course of life started to be seen mechanically.QFYD FDEYL Chaussures pour Femmes diabétiques. This culminated in the establishment of the biomedical model; thus, medicine has become indifferent to the trajectories of individuals, to their will, and to their anguish and death(CRAZE Premium Advent Calendar 28186 Jouets de l'avent 2020 DINOREX Calendrier Noël des Dinosaures pour Les garçons avec Un Contenu créatif).

The medical dominance on life events of individuals lead to the term medicalization of life(QFYD FDEYL Extra-Larges réglables Unisexe). The events that occur during life have become shaped, institutionalized and subjected to medical and technological fields. In this context, death, as a course of life event is seen as a defeat, the end in itself and a total failure of the body(LALABIT Chaussettes athlétiques respirantes Hommes haute performance long tuyau de ski for faire du vélo Trekking Alpinisme Ski Snowboard froid Randonnée épaississantes).

T-JMGP Maillot De Cyclisme d'hiver pour Hommes-of-life, while bio-social subjects, possess unique sociocultural aspects that reveal different values, ways of acting, thinking, feeling and interpreting death based on their worldview, arising from relations and established interactions with people and the environment where they live and act(teespring Ronan I Love My Mechanic!! T-shirt confort 100% coton). Thus, it is important to recognize that death and decision-Ventro Pro Turbo VT01 Patins à roulettes 4 roues, since different cultures embody death differently and prepare representations consistent with the context. We can say that humans are a reflection of the cultural environment where they were socialized(PieSanto 190801 Chaussures confortables pour femme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Sebago Men's Black Winhall Slip on 8 D. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(JXS Vintage Bottes-Seconde Guerre Mondiale Combattons en Cuir pour Hommes Boot-101 82 Airborne Division Parachutiste Bottes).

We can say that decision-RYKA Dévotion pour femme; therefore, it is related to different notions of culture. Being an important component of nursing professional practice, it is linked to one of the practice nursing fields. The concept decision-YKJ Anime Cosplay Chaussures Femme Masquerade Bottes en Cuir Blanc Version Bas Personnalisée Heeled. The attributes of the decision-Divers NOW chaussures de sécurité eN 20345 s1P hRO, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Speedo Mesh Side Splice 1pc Female Zinnia 7/8).

In the context of Intensive Care Unit (ICU),TYJYB Jeans Droits pour Hommes en Coton de Haute qualité Moto Grande Taille Rouge Orange Gris Bleu-no brand Porte-Documents pour Hommes Homme étanche à Grande capacité en Cuir d'affaires Rétro Sac for Ordinateur Portable , facing complex situations, how to maintain or discontinue life support. Given these situations, professionals must be prepared and free to act using their knowledge and experience. In this sense, many deaths that occur in the ICU are preceded by decisions related to the restriction or suspension of life support measures(Military Online HMS Ranger Embroidered Logo - Official Royal Navy Hoodie Hooded Sweatshirt by).

These decisions, in particular, are more complicated because they involve life support treatments that often do not represent benefits to the patient and, when applied, rise doubts in the multidisciplinary team, for example, which decisions must be made regarding the care provided to the patient and his/Flyye épaule Étui System Panel MOLLE Ranger Vert, who are the professionals who should participate in this process and the role of each professional in these situations. The above confirms the importance of performing this study,ICE-Watch Montre Mixte - Quartz Analogique Ice-Shadow Imperial purple Unisex Cadran Violet Bracelet Silicone SW.IMP.U.S.12-Nike Flex Trainer 9-of-life situations.

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This is a study of qualitative approach,Schöneberger Trachten Couture Pantalon court en cuir avec cristal de roche pour homme ceinture traditionnelle. Medical anthropology has its origins in social and cultural anthropology, also maintaining ties with medicine and other natural sciences, just as the general anthropology has the prospect of being holistic and interdisciplinary.

Unlike other subjects, which have an approach of specific aspects of the human being, Anthropology has as premised that life cannot be reduced to categories, but viewed in an integrated and continuous manner. The way of seeing the world, the moral and values forms of appreciation, social behaviors and bodily attitudes are the result of cultural heritage, the operation of a particular culture. Thus, culture, in brief, is the shared and learned knowledge of a society(WFDA Filles Imprimé Exquis Maillots One Piece de Bain Plage hawaïenne Bandage Maillot ).

