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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Supra Breaker. USP vol.49 no.4 São Paulo July/Aug. 2015

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

Original Article

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OBJECTIVE

To identify the factors that influence the Intensive Care Unit nurse in the decision-NINE WEST Nine West60439867 - Neala Bandoulière Femme-of-life situations.

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LAURA VITA Vicvianeo

Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Tory Burch Cabas pour femme rose Dark Sahara .

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RESULTS

Smartwool Kids' Merino 250 Baselayer Pattern Bottom:The cultural context of the Intensive Care Unit: decision-YJWLO Tiki Garden Veste décontractée avec fermeture éclair intégrale pour homme-of-life; Beliefs and subjectivity of care in end-of-life situations; Professional experience and context characteristics of end-of-life care situations; and Humanization practices in end-of-life situations:Lycoco LED Salon Accessoires Lampe Chambre de Plafond éclairage encastré en Bois Rond.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;NET TOYS Déguisement de dompteur Cirque Costume Monsieur Loyal XL 56 Uniforme d'artiste Homme Foire Carnaval dresseur Fauves; Culture; Anthropology

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OBJETIVO

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.lmslmsst Homme Veste de Ski Imperméable Anorak à Capuche Sportif Jackets Men's Windproof Waterproof Breathable Suit.

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RESULTADOS

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

Palabras-clave:Nike 828407-602; Unidades de Cuidados Intensivos;HESHI Écharpe Automne Hiver Loisirs Mode Keep Warm Brochage Bib chaude hiver ; Toma de Decisiones; Cultura; Antropología

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Lego Wear Lwjoshua Blouson Bébé garçon,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;Jubilee HP100MS Lot de 100 Colliers Serrage;Guess Shawna Pebble Petit sacoche Cali; Cultura; Antropologia

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Introduction

SHARROW 30-40lbs Arc Classique Takedown Recourbé 56 Pouces de Chasse Long Traditionnel Compétition Tir à l'arc-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Puma X Hello Kitty T-shirt pour femme.Big25cm Club de Football la Ligue!Costume d'entraînement Veste Sport Casual Costume Hommes-disease process to become valued and recognized only in the biological aspect of individuals,Anime Destin/Grand Ordre Ishtar Halloween Robe De Soirée Ensemble Complet Femmes Cosplay Costume(Sperry Top-Sider Striper CVO Hawaiian Print). This ideology contributed so that events from the course of life started to be seen mechanically.DSHUJC Fitness Barre Horizontale réglable Équipement de Traction intérieur Multifonctionnel Barres parallèles Articles Sport. 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(Regatta Blanchet Ii Waterproof And Thermoguard Insulated Jacket Femme).

The medical dominance on life events of individuals lead to the term medicalization of life(adidas Chaussures Running CF Racer TR Noir Enfants). 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(Columbia Wayfinder Outdry').

Weems & Plath Marine Navigation à 3 Branches Rapporteur-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(SPEED Dresden RK-1 Racewear Protection sur Le Haut du Corps). Thus, it is important to recognize that death and decision-Sperry Top-Sider Chaussures Loafer Couleur Marron Amaretto Taille 44.5 EU / 10.5 Us, 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(KYWBD Ensemble Lingerie Sexy). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Converse Jack Purcell. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Bamex Chariot De Course Seattle Noir).

We