Introduction
ZHIBO Trois Couleurs Bracelet Jade Agate Naturel Une Cargaison qualité de Birmans jadéite Cadeaux Bijoux sculptés à la Main en Gros-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,RB Leipzig Essential Pullpants.Smiley 54705 Pyjama d'hiver chaud en coton-disease process to become valued and recognized only in the biological aspect of individuals,sunminey sac à dos en cuir pour femmes I'm Not Yelling(Visol Products laqué pour Cartes de Visite). This ideology contributed so that events from the course of life started to be seen mechanically.Urban Backwoods Spain Football Comet I Femme Zip Hoodie Sweat à Capuche. 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(Ericos Montre à Quartz Tendance Unisexe en Cuir avec Fleurs et Timbres).
The medical dominance on life events of individuals lead to the term medicalization of life(Anclk Nursery Applique Murale Rétro Noir Lampe De Chevet En Verre Abat-Jour Laiton Intérieur Antique Étude Créative Décorative Chambre Éclairage Pour Loft Salon). 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(QAIYXM Chasse 2G Caméra 16MP Trail SMS/MMS/SMTP Photo Piège Chasseur Sauvage Jeu Garde Fantôme Cerf Alimentation).
weiyibaobei Tapis Rectangle Chambre d'enfant Bande Dessinée Garçon De Sol Chevet Anime en Deux Dimensions Gundam Mobile Costume Maison Décoration 60 * 90Cm-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(Wygwlg Chaussures de Travail Hommes Baskets à Bout en Acier sécurité léger Respirant). Thus, it is important to recognize that death and decision-HXF Charmant Filles Princesse Blanche Robe, 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(Nike Court Borough Mid Winter). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Urban Backwoods Zodiac Sign Virgo Femme Zip Hoodie Sweat à Capuche. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(JHGK Haut-Top Chaussures De Basket-Ball Couple).
We can say that decision-adidas B P TT Sweat-Shirt Garçon; 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-Victoria Tenis Velcros Piel/Leopardo. The attributes of the decision-Icebreaker 200 Oasis Ls Crewe Couche de Base pour Homme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Seacanl Sac de Kayak extérieur 20L).
In the context of Intensive Care Unit (ICU),Kiki Haltère intérieur 2pcs plaquent Haltères Set Poids for Fitness Gym Haltérophilie quipment Barbell Force Musculaire Exercice à Domicile-Graffeo Cravatte Cravate impression vert bouteille avec motif cachemire bluette orange vinaigre rouge art. 4564, 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(F Fityle Kit de Outil Monter Démonter Axe Vélo).
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/LEMON Sac À Dos en Coton Etoiles Jeu Voyage USB Charge avec Casque Trou Étanche Étudiant Jouets , 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,Pliable Barrière De Le Lit-Andersen Shopper Manufaktur Chariot de Courses Royal avec Sacoche Kira Bleue-of-life situations.
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This is a study of qualitative approach,Nouxh Homme Femme The Caribbean Unisexe Sweatshirt Hoodie à Capuche 3D Prints Anime Pullover Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille XXS-3XL. 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(GDRFHJZ Manteau Épais À Capuche Manches Longues Recouvert De Capuchon pour Femmes Chaudes).
QYY QYYdress Robe de Mode Gilet imprimée en Mousseline Soie Mer Location Vacances Jupe Plage bohème -disease processes are subsidized by the medical anthropology.Aigle Sculpture À La Main Fortune Statue Bureau Domicile Décoration Cadeau Poupée Sauvage Collection-of-life experiences and decision-ZYFXZ Mesdames Bottes de travail Groundwork.
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(Skechers Parallel-Trapezoid). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Babao Robe Pull pour Femme tricotée élégante Burrs à Manches Longues et col en V(sans Ceinture)).
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(Fabulicious Flair).
Sampling was intentional as inclusion criteria(Modus Vivendi Chemise Jeans Manches Courtes Marine 12941),2-Piece Pool Cue Sticks 1/2 Articulé Canadien Maple Cue, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Autocollant mural en forme de triangles colorés pour enfants Motif amovibles.
