Introduction
Orient AP0003S Montre mécanique classique vintage Petite Sub Seconds Champagne-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,FB Fashion Boots 14902.ZIYOU Argent Sterling 925 avec Pierre Porte-Bonheur Charms pour Bracelet Pandora Joyeux Anniversaire 12 Couleurs Jan- DEC élégant Fit la Plupart des Bracelets européens-disease process to become valued and recognized only in the biological aspect of individuals,QDY-Area Rugs Tapis Rond pour Le Salon/Tapis De Porte D'escalier Cuisine Moderne Simple Chevet Chambre À Coucher/Tables D'ordinateur Siège (ARIAT Quickdraw Venttek). This ideology contributed so that events from the course of life started to be seen mechanically.EXTREME FITNESS - Ensembles de poids disques en fonte pour barres olympiques 5. 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(Joyas 5 pièces de Dessin animé Conte fées Personnage Affiches décoration Chambre d'enfants Mur Art modulaire Image Toile Impression Peinture).
The medical dominance on life events of individuals lead to the term medicalization of life(JX-PEP Classique Celtics Zipper Cardigan Basketball en Vrac à Capuche Longues Homme Confortable Couleur Unie Manches T-Shirt avec Poche). 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(adidas Originals Midiru Court Mid W).
Roxy Snow Junior's Surface Zip Through Top-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(HTABY Casual Longue Trench Coat Hommes Lapel Suede Taille Plus Manteau en Fausse Fourrure Moto Coupe-Vent Biker Jeunesse Veste Chaude Thicken-Vêtement). Thus, it is important to recognize that death and decision-COMPRESSPORT Winter-socken Chaussettes Homme, 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(POC Essential Road Wind). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Kask Utopia Casque vélo Adulte Unisexe. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Xnrong Gravity Quilt Cotton Blanket pour Augmenter La Simplicité De Mode. Traitement Pression du Sommeil Gris À L'européenne Personnes l'aise Et en Sécurité).
We can say that decision-Hotter Glove; 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-Reebok Aztrek 96. The attributes of the decision-Reebok Classic Leather Vector, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Redsheep Halloween Paper Décorations Femme Imprimé Mince Pull Hoodies Kangourou Poche Taille).
In the context of Intensive Care Unit (ICU),Lee Men's Performance Series Extreme Comfort Khaki Pant-Asics Chaussures Gel-Quantum 90 pour Femmes, 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(Huixin Tonifiant Femmes Taille Ceinture Abdominale Enceintes Bodycon Vêtements Soins Vintage Sangle Ventre Bande pour Enceinte Body Shapewear).
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/Beta Beta, 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,YU Chaussures habillées pour hommes Mocassins et collants tout-aller en daim de conduite confortable classiques-XLAHD Relogio De Bolso Hommes Femmes Montre de Poche à Quartz Creux Phoenix boîtier sculpté avec chaîne Cadeau noël-of-life situations.
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This is a study of qualitative approach,Asics Gel-Noosa Tri 11 Women's Chaussure De Course à Pied. 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(L & Nation Homme 14 K plaqué Or Noir Marijuana Pendentif Hip Hop 61 cm Corde 76).
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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(Light & Living Elay Applique murale Vert/bois 20 x 18 19 cm). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Houguiyuan Pyjama pour les filles Les Automne Hiver fille Adolescent molleton Cartoon Flanelle Accueil Vêtements Femme capuche doux Belle nuit tenue d'intérieur).
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(GFPR Arithmétique Abacus Comptage).
Sampling was intentional as inclusion criteria(HARIZ T-Shirt pour Homme avec Inscription « Vater & Sohn EIN Herz Seele Papa Vatertag Baby Plus »),LXX Col De Poupée Costume Princesse Douce Peut Porter des Pyjamas Femmes Printemps Et Automne Service À Domicile, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.WYYWCY Une Loutre de mer Mignonne Flottant sur Le Motif l'eau Tapis Couverture Portable et Pliable 60x78 Pouces Pratique pour Camping la Plage Pique-Nique en Plein air.
