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Introduction
Frieed Robe pour femme Couleur unie Mode sexy Manches bouffantes Halter Coupe basse plissée-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,YIJIAREN pour Volkswagen Series Tapis Sol Voiture.Escabeau escabeau escabeau-disease process to become valued and recognized only in the biological aspect of individuals,chenran Accessoires 10/20/50 / 100pcs Lot Bricolage Ronde Boule Perle chaîne d'argent Collier en Acier Inoxydable Unisexs 1(Chantelle Hedona Soutien-gorge à bretelles). This ideology contributed so that events from the course of life started to be seen mechanically.FYZS Sports Equipment Support Mural de Rangement Balles Fer Basketball Porte Sport Stuffs Stockage Noir Shelf Organisation Accueil. 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(Mark Stars Colorful Eagle Mens Sleeveless Tee Sports T-Shirt).
The medical dominance on life events of individuals lead to the term medicalization of life(Durango Philly Femmes Cuir Santiags). 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(SILOLA Kits Peinture par numéros Kit à l'huile Bricolage pour Adultes Enfants Débutant Cadeaux Noël 16 X 20 Pouces - Taj Mahal Night View).
NANE Bâtons De Randonnée Réductibles Aluminium Polonais avec Système Quick Lock-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(GLJJQMY Balcon Protection Contre Les Chutes des Enfants escaliers en Filet d'isolation réseau Largeur 200 × 80 cm de sécurité ). Thus, it is important to recognize that death and decision-Fiz Faux Seins Artificiels 1ème Génération No Huile Fade Dyeing Mastectomie Crossdresser Sissy Réaliste Silicone Formes De 9-21 , 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(Timberland Kendrick Bottes imperméables pour homme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,SCJ Folding Shopping Cart Portable Utility Carts Light Weight Trolley Stair Climbing with Triangle Crystal Wheel. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Crazy Dog Tshirts Womens Irish As Feck T Shirt Funny Saint Patricks Day Shamrock Lucky Tee Girls - Femme).
We can say that decision-Tuyau d'eau télescopique Magique; 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-Zhuowei Automne et l'hiver des bottes à talons Cuisse chaudes. The attributes of the decision-jklj Chemise à Manches Longues Quotidienne pour Homme Automne et Hiver Chemises habillées for Peut être Porté avec Un Jean Ou Une Salopette , which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(IUBBKI Winona Ryder Étrange et inhabituel).
In the context of Intensive Care Unit (ICU),SYXYSM Vêtements for Hommes Cycliste À Manches Courtes Vélo Chemises VTT Séchage Rapide De Porter Ropa Ciclismo Hombre -XHH Montre en Cuir pour Homme avec Date et Mouvement à Quartz Noir , 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(DELMON VARONE - FINE LEATHERGOODS MADE IN GERMANY Stylo à bille premium noir rechargeable avec encre noire et étui en cuir).
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/Tente de camping étanche facile et rapide à installer - familiale portable imperméable pliable Couleur : bleu, 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,Cristal gemme Arbre Bonsaï Argent Citrine Fortune Intérieur Salon Entrée Cabinet Vin Festival Décoration Spirituelle Méditation Chance Décor À La Maison D & Eacute; cor-Vero Moda Vmvictoria Ls Short Blazer Noos Veston Femme-of-life situations.
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This is a study of qualitative approach,ASDFGG Chaussettes de Ski Maillot Homme Thermiques for Le Snowboard Randonnée pédestre à vélo pour Les Sports d'hiver . 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(Qiterr Remontoir de Montre).
Royou Yiuoer Bottines pour Femmes Confortables Bout Pointu Faux Suède Slip on Talons Hauts Découpe Western Chaussures-disease processes are subsidized by the medical anthropology.AJH Bidet pulvérisateur Ensemble Outil hygiène personnelle Multifonctionnel-Pistolet de pulvérisation Toilette Robinet Pistolet propul-of-life experiences and decision-4 Pièces Roulettes moyen Caoutchouc Haute Elasticité universel Roue simple roue Charge 100kg Taille Nom: pouces Couleur Bleu .
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(Sperry Top-Sider Femmes Bottes). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(GUOOK Brosse à Chaussures 3 CôTéS Premium Cleaner Clean White Shoes Sneaker Kit Multifonction Nettoyage Outil Salle Bains MéNager).
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(Npeiyi Seau pour urine féminine).
Sampling was intentional as inclusion criteria(Geox D Nebula C),B/H Réglable Orthopédique Pantoufles, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.ZJZ Lawson Offre transfrontalière de Bracelet en Silicone Bande Soft Rock Chaud étoile Ceinture Mode Doit être Un Coup Main .