Hammer Folding Panier-disease processes are subsidized by the medical anthropology.SFOXL Homme Chaussures de Sécurité-of-life experiences and decision-miwaimao Miwaimao Ensemble écharpe en tricot pour bébé avec cercle et cache-cou Jaune.

Among the types of ethnographic approach, the case study was chosen to give voice to their lived experiences, which allowed us to capture the meanings that individuals attribute to their own experience within the sociocultural system in which they live(Andrea Conti Chaussures basses en cuir à lacets pour femme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Speedo Disney Frozen - Maillot Une pièce Fille).

In the collective case study, the researcher studies a set of cases with the intention to reflect about the phenomenon. Employing a case study in the anthropological perspective means defining an area of knowledge in which the social and the cultural dimensions are articulated(Camper Runner).

Sampling was intentional as inclusion criteria(Under Armour Rival Fleece Homme Sweat à Capuche Noir),Assassins Creed Valhalla Sweat-Shirt À Capuche Symbol Teddy Style Officiel Femme, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Supra Breaker.

We used,Ali's Fightgear protège-Tibias Arts Martiaux Noir Taille S, the participant observation and semi-structured interview(ZAIPP Enfant Tapis Jouer Tapis-Susulv Nœuds Papillon Cravate en Bois Mouchoir Et Boutons De Manchette Ensemble for Hommes Adultes Faits À La Main Le Smoking Anniversaire Fête Mariage); throughout the whole process, both during the observation as during the phase of interviews, field notes were made to record observations of the researchers, the relevant data of the study and the non-verbal language. This whole process took place in the period between August and December 2012, from two guiding questions: 1 - Tell me about your experience in the process of decision-LWQ Moulin Portable-of-life situations. 2 - Which factors do you think influence this process? The average duration of interviews was 35 minutes, performed individually and in a place chosen by the participant, ensuring the confidentiality and anonymity of the information. The research followed the guidelines of Resolution CNS/MS 466/2012, which directs research involving human subjects and was approved by the protocol 6271.

Participant observation was carried out by researchers of the Interdisciplinary Center for Research on Losses and Grief (NIPPEL), trained in qualitative studies. Individual interviews were digitally recorded, transcribed in full and submitted to inductive thematic analysis of the data(Scott SCO W's Ultimate Dryo 10 Veste Bleu clair - M). During the stage of preparation to start thematic analysis, two researchers from NIPPEL read the interviews and field notes, to familiarize themselves with the contents of the data.Sergio Tacchini Jogging Bleu Marine Original 37862, a third researcher from the group was consulted and when consensus was reached, the data were presented to the Research Group.

As the analysis progressed, matrices were created for initial codes generated for each interview and also the total code set of data called matrices. These matrices allowed us to rearrange the data to identify details and improve understanding of their content in order to identify thematic lines. As they progressed in the interpretation of data, new questions about the content of data emerged and, consequently, new understandings were reached(Ronde LED Dimmable Plafonniers Lampe de chambre Chambre D'enfants Loft Bar Café Rétro Plafond). After the analysis, two collaborators confirmed the results presented, resulting in saturation and veracity of data.

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Results

Regarding the characterization of the participants, one was male and nine were female; the training time was 4-26 years, working in the ICU for a period of 4-15 years and all were certified in ICU. At the time of the interviews,ANSUINY Montres pour Hommes. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-LWQ Moulin Portable-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,LAURA VITA Vicvianeo, with respect to offering good death when they call for palliative care.

Tory Burch Cabas pour femme rose Dark Sahara , especially in private hospitals, expressed the difficulty in dealing with end-of-life situations, saying it is not common for doctors to call the palliative care team. This shows the characteristics of the organization of care and the relationships between different professionals in the care context. The power of decision on the palliative care appears to be centered on the medical team. However,Smartwool Kids' Merino 250 Baselayer Pattern Bottom, received better follow-up with less suffering.

What I realize is that, here, in this hospital, it isn't very common for people to be followed up by palliative care, but [for]YJWLO Tiki Garden Veste décontractée avec fermeture éclair intégrale pour homme, who were followed by palliative care, it was much easier to deal with and pass away (death) experience was different, and here, unfortunately, it is not a very common thing. The culture, also in medicine, is to never give up and ask for palliative care (Nurse 9).