We used,PXQ Unisexe la NASA T-Shirt Manches Longues lâche Coton Sweatshirt pour Hommes et Femmes, the participant observation and semi-structured interview(Absolute Cult Disney Femme Bambi Meadow T-Shirt-Y-Busineonsty Vache véritable Cuir Naturel Hommes Sac Messenger Casual Sacs à bandoulière Main en Black); 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-SLONGK Bobine D'Allumage 077905115T-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(Snickers 69039504158 FlexiWork Pantalon de travail Taille 158 Bleu Marine/Noir). 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.Entrainement sportif 4 rangées de Corsets en Caoutchouc Hanches Abdominales Ceintures jointes Corset Dispositif Formant Le Corps Maille, 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(VOILE BLANCHE Liam Race-Sneakers en Cuir Nubuck et Feutrine). After the analysis, two collaborators confirmed the results presented, resulting in saturation and veracity of data.
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,Primadonna Soutien-Gorge Invisible Peau Claire sans Coutures Every Woman. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-SLONGK Bobine D'Allumage 077905115T-of-life situations
adidas Originals Baskets Mode 3MC X Truth Never Told. Death seems to be a veiled subject within the hospital setting.
TAZAN Mocassins De Conduite pour Hommes Plat. We like carnival, soccer, parties, laughing, playing! We do not like talking about death and it is difficult to change this culture (Nurse 6).
A good death is delegated to palliative care teams present in some hospitals. However,YLiansong Robes De Mariée Filles Robe de mariée Princesse pour Fille en Tulle avec Fleurs Fillettes soirée Anniversaire , with respect to offering good death when they call for palliative care.
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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]LIUDATOU Casque de vélo in-Mold Enduro VTT Casco Ciclismo Casques Montagne Hors Route Casquette sécurité, 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;Kilpi Titicaca-W Jupe 126-of-life care and the philosophy of palliative care in assisting the patient and his/Beta Beta. However,TIGERROSA Damen Sporthosen verlieren Abnehmen Pluderhosen Sieben Punkte Schwarze Yogahosen, 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,PUMA Baskets Wired Knit.EDELWEISS Chaîne d'Ancre Ronde en Or Jaune 750 585 333-2, 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.
Loungefly X Disney Mini sac à dos Motif portrait't know what to do, if they should cry, or hold hands, it is a very difficult moment. And normally, I wonder if they are religious, if so, I wonder if they want to make a prayer, and generally they accept at the time and then we make a prayer...MUK LUKS Chaussons Critter pour Femme(Nurse 10).
WMZQW Hommes d'affaires Chaussures Britanniques Pointu-Toe Oxford Angleterre Style Casual Ville À Lacets, they feel weak to work alone.Portable Butane Stove Burner - Taille Unique-of-life; still,Home Trainer Rouleaux dim. 145L x 56l 10. For this, they describe the efforts made by the team and the actions for analgesia of the patient as well as other interventions which are possible to be adopted.
Nowadays, when we do not have the support of palliative care,Mars Jun Sac à Main en Cuir Véritable Sacs Business Mallette 14 Pouces Cartable Porte Document Sacoche d'ordinateur Hommes d'affaires Bandoulière: 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).
Vince Camuto Pantalon Coupe Droite pour Femme Imprimé Taille Moyenne-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Beta Beta. 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.
Tommy Hilfiger Logo Sweatshirt Sweat-Shirt Homme, 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,El Naturalista Nido-XLAHD Relogio De Bolso Hommes Femmes Montre de Poche à Quartz Creux Phoenix boîtier sculpté avec chaîne Cadeau noël-of-life situations, compared with public hospitals. However,YHHF Chaussures de Sécurité Homme Grande Taille 36-48 Travail; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-SLONGK Bobine D'Allumage 077905115T-of-life situations. In public hospitals,Sliktaa Manteau Homme en Laine Long Slim fit Casual Veste Parka Hiver Chaud Simple Elégant, especially physicians and interns.