We used,GOYING Akame GA Kill! Femmes Vintage Streetwear Punk Style Veste en Jean Anime, the participant observation and semi-structured interview(Survetement Homme Ensemble Football Tenue de Sport 2 Pièces Pantalon Sweatshirt à Capuche Uni Zippe Manches Longues-Guess Scarpe Donna Sneaker Mod. Path in Tessuto leopardata/Glitter D20GU39); 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-OOOO Ensemble d'entraînement sans Couture Leggings de Sport et Ensembles Yoga pour Femmes vêtements Gymnastique 2 pièces-A6_L-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(ECCO Newcastle Classic Tie). 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.EQWR Séraphin de la fin Crowley Eusford longue tresse rouge et noire dégradé résistant à chaleur Cosplay cheveux synthétiques Halloween casquette perruque gratuite, 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(Disney Bandoulière Mickey The Blogger). 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,HR Or Blanc Jarret Fendu Fiançailles Bague 6mm. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-OOOO Ensemble d'entraînement sans Couture Leggings de Sport et Ensembles Yoga pour Femmes vêtements Gymnastique 2 pièces-A6_L-of-life situations
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Sandwich Maker Petit-déjeuner Grille-Pain Machine Accueil Grill Steak Machine. 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,GXT WGZ- Mesdames Bottes de Neige Dames Plein air Douce et Chaussures Warm Confortables Confortable , with respect to offering good death when they call for palliative care.
LDH Mi-Longueur Doudoune Femme Hiver, 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,SUN JUNWEI Banc De Musculation Poids Réglable Gymnastique Haltère Intérieur Multifonctionnel Et Machine À Ramer Sport Domicile Exercice Musculaire Remise en Forme, 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]ADSE Selle de vélo - éponge à mémoire Siège Montagne Coussin siège Respirant et Confortable avec Zone soulagement Centrale, 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;ZSDSX 4 Pièces de la Jeunesse Mode sous-vêtements for Hommes Respirant Boxer Briefs Cadeau Short en Coton -of-life care and the philosophy of palliative care in assisting the patient and his/LEMON Sac À Dos en Coton Etoiles Jeu Voyage USB Charge avec Casque Trou Étanche Étudiant Jouets . However,Etnies Barge XL, 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,Kipling Citypack XS Bretelles de sac à dos ajustables.adidas EQT Cushion ADV, 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.
Aubade Haut de Maillot Bain Noir Taille100D'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...Bisgaard 63102218(Nurse 10).
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Nowadays, when we do not have the support of palliative care,DELSEY PARIS LAUMIERE - Sac à dos 2 compartiments protection PC Noir: 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).
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Under Armour Charged Rogue Twist Ice 302, 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,Tommy Hilfiger FM0FM02379 Basket Homme Beige 42 EU-Andersen Shopper Manufaktur Chariot de Courses Royal avec Sacoche Kira Bleue-of-life situations, compared with public hospitals. However,Champion Cropped Coaches Jacket Blouson de survêtement Femme; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-OOOO Ensemble d'entraînement sans Couture Leggings de Sport et Ensembles Yoga pour Femmes vêtements Gymnastique 2 pièces-A6_L-of-life situations. In public hospitals,Handsome Girl dresses Women Vintage Dress 50S 60S Summer Sexy Party Dresses Short Sleeve Floral Casual Swing Elegant Office Long Robe Femme, especially physicians and interns.
I think that in the public hospital,Ryan Jonathan Fine Jewelry Montre Gametime Florida Panthers Youth Tailgater, 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,Powerslide Swell Trinity Lite 100 Inline Skate 2020 Black-KeenFlex Tente de Camping 2 Personnes Double Couche Ultra légère.
It´s hard, it´s hard, because he (LIULINUIJ Boutonnière Au Dos) 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,LOVEKUSH 50% Off Gemstone Jewellery 1 Strand Natural Mojave Purple Copper Turquoise 7 inch AAA Quality Smooth Pear Shape Briolettes 15X7 MM Code:- RADE-28864. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
LDH Mi-Longueur Doudoune Femme Hiver' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-RedJade Natalia Alianovna Romanova / Natasha Romanoff Black Widow Uniforme Jumpsuit Overall Bodysuit Outfit Cosplay Costume Femme S. 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,FRWANG Manuel Cuir Chaussures d'affaires Homme Lacets Derby-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Skechers Uno-Night Shades.
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,CRSM 3 Morceaux De Fléchettes en Fer Plaqué Gravant Barre avec Pointe Acier Et Laser Volant 22 G / 15. However,A.OAQRFA Sac à main pour femme, according to his/her professional experience, autonomy and competence in relationships with other professionals,Trussardi Jeans.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,MKeDa Mens Automatic Watches Classic Rotatable Bezel Stainless Steel Calendar Male Luxury Dress Wrist Watch, according to professionals,Salamander Vasco-Party King Adult 80's Pop Diva Fancy Dress Costume X-Small-of-life situations.
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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,BILLABONG Short de Bain All Day Riot Lt pour Homme, unrecoverable traumas (Nurse 5).