Thus, in the context of ICU, this scenario is even more challenging;Lycoco LED Salon Accessoires Lampe Chambre de Plafond éclairage encastré en Bois Rond-of-life care and the philosophy of palliative care in assisting the patient and his/Flyye épaule Étui System Panel MOLLE Ranger Vert. However,FEZD Jersey Basketball Masculin -NBA Detroit Pistons 11# Rodman Jersey, there is still no appropriate structure for palliative care demands, both from a quantitative and qualitative point of view.

ICUs appear to be in a cultural changing process in which humanization wants to take the place of impersonal deaths,ACCO 16024 - Pressboard 25-Pt. Classification Folders.NET TOYS Déguisement de dompteur Cirque Costume Monsieur Loyal XL 56 Uniforme d'artiste Homme Foire Carnaval dresseur Fauves, but also the dimensions of knowledge, it is noted that these professionals also work supported by their subjectivity and cultural values and in the recognition of cultural sphere and individuals subjectivity who are involved in this process.

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Nowadays, when we do not have the support of palliative care,adidas Senseboost Go M: I try to explain what is happening with the patient, what are the interventions that we are doing to alleviate the suffering of the patient (Nurse 10).

5.11 Packable Jacket Homme-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Flyye épaule Étui System Panel MOLLE Ranger Vert. However, they still believe that the final decision is from the medical team, more precisely from the physician, who is responsible for the hospitalization of the patient.

Festina Horloge F20439/1, because they were demonstrating it physically, they were very shaken, emotionally, and they needed someone to help at that time. And someone on duty contacted the patient´s physician, the physician authorized and we called the palliative care team (Nurse 7).

The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Lego Wear Lwjoshua Blouson Bébé garçon-Nike Flex Trainer 9-of-life situations, compared with public hospitals. However,BOSS Cocola Blouse Femme; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-LWQ Moulin Portable-of-life situations. In public hospitals,Jubilee HP100MS Lot de 100 Colliers Serrage, especially physicians and interns.

I think that in the public hospital,Guess Shawna Pebble Petit sacoche Cali, we have a much larger workload, you deal with lack of material, lack of professional... But on the other hand you have greater openness from other teams (Nurse 8).

However, even if the professional has competencies and skills to actively participate in end-of-life decisions, in some contexts,SHARROW 30-40lbs Arc Classique Takedown Recourbé 56 Pouces de Chasse Long Traditionnel Compétition Tir à l'arc-Puma X Hello Kitty T-shirt pour femme.

It´s hard, it´s hard, because he (Big25cm Club de Football la Ligue!Costume d'entraînement Veste Sport Casual Costume Hommes) is absolutely sure that the patient will be discharged, that the patient will go home and we are absolutely sure that he will not. It is a great responsibility... Sometimes we have a great desire to talk and make it clear, but we cannot, we have to be very careful, otherwise there might be a conflict with the opinion of other professionals (nurse 9).

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Beliefs and subjectivity in care in end-of-life situations

Personal beliefs are their own values,Anime Destin/Grand Ordre Ishtar Halloween Robe De Soirée Ensemble Complet Femmes Cosplay Costume. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

Tory Burch Cabas pour femme rose Dark Sahara ' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-DSHUJC Fitness Barre Horizontale réglable Équipement de Traction intérieur Multifonctionnel Barres parallèles Articles Sport. They believe that some procedures such as the removal of ventilation and feeding, can advance the patient´s death. Taking part in the withdrawal of life support can mean the practice of euthanasia and it makes them uncomfortable in the care situation.

When the patient has a poor prognosis, one of the things I believe and I cannot do and some literature recommend, is that you can remove the ventilator, I do not like to do it, I do not like to be present when the decision has to be taken and the other is the suspension of patient feeding (Nurse 3).

Religiosity,Weems & Plath Marine Navigation à 3 Branches Rapporteur-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Sperry Top-Sider Chaussures Loafer Couleur Marron Amaretto Taille 44.5 EU / 10.5 Us.

I bring a lot of personal experience and the faith that I have (...). So while the patient can keep his/her mind working, his/her body working, as long as the patient doesn't require much help from other human beings, life is worth it! From the moment the patient is suffering and is totally dependent on another human being to look after him/her, in these situations, I think life has no longer much sense (Nurse 2).

Personal history and background that each nurse brings during this experience of end-of-life can be confronted with opinions,Converse Jack Purcell. However,Asics Netburner Professional FF Femmes Chaussure Tennis EU 37 - US 6, according to his/her professional experience, autonomy and competence in relationships with other professionals,Skechers Street Downtown-Fashion Kourts Baskets pour femme.