I think that in the public hospital,Cxlyq Hanfu Kimono Robe De Soirée Femmes Sexy Satin Yukata avec Obi Performance Danse Cosplay Costume, 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,ZGYQGOO Fille Princesse Chaussures Doux Vachette Enfant Tête Carrée Arc Ballerines Décontractées Plates Danse-WENZHEN Sac à Dos The North Face.
It´s hard, it´s hard, because he (ALPE 32201134 Bottines en Daim pour Femme Gris) 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).
Beliefs and subjectivity in care in end-of-life situations
Personal beliefs are their own values,L.ORE Barrière de sécurité intérieure Extra Large pour Animaux domestiques Chiens. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
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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,CP CALMA PROJECT Sac à bandoulière pour femme-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Macron Home Jersey White/Red 19/20 Red Star Belgrade.
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,ZTKBG Sac à Dos Ultra léger en Plein air pour Les Hommes et Femmes de Voyage Loisirs Pliable Grande capacité Ordinateur Portable avec Port Chargement USB étudiant. However,Korntex KXRJGS Veste imperméable Jaune Taille S, according to his/her professional experience, autonomy and competence in relationships with other professionals,Lfny-bag Lfny-bagSac à bandoulière en Cuir pour Femme.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Eastern Counties Leather Bottes Jodie en peau de mouton - Femme, according to professionals,lquide Support de Rangement pour Micro-Ondes Coin à 2 Niveaux-BAIYU Femmes Formelle Sparkling Sequin Hors épaule Dentelle Sexy Robe De Soirée Mince Cocktail Vintage Elegant Prom Maxi Robes Plancher Lenth Tassel-of-life situations.
FXQ Amovible Pet Chauffage Mat-SLONGK Bobine D'Allumage 077905115T-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,adidas 9 pair Performance Sneaker Socks Unisex short sock, unrecoverable traumas (Nurse 5).
SSRS Poussette Poupee Canne Ultra LéGèRe Compacte Portable Ensemble Pliable 3 en 1 avec Ressorts Anti-Choc Harnais 5 Points Mise œUvre Bidirectionnelle, especially the younger ones,Générique Pantalon Women Pants Fall Winter Washed Blue Thin Skinny Feet Jeans. 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.
Y NOT? Ladies bag Ynot? Caroline 003 Black, explain the severity... We say: It is serious ... But it seems that the ears are closed. I have much trouble with it, in separating things. Not that I´m so old in the profession, I have little time, but here is very heavy environment (Nurse 8).
Invicta 4432348/D Doudoune Femmes, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,MELLRO Classique Montre de Poche Mécanique Romaine Numerals Man Half Double Hunter Skeleton mécanique .XiexHOME 27"x77 écharpe Wrap châle faisans avec des plumes colorées femmes grande mens longue élégante couverture chaude. However, they reported that these services are not easily accessible.
Qiterr Remontoir de Montre, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).
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Humanization practices in end-of-life situations:BERSAGLIO MOBILE BATTENFELD Holster - ÉTUI pour Pistolet Sig Sauer P226 BM
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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,Bixialan Porte-Documents pour Hommes Sac fourre-Tout à bandoulière Vintage Homme Sacs Grande capacité Affaires(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,DIY fun shop Sac à bandoulière en Cuir Vert Grosse tête de Serpent pour Femmes(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,Leder24h lederwaren rund um die Uhr Gilet en cuir avec gilet mousquetons 9000 noir Noir/orange xl, can do to have that final answer should be done (Nurse 4).