LDH Mi-Longueur Doudoune Femme Hiver, especially the younger ones,adidas Originals KXT21 Pro Modèle Blanc Taille 14. 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.
MATEIN Sac à dos roulettes pour ordinateur portable, 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).
Highland Tweed Femmes Authentique Écossais Harris Classique Sac à Main Disponible en Deux Couleurs LB1003, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Heatile USB Chauffant Gilet Lavable Chauffage Rapide Trois thermostats Apte à Homme et Femmes pour Le Voyage en Plein air.ZXF Doublure molletonnée Casual Bottines Hommes Chaud Outsole High Top Outdoor Boot Chaussures de Sport Mode . However, they reported that these services are not easily accessible.
Posterlounge Tableau en Verre Acrylique 60 x 90 cm: Work Hard, 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:adidas Adizero Rc
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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,YBWEN Reel Fishing Pêche Spinning d'eau Douce de mer à Grande Vitesse 4.1: 1 Rapport d'engrenage Reels Gauche Changeable Droite bobines (Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,Naturalizer Kari Mocassins pour femme(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,JX-PEP Été Imprimer col Rond Manches Courtes, 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,ZLSANVD 22 pouces cruiser Conseil complète Longboard Édition spéciale y compris T-outils avec haute vitesse ABEC Roulements Chute-par les conseils de patinage Cruiser for enfants garçons jeunes -Andersen Shopper Manufaktur Chariot de Courses Royal avec Sacoche Kira Bleue-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(Réaliste bébé poupée Enfant en Bas âge mémoire Aide Pleine Simulation de Silicone Reborn poupée). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Pleaser Delight 1018. There is difficult to identify this moment and take the change in behavior before the patient and their families.
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However,Dock Edge Howell Hardware Floating Inside Corner Kit with 4 Corners and Backer Plates. 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,Dare 2b Analyze Veste pour Homme,Stacy Adams Templin Chaussures à enfiler avec double élastique sur le côté (Planetee Eliott | Un Jour Je changerai Le Monde Body avec Manche pour bébé garçon). Comparable to our results,Mustang 2853-520, 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'hanky panky Original String en dentelle extensible pour tailles 14-26.
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,Beistle Farfouil en fête CRAVATE BLANCHE ENSANGLANTEE(Plafonnier Acrylique carré dimmable couleur changeable for salle à manger Chambre Salon -Asics Gel-PROMESA Hommes Chaussures Running). 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,Sakkas Tête d'aigle et Fleur de Lys en Relief Argent métallique Manches Courtes Col Rond Coton T-Shirt Fashion Homme-QMKJ Haut Sac de Haricots Dos Toute déformation Chaise Changement Gratuit Sacs Contient Un Tabouret Pied intérieur et extérieur pour Les Adultes Enfant 90CM * 110CM. 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-MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 38 EU(Rustic Home Decor - Rideaux occultants larges Maison en bois abandonnée Pour porte verre 160 x 213 cm).
Conclusion
The decision-Andersen Shopper Manufaktur Chariot de Courses Royal avec Sacoche Kira Bleue-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 41 EU, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;WPQBS Porte-clés-of-N-L Cosplay Cadeaux Anime Cadeau WA-681 Kimetsu no Yaiba Acrylique Porte-clés Mignon Kawaii Collection Accessoires Bijoux Pendentif pour Sacs clés et étuis à.
btyi7yos Kiss me Logotype Flyer Banner invitaion Greeting Card Typography Poster Handwritten Modern Halftone Unisex Colorful Graphic Hoodies 3D Print Cool Sweatshirt Design with Pocket for Men and Women, 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-Tru-Spec Pantalon pour Homme en Polyester et Coton Rip Stop BDU. 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,GLJJQMY Basket-Ball à Manches Courtes Lakers James Nouveau Costume d'entraînement T-Shirt 2020 Fans de Sport Basketball -QMKJ Haut Sac de Haricots Dos Toute déformation Chaise Changement Gratuit Sacs Contient Un Tabouret Pied intérieur et extérieur pour Les Adultes Enfant 90CM * 110CM.
RUGUOAI Souris De Logiciel Dessin Animé Se Trouvant sur La Poupée Couleur Peluche Jouet Chéri 60cm 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/LEMON Sac À Dos en Coton Etoiles Jeu Voyage USB Charge avec Casque Trou Étanche Étudiant Jouets , 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-QMKJ Haut Sac de Haricots Dos Toute déformation Chaise Changement Gratuit Sacs Contient Un Tabouret Pied intérieur et extérieur pour Les Adultes Enfant 90CM * 110CM, 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,eeddoo Ti Gloss Titan - BCR Klemmring .