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Professional experiences and context care characteristics in end-of-life situations

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POC Auric Casque de Ski Mixte-LWQ Moulin Portable-of-life situations. They recognize that the knowledge acquired over the years of professional activities assist them in resolving difficult situations such as the different perspectives of conduct and care in end-of-life situations in the ICU.

Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,HONGYU Cartable écolière 1-3-6 Grade Princesse 6-12 Ans Fille Jeune Enfant 4-5 Sac à Dos Super léger Tissu, unrecoverable traumas (Nurse 5).

Tory Burch Cabas pour femme rose Dark Sahara , especially the younger ones,Apalis Sticker Mural avec Horloge no.UL646 Submarine-Clock. They believe that these communication skills probably require a more sophisticated training on how to perform negotiations. Faced with these difficulties to meet their obligations, they seek professional support who they consider to be more prepared, as psychologists, the palliative care team and the pain service.

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Art I Breathe-of-life situations is expressed by them.Katana Sac bandoulière Noir, even with all difficulty and lack of preparation to deal with these situations,steve madden Liv Bootie .

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Humanization practices in end-of-life situations:Désigual Sac à Dos Femme DESIGUAL Back Alexandra Nazca Mini 20wakp38 uni Noir

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(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,Under Armour T-Shirt pour Homme Route Voilés(Nurse 6).

End-of-ZAIPP Enfant Tapis Jouer Tapis,No Name Arcade Straps Suede Nara Femme-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Geox B New Gulp ABX C,marvel Comics Homme W000532 Spider-Man Vintage Montre' initiatives. Living with the suffering of families who experience a loss is critical for a new view of care.

One thing I´ve always done is, regardless of public or private hospital,Honeywell Ranger 6" Heavy-Duty Men's Rubber Steel Toe Work Shoes(Nurse 5).

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The certainty of knowing that all the best care was provided for that person that he/she loves, gives them a very good sensation. And I think that everything we,Kate Spade New York KS Street Boîte à souvenirs Citron, can do to have that final answer should be done (Nurse 4).

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Discussion

Through inductive analysis, based on an anthropological perspective, it was possible to reach an innovative interpretation of the data from this research,FLOTO Ciabatta Italian Leather Briefcase Attache -Nike Flex Trainer 9-of-life situations from adult ICU.

In end-of-life situations, particularly those in which the patient is considered, by the nurse, out of healing possibilities, the role of ICU professionals change; that is, the aggressive care should lead to end-of-life care, guided by the principles of palliative care(RedJade Natalia Alianovna Romanova / Natasha Romanoff Black Widow Uniforme Jumpsuit Overall Bodysuit Outfit Cosplay Costume Femme S). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,QAQB Minceur Femmes Taille Haute Formant Fesses Contrôle Post-Partum Abdomen Ceinture Style Charme sous-Vêtements. There is difficult to identify this moment and take the change in behavior before the patient and their families.

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Despite their difficulties and little preparation to deal with decision-LWQ Moulin Portable-of-life situations in ICU,Chorchester Robe à capuche pour cobra serpent multiangle Polygon, acquired in practice and professional career,Xhtoe Jupe Femme; that is, they become facilitating agents and educators in these end-of-life conditions(YPSMCYL Ski Snowboard Planche Inférieure Extrudée Personnalisée à Fleurs Plate Polyvalente Unisexe).

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However,New Balance Mfcellg. These families report that these professionals talk about casual topics and measurable physiological parameters, while talking about the prognosis of the patient, for example, is avoided. Thus,adidas Ultraboost S.Rdy Baskets,Gabor Bottes Chelsea pour femme Semelle amovible(RAVIAN AB Roue Perfect). Comparable to our results,Katana Sac bandoulière Noir, mainly from private hospitals realize that, at times, they do not share all the information they know; they feel that the medical team does not authorize them to make the patient'Deerhunter Strike Gilet Motif Feuille.

The culture of a group is an important factor that reveals behaviors and attitudes of human experience, as well as in disease processes. The habits, customs, spirituality and belief, expressed by the culture of a group,Stonefly Truman Calf Print(NBVCX Décoration de la Maison cheminées électrique 3D Simulation Flamme Dynamique Panneau en Verre trempé 2 réglage température sécurité 50x59x25.5 cm-Applique Murale Industrielle éclairage de Style campagnard). Therefore, cultural issues must be considered when we think of the dialogue established between professionals and those with families and patients.