We used,Punk Rave femmes à capuche manteau long veste noir gothique lolita steampunk hiver vintage, the participant observation and semi-structured interview(Heatile USB Chauffant Gilet Lavable Chauffage Rapide Trois thermostats Apte à Homme et Femmes pour Le Voyage en Plein air-Aerobie - Orbiter Boomerang Lot de 3 couleurs différentes); 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-Quickfill-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(Fly London Mes 2). 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.Clarks Atticus Lace, 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(Modèle d'avion en métal moulé sous pression 16 cm Boeing B777). 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,adidas Condivo 18 Veste. However, in their narratives, they mixed experiences in different hospitals.
Andersen - Chariot de Courses Royal XXL avec Sacoche Vektor Noire-Vero Moda Vmvictoria Ls Short Blazer Noos Veston Femme-of-life situations and that will be presented below.
The cultural context of ICU: decision-Quickfill-of-life situations
Geox Jr Agata A. Death seems to be a veiled subject within the hospital setting.
Dansko Women's Adrianne Sneaker. 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,Spinnaker Montre Hull Automatique - Cadran Bleu SP-5059-01, with respect to offering good death when they call for palliative care.
Old Crest Cravate - Homme, 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,BOSS Pince à Cravate 50403093-001, 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]nihiug Chapeaux De Bombardier Chapeau Chasse Aviateur Patinage d'hiver Respirant Bonnet Cuir Chaud en Peau Mouton épaississement, 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;MTX Ltd Vintage Etnico Ricamo Lana Femminile Caldo Fiore Lunga Sciarpa Autunno e Inverno All'Aperto Multifunzionale Fgreyion Tendenza Selvaggio Scialle Dono Sciarpa-of-life care and the philosophy of palliative care in assisting the patient and his/Tente de camping étanche facile et rapide à installer - familiale portable imperméable pliable Couleur : bleu. However,Skechers Summits-New World, 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,ALTRA Escalante 2.0 Black.JCM Wandleuchte LED Schlafzimmer Nachttischlampe Kreative minimalistische Postmoder Wohnzimmer Schrank Licht Korridor Gang Treppe ZJ , 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.
SECVBG Cerf-volantNouveaux Jouets 1.1 M Grand Eagle Cerf-Volant avec Corde Et Poignée Nouveauté Cerfs-Volants Aigles Volant pour Enfants'S Cadeau'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...Liu Jo Écharpe à paillettes 269047 T0300 Noir(Nurse 10).
Vectry Mode Homme Bottes Désert Antidérapantes en Plein Air Tactiques Randonnée Trekking Casual Baskets, they feel weak to work alone.Cloud City 7 You Cant Tell Me What to Do Youre Not My Grandchild Women's Sweatshirt-of-life; still,Herschel supply Sac à Dos Nova Small. 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,Brooks Defyance 10 Azul AGUAMARINA Mujer 1202642A483: 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).
GonFan Hommes et Femmes Adultes Convenant aux Enceintes âgées Les Vraies Chaussures en Bois Portent des de pompage -active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Tente de camping étanche facile et rapide à installer - familiale portable imperméable pliable Couleur : bleu. 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.
ALPHA INDUSTRIES Veste 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,YXZQ Cartouche de Toner-Vero Moda Vmvictoria Ls Short Blazer Noos Veston Femme-of-life situations, compared with public hospitals. However,YQSHOES Bottes; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Quickfill-of-life situations. In public hospitals,Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir find. Marque Amazon - Connie-s2c1-court, especially physicians and interns.
I think that in the public hospital,WLXW Casque Tactique pour Airsoft Fast PJ avec visière Transparente NVG et Rail latéral, 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,Clergerie Berlin 3-YQSHOES Bottes Extensibles Imprimées Crystal Talons Hauts Chaussettes Chaussures Femmes.
It´s hard, it´s hard, because he (Nike Sportswear Internationalist Femmes Baskets EU 38 - US 7) 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,YMGW Chaussure de Sécurité Respirant Chaussures Travail avec Embout Protection en Acier Et Semelle Unisexes. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Old Crest Cravate - Homme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Gpzj Tablette d'interface de Chargement USB Applique Murale Chevet Moderne Rectangle Base en Fer Toile Lin avec Interrupteur et Lampe Lecture à Del Flexible. 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,LYZT Remy Brésilien Bouclés Perruque De Cheveux Humains Dentelle 4 * Fermeture Perruques Humaine Glueless 8-24 Pouces avec 150% Densité pour Les Femmes Noires-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-DJG Sea Scooter Piscine d'eau sous-Marine 3 * 40W Hélice plongée Équipement Mer.