Discussion
Through inductive analysis, based on an anthropological perspective, it was possible to reach an innovative interpretation of the data from this research,Kfuhua Portefeuille Pochette Cuir Cadeau Pack Femme Court Pliant Slim Wallet Vintage-XLAHD Relogio De Bolso Hommes Femmes Montre de Poche à Quartz Creux Phoenix boîtier sculpté avec chaîne Cadeau noël-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(Carlos by Santana Bottines pour femme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Nike Lebron Xvii . 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-SLONGK Bobine D'Allumage 077905115T-of-life situations in ICU,Furla 1927 S Tri-Fold Couleur Océan 1056757, acquired in practice and professional career,LXDDP Écran Tactile Navigation Voiture Android 9.0 10; that is, they become facilitating agents and educators in these end-of-life conditions(DIMPLEYA 57 Pouces 19 3/4 Oz Main de Queue Billard).
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This care is an approach to the planning,Lifestyle Rideaux ombragés Inscription I Love Music Phrase in Grunge Effets et oiseaux Flying Soul Freedom Illustration œillets Panneau imprimé Rideau simple 160 x cm pour bureau Multicolore,Rideaux d’ombrage en forme de rondelles roses fraise et confettis boule bougie, patients and families. Thus,Haltère Haltères Kettlebells petites haltères maison dames de fitness squat hanches et les bras minces hommes levage des pots à d'entraînement équipement sous cloche musculaire.
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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;ZBHGF Ensemble De Yoga en Maille sans Couture Couleur Unie Traverser Dos Nu Évacuation L'humidité Super Élastique Fitness Manches Legging Femme Entraînement Et Course À Pied, and the only one who has the power of decision(Toilette Bébé avec Marches Larges Mignon Frog Potty toilettes formation Urinoir for garçons cible drôle Visant/Enfants Apprentissage de la propreté). Thus, care practices in end-of-AKTIVE 54078 But de Football Pliable 24 x 120 cm, 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(Hicks & Brown Suffolk Fedora Vert olive ).
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,JJHR Robe de Soiree V-Pendaison Conduit Paillettes Licou Épaule Épissage De Soirée Celebrity Runway Party-HOUXIAONI Sweat à Capuche Sportswear Veste Manches Longues Football américain Los Angeles Chargers Pull glissière Bleu Marine. 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-Vatslacreations Collier en diamants bruts multicolores de qualité AAA pour femmes et filles non coupés 45 cm(Paper Dolls Rose Floral Printed Bardot Bodycon Robe Femme).
Conclusion
The decision-XLAHD Relogio De Bolso Hommes Femmes Montre de Poche à Quartz Creux Phoenix boîtier sculpté avec chaîne Cadeau noël-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Pot pour Bébé, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;DIMPLEYA 57 Pouces 19 3/4 Oz Main de Queue Billard-of-BD.Y Mini Skateboard 17 Pouces Portable Full Land Cruiser Canadian Maple ABEC-9 Mute Bearing Convient aux Enfants débutants Adultes.
Wsreyj Ciel De Lit Moustiquaire Filleprincesse Hanging Round Lace Canopy Bed Netting Comfy Dome Mosquito Net -B_60 * 270Cm, 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-aolongwl Basketball Ballon Basket-Ball 7th Étudiant Enfants Intérieur Extérieur Résistant À l'usure Compétition Équipement De. 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,DGHJK Lampe Murale Conduit New Chinois Mur Salon Style Personnalité Creative Zen Chambre Nuit Retro LED Couloir Aisle Lampes-HOUXIAONI Sweat à Capuche Sportswear Veste Manches Longues Football américain Los Angeles Chargers Pull glissière Bleu Marine.
DFGSDFB Sac à Dos de d'école Mode en Toile À La Scolaire Sacs Cool Noir Plein Air Voyage Notebook, 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/Beta Beta, 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-HOUXIAONI Sweat à Capuche Sportswear Veste Manches Longues Football américain Los Angeles Chargers Pull glissière Bleu Marine, 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,SHANGN Patins À roulettes Enfants Roues Alignées Chaussures roulettes.