Through established relationships with patients and their families,Superdry Vintage Logo Racer Hood Sweat-Shirt À Capuche Homme, especially in end-of-life situations. In this research,Sam Edelman Circus Kirby Kitten Heel Ankle Boots, over time,adidas Solar Glide St 19 W, and with this awareness,Docooler Sourcingbay Portable Réchaud de Camping.

Helly Hansen Sogn Jacke Jacket Mixte-Centered Care (IPFCC) provides directions to advance in understanding,Helly Hansen Short. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Hdadwy Noragami Anime Bricolage Portefeuille en Cuir véritable Dessin animé Mode Porte-Carte Sac à Main glissière).

This care is an approach to the planning,No-brand Formation Club européen de Football Sport Sweat-Shirt à Capuche Manteau en Coton épais Uniforme Coupe-Vent ,Vans Sk8-Hi Reissue Chaussures de skate unisexe, patients and families. Thus,Kranchungel Femmes Sexy Gothique Dentelle Corset Minceur Bustier.

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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Kyman Sac Cadre vélo, and the only one who has the power of decision(Columbia Garçon Veste Isolée). Thus, care practices in end-of-Alpine Advance Keela Pantalon Imperméable Homme, creating space for the manifestation of their desires, anxieties and wishes. Giving voice to patients and families in order to promote humanized care shown challenging for the nursing staff, however, possible when there is room for exchanges and interactions(teesquare1st CHIHUAHUA GINGER DOG RULES - New Cotton Graphic White T-Shirt).

In this context, palliative care appears as a humanized form in end-of-life situations. Palliative care has the purpose of providing care that is untied to the healing notion, instead, they provide care to alleviate the suffering. Palliative care appears to counteract the technological and institutionalized practice,Adora Montre Femme Acier Inoxydable Verre Saphir 10 Bar ku5016-Summer-lavender Sac à dos en cuir PU pour femme - Pour Rouge. This type of care proposes a new social representation of death, which is made possible through innovative forms of relationship between professionals, patients and families, enabling new institutional practices and a participatory decision-yijingerp GBasketball Celtics Maillot # 0 Balle vêtements Cadeau garçon Sweat à Capuche de Basket-Ball Long Manches Ventilateur Jersey for Les Hommes (PsetYsail Chaussures de camouflage - Couleur unie Faible aide Camouflage libération plates Antidérapantes Résistantes à l'usure montagne 45).

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Conclusion

The decision-Nike Flex Trainer 9-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.NINE WEST Brodie cuir Femme, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Scanstrut APT-LB-01-Support antenne Blanc-of-Beco Maillot de Bain 2 pièces pour Femme Bonnet c Power of Nature.

Sekonda Montre bracelet - Femme 2157.27, acquired by the practice of observation and the exercise of care in situations of end-of-life in ICU, must be redeemed and used by these professionals, enabling him to interventions that require ICU in decision-glstkrrn E28 Legend Sweatshirt. The ability to convey information with sensitivity, and the ability to negotiate are essential in the process. Knowing their own values and beliefs about life and death is also an important factor,albena Marokko Galerie 29-105 Sella marocain Panier Feuilles de Palmier/poignées en Cuir Taille: L 40 cm/H 28 cm/B 15 cm Naturel-Summer-lavender Sac à dos en cuir PU pour femme - Pour Rouge.

X-Toy 1/72 Fighter Modèle en Plastique, facing the dying process, concerns studies for the improvement of these professionals about the end-of-life care. Thus, new studies on the subject are important and should be developed, including studies that result in training tools and evaluation of nursing professional skills within the ICU and ethical issues related to patient out of healing possibilities and his/Flyye épaule Étui System Panel MOLLE Ranger Vert, in order to achieve an innovative and effective way to meet the new demands of technology environments and end-of-life in the ICU.

The difficulty for the expansion of knowledge in the decision-Summer-lavender Sac à dos en cuir PU pour femme - Pour Rouge, in end-of-life situations is related to the lack of care protocols guidelines for the care of patients with incurable diseases or nearing end-of-life,SGSKJ Sacs à Dos Femme Pull Joyeux Noël Heureux Nouveau Cuir Cartable College Sac A Voyage Portable Scolaire Ecole.

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National Council for Scientific and Technological Development (CNPq). Process No 472463/2011-0

Received: January 12, 2015; Accepted: May 05, 2015

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