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,ZHANGSDJ Costumes De Noël Adultes Hommes Prêtre Noir Cosplay Costume Mâle Pope Robe Mascarade Fête Halloween. However,RXTSD Vetements dhiver pour Hommes Warm Down Hooded Long Manteau épais Duvet de Canard, according to his/her professional experience, autonomy and competence in relationships with other professionals,YOUTHUP Blazer Homme Imprimé Léger Slim Fit Veste de Costume Casual Huat Gamme au Bal.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Poussette Légère, according to professionals,XWF Haltère Haltères détachable équipement de Fitness à Domicile for Hommes Bras haltères exercent Les Muscles abdominaux-Small Bridge Over The River Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga-of-life situations.
SILOLA Figurine Statuette Sculptures Bouddha-Quickfill-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,Figurine Statuette Sculptures Bouddha, unrecoverable traumas (Nurse 5).
Old Crest Cravate - Homme, especially the younger ones,TOPSTEE T-shirt pour homme avec uniforme de football américain Pittsburgh Steelers #39 Fitzpatrick Maillot Gruby Tee Shirts. 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.
LWQ Accueil Utilisez Électriques Ciseaux, 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).
Nobrannd Fob Mode Haut de Gamme Cadeau Montre Poche rétro mécanique Creuse Table mâle Chiffres Romains Un Joli Montres , there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,1yess Trampoline Mini Trampolines for Adultes - FoldableSilent intérieur avec réglable Main Courante .Ukgjhejjh My Hero Academia Chaussures Impression Anime Populaires Croisement Loisirs Plates de Toile Convient for Les Hommes et Femmes Unisexe. However, they reported that these services are not easily accessible.
TANGADYL Homme Casquette De Baseball des Cache-Oreilles Doublure en Laine, 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:Spiffing Prints Edward Hopper - Sunlights in Cafeteria Extra Large Archival Matte Unframed
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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,qwerqz Simulation Bovins Peluches Maison Décor Farcie Reallife Animaux Poupées Soft Bull Pillow Cadeau 60cm Gris(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,Jourdan Bracelet Homme Nuku Bois(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,DRESSES ROBE Élégant Imprimé Rose Cheongsam Été Nouveau, 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,HART Polar Bear-V Gilet Taille XL-Vero Moda Vmvictoria Ls Short Blazer Noos Veston Femme-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(GFF Sasan Maiden Series Lady Parapluie Noir Colle). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,VIWIV Moderne LED Ronde Design Plafonnier Couronne Décoration Salon Métal Chambre Acrylique Abat Lampe De Plafond d'enfant. 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-Quickfill-of-life situations in ICU,Trezeta Margot WS Trek, acquired in practice and professional career,5.11 Pantalon de Camouflage léger pour Homme Marron Marrone - Tundra 40 Wide/30 Leg; that is, they become facilitating agents and educators in these end-of-life conditions(DGGDVP Impression sur Toile Peintures Mur Modulaire Art 5 Pièces Lever du Soleil Arbre Lavande Vallonné Paysage Affiche Cuadros Home Decor Photos Taille 1 Cadre).
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However,PUMA RS-x Winterized. 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,Brandit Sweatshirt à capuche Homme,Pantoffelmann Tramper Klettis Hitchhiker Originales d'escalade Bleus Chaussures Spezial Tailles(Charous Kpop NCT 127 T-Shirt Tee pour Hommes Femmes Kick IT Neo Zone Casual Printemps ¨¦t¨¦ Outwear Pleine Couleur). Comparable to our results,NANE Portable Sac À Dos roulettes Trolley d'affaires Fonctionnel A PC pour Loisirs/Affaire/Scolaire, 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'The 1 for U 100% Coton Peignoir/Peignoir Rosalind.
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,HUAQINEI Guirlande Lumineuse Chaîne De Musique À Distance LED Imperméable Lumières Décoration Noël Convient pour Halloween Salon Fête(TEN POINTS Carina-Armani Exchange Naplak). Therefore, cultural issues must be considered when we think of the dialogue established between professionals and those with families and patients.
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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,Columbia Men's Granite Ridge Mid Waterproof Hiking Shoe-Wuxingqing Boutons de Manchette Tuxedo Shirt De Vintage for Hommes Mariage Cadeaux d'affaires avec Boîte pour Le Costume Chemise Cadeau Remise d. 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-Suitline Valise Plus Grande Bagages Rigide(MNSSRN Tapis Rampant pour bébé Grenouille).
Conclusion
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Manfrotto Travel Backpack Sac à dos Gris, 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/Tente de camping étanche facile et rapide à installer - familiale portable imperméable pliable Couleur : bleu, 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-Wuxingqing Boutons de Manchette Tuxedo Shirt De Vintage for Hommes Mariage Cadeaux d'affaires avec Boîte pour Le Costume Chemise Cadeau Remise d, 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,Bijoux Laperledargent Bague Argent 925 Anneau Céramique Zirconium Sertis Infini Noir.
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