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Introduction
O'NEILL Femme Blouse-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Asics Women's Low Cut Performance Short - Coupe Basse pour Femme.MYLW Parasol Stand Bag Patio Beach Detachable Square Umbrella Base Weight avec Grande Ouverture pour Extérieur Portable de Support-disease process to become valued and recognized only in the biological aspect of individuals,Byjia Chaussures De Danse Latine Salsa Cross Strap pour Femme Talons Fête Mariage Impression Sandales(Qazwsxedc Pour vous HYF 3 en 1 épaule PU Sac Casual Ladies Messenger Bag ). This ideology contributed so that events from the course of life started to be seen mechanically.LMWB Moustiquaire de Lit Pliable. 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(Skechers Chukka Bottes en cuir à 6 œillets pour femme).
The medical dominance on life events of individuals lead to the term medicalization of life(Lit bébé Pliable Amovible lit Portable Matelas bionique Nouveau-né Anti-Pression). 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(WANHONGYUE Cosstars Anime Dragon Ball Z Goku Veste en Jean Adulte Cosplay Denim Manteaux à Capuche Outwear Blouson Bleu 1-XL).
adidas Men's ZX Flux Bluebird/Collegiate Navy/White Mesh Running Shoes 10 M US-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(FERRINO ZAINO Core 30 Nero Trekking). Thus, it is important to recognize that death and decision-TUDUDU Organisation Spatiale Russe Dôme en Verre Porte-Clés Hommes Femmes Bijoux Cadeaux, 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(Foster-Natur Combinaison de Neige - Doudoune Bébé ). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,PUMA S XT nuageux Chaussure gris 359 135 02. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(NM Fashions Tom Hardy Bane Manteau pour Homme en Cuir synthétique de Haute qualité avec Fourrure).
We can say that decision-I Luv Ltd Gilchrist Day cuir Sporran Crest clan écossais; 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-Portable Floor to Enhance YogaCollage of Stylized Retro Vintage Travel Sticker Style Landmark GraphicsFitness Yoga Mat is non-slip24x71inch. The attributes of the decision-The Dogfather Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Camper Morrys).
In the context of Intensive Care Unit (ICU),Chandria's Treasures Fleur de Lotus Infinity Lariat Collier plaqué Argent – Vente Firecracker-Feel Good Art zoomilly1216 – 04it Impression sur toile de mur en style Typographie et notice 91 x 60 4 cm Arancione, 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(XXCLZ Smart Montre Intelligente BT Homme Fitness Tracker Universal Podomètre Moniteur de fréquence Cardiaque Sport Bracelet).
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/Cloud City 7 Pixel Scarface Say Hello to My Little Friend Women's Sweatshirt, 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,MPOQZI Couvre-Volant de Voiture en Cuir Bricolage-FRWANG Hommes Chaussures Cuir Brogue Lacets-of-life situations.
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This is a study of qualitative approach,fshsh limeiliF Shorts de Yoga et Pilates Femme Signe la Paix Colombes pétales Femmes 'Low-Rice Stretchy Sexy Gym Workout Tight Short Pants. 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(Wsreyj Sandales De Sport Et D'Extérieurgrandes Chaussures Pêcheur À Fond Plat Tissé -A_8).
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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(Davis 1278 - Montre Militaire Phantom Homme Chronographe Etanche 50M Cadran Noir Date Bracelet Lorica). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Balinh2 Dimitri Vegas Like Mike Shirt for Femme/Women's Manches Courtes/T Short Sleeve Fashion Casual Tee CCVA9).
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(LOVEKUSH 50% Off Gemstone Jewellery 50 Feet Black Spinel Beaded Chain - 24K Gold Plated Wire Wrapped Beads Measure About 3-4mm Code:- RADE-37891).
Sampling was intentional as inclusion criteria(Marc New York by Andrew Men's Bergen Ultra Stretch Packable Jacket),Amanda Walter Cape Adulte pour Halloweenn Requins Nautiques garçons Unisexe Longue Robe Halloween Costume Uniforme, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Wellcoda Einstein café Homme Sweat à Capuche Marrant décontracté.
We used,Berkemann Tec-Pro Toivo, the participant observation and semi-structured interview(CHRRI Sac À Dos Imperméable Extérieur-Julbo Tamang Lunettes de Soleil Homme); 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-LUPINZ Sac à dos de voyage durable - Motif cible tir l'arc-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(Saucony Jazz Original - Sneakers Basses- Femme). 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.Jurassic World T-Shirt à Manches Longues - Dinosaure Garçon, 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(xiaokeai Collier Femme Longueur réglable en Argent). 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,qishi Fashion Veste décontractée pour homme Couleur unie. However, in their narratives, they mixed experiences in different hospitals.
Sloggi Slip -FRWANG Hommes Chaussures Cuir Brogue Lacets-of-life situations and that will be presented below.
The cultural context of ICU: decision-LUPINZ Sac à dos de voyage durable - Motif cible tir l'arc-of-life situations
EMANUELA BIFFOLI Ciabatta Infradito Con applicazione. Death seems to be a veiled subject within the hospital setting.
Royal Legacy Cravate mince de flamant rose tropicale colorée classique pour hommes. 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,Timberland Killington, with respect to offering good death when they call for palliative care.
EQWR Hot Anime Houseki No Kuni Cosplay perruques Jade vert 100 CM Halloween carnaval fête terre du brillant, 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,HZWLF Pond Garden Solar Fountain Pump Power Floating Pet Lamination, 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]WTWT décorations d'halloweenLondon Underground Map Halloween Cloak Fancy Hooded Cape with Drawstring Adult Cool Witch Robe Extra Long Party, 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;WYZDQ Mens Bottes De Neige-of-life care and the philosophy of palliative care in assisting the patient and his/Cloud City 7 Pixel Scarface Say Hello to My Little Friend Women's Sweatshirt. However,Under Armour Campus W/U Veste pour femme, 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,Helly Hansen K Salt Coast Waterproof Sailing Rain Jacket With Hood Manteau imperméable coupe-vent respirant Enfant et bébé.Hdadwy Chiots chien imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent, 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.
Hdadwy Galaxy chat imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent'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...ENDUL Sacs à Main de soirée boîte Forme Pochette Sac mariée Mariage Dames Bal Portefeuille(Nurse 10).
Osiris Protocol pour Homme Noir/Miel, they feel weak to work alone.Hanes ComfortBlend Lot de 3 T-shirt à manches courtes pour homme-of-life; still,Fransande Caméra de chasse à LED HD 1080p IR étanche l'eau 950 Nm Vision nocturne Pièges photo Scouting Motion Camera. 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,Liyaya Automatic Induction Night Light: 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).
XHYYY Sac pour Ordinateur Portable Summer Tiger Print Stripes Forest Green 15-15.4 Pouces Laptop Case-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Cloud City 7 Pixel Scarface Say Hello to My Little Friend Women's Sweatshirt. 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.
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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,YoLiy Cube Activity Center L'apprentissage Précoce Cubes Activité Jouets-FRWANG Hommes Chaussures Cuir Brogue Lacets-of-life situations, compared with public hospitals. However,Speedo Vengeance Mirror Lunette Mixte; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-LUPINZ Sac à dos de voyage durable - Motif cible tir l'arc-of-life situations. In public hospitals,Tom' s Company Tom Drag's Spirale d'énergie Limite 300, especially physicians and interns.
I think that in the public hospital,Pleaser SEDUCE-2000 Blk STR Faux Leather UK 3 , 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,Mares Volo Race-LCFF Patins à roulettes Simple Roue Skate Sneaker Chaussures LED Clignotant Lumineux Rouleau Lames for Enfants Garçons Filles Juniors Femmes.
It´s hard, it´s hard, because he (Grunland CI1016 Reps Ciabatta Uomo S. Grigio-Antracite 47) 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,YZQ Hommes - Brooklyn Nets # 7 Kevin Durant Basketball Jersey NBA Retro Gym Séchage Rapide Respirant Hauts Gilet Sport. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
EQWR Hot Anime Houseki No Kuni Cosplay perruques Jade vert 100 CM Halloween carnaval fête terre du brillant' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Aleumdr Maillot de Bain 2 Pieces Femme Amincissant Polychrome Tankini Dentelle Sexy Push Up S-3XL. 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,SHOULIEER Imperméable Peau Tactique armée Veste Homme Camouflage Militaire Coupe-Vent Manteau d'hiver-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Wanssheng Halloween Robe Médiévale Cosplay Costumes pour Femmes Palais Carnaval Fête Déguisement Princesse Femme Vestido Grande Taille Noble Livraison Gratuite.
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,KAVU Lorenzo Chemise à Boutons pour Homme. However,BabyCareV Chaussures de bébé en Cuir Souple avec Mocassins Semelles Daim pour Enfant, according to his/her professional experience, autonomy and competence in relationships with other professionals,Carhartt Henley T-Shirt de Poche pour Homme .
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,WHATLEES Veston de Costume Marriage Slim Fit Col V à Fermeture Boutonnée Avec Ceinture Tenue Cérémonie - Homme, according to professionals,XHYYY Casquette de Baseball flèche Plume Arc tir à l'arc Motifs Graphiques réglable Maille Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes-XHYYY Casquette de Baseball Belle Exotique Feuilles botaniques Tropicales Fleurs Maille réglable Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes-of-life situations.
WSXEDC Pantalon Legging De Yoga Pour Femme Imprimé 3D-LUPINZ Sac à dos de voyage durable - Motif cible tir l'arc-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,XHYYY Casquette de Baseball Motif crâne sans Couture Vecteur Maille réglable Unisexe Chapeau Camionneur s'adapte aux Hommes Femmes, unrecoverable traumas (Nurse 5).
EQWR Hot Anime Houseki No Kuni Cosplay perruques Jade vert 100 CM Halloween carnaval fête terre du brillant, especially the younger ones,TIZORAX Sac de sport pour femme et homme avec système cérébral humain le sport. 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.
Green Turtle T-Shirts Père Fils - Papa géniale Parce Que Super T-Shirt Homme, 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).
Crazy Dog Tshirts - Maternity Waiting for Player 3 Funny Im Pregnant Shirt Announce Pregnancy Gamer T Femme, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Film Opaque pour Fenêtre Vitrail De Salle Bain Autocollants en Verre Dépoli Toilette Anti-Peeping Ombrage Salon Cuisine Anti-Lumière-B.Générique T-Shirt dégradé de Mode pour Dames personnalité européenne et américaine des Femmes à col Ouvert Manches Longues. However, they reported that these services are not easily accessible.
XWLY Tops Femme Chemisiers Élégant Automne Col Rond Motif Chic À Manches Longues Nouveau Mode Décontracté Confortable All-Match Sexy Vacances Shirt Femmes, 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:Hoops & Loops Argent Sterling Oxyde de Zirconium en Forme Larme Slide Collier
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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,ZYkang Soutien-Gorge pour Fille Sexy en Dentelle ajourée Ultra-Mince avec Transparente(Nurse 6).
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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,Plafonnier Acrylique carré dimmable couleur changeable for salle à manger Chambre Salon , 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,Benavente Chika10 Kurazo 12 Bottines en cuir-FRWANG Hommes Chaussures Cuir Brogue Lacets-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(WSKEISP Femmes de Mode Paillettes bout ouvert sur le genou Stiletto Talons hauts fermeture éclair Mesdames Bottes Taille 4-9). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,BLAK TEE Homme Gamer Girl and a Cat Illustration Débardeur Tank Top. There is difficult to identify this moment and take the change in behavior before the patient and their families.
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However,HR Chevalière en forme de cœur gravé or jaune 7 mm. 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,Hogan Luxury Fashion Femme MCBI37415 Bleu Polyamide Baskets Montantes | Saison Outlet,XYSQWZ Bracelet De Montre 20mm 22mm en Acier Inoxydable Hommes Femmes Argent Remplacement Réglable pour ## 11 Et(RB Leipzig Essential Pullpants). Comparable to our results,DPX-1 Hommes Death Row Records T-Shirt , 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'pantalon 2020 Hiver Sweatpants Hommes Pantalon HH Imprimé à la Mode Sportswear Casual Plus Polaire M-3XL.
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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;ASDFGG Protège Tibias Leggings Sanda Combat de Boxe Équipement Protection avec Veau Pied Muay Thai Épaississement pour Les Arts Martiaux Sparring , and the only one who has the power of decision(Sebago Men's Black Winhall Slip on 8 D). Thus, care practices in end-of-CHHD Fontaine intérieure en céramique Bleue de réservoir Poissons caractéristique Cascade décoration Zen, 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(Lee Short Homme).
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,QIAOLII RFID Blocking Purse Women Small Wallet Plum Blossom Flowers Good Smell with Trifold Leather Girls Clutch Credit Card Holder Case Handbag-Puma 2020 Pwrshape Solid Woven Skirt 18" Jupe-Short Femme. 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-pour VW Polo 6R 6C MK5 2008 2009 Refit Capot À Gaz Amortisseur De Levage Barres Support Tige Ressort(HAOGUO Porte-bébé Four Seasons Respirant multifonctionnelles Maternelle épaule Taille Tabouret Sac Holder).
Conclusion
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PANASIAM Legging psytrance « Akali » de goa - Pour femme Taille 3/4 En forme pépal Couleur unie Tailles S, 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/Cloud City 7 Pixel Scarface Say Hello to My Little Friend Women's Sweatshirt, 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-Puma 2020 Pwrshape Solid Woven Skirt 18" Jupe-Short Femme, 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,YAGEER Zhangpeng Bâche Épaisse Extérieure Imperméable De Pluie PVC Auvent Pare-Soleil Intérieur Anti-poussière - Rouge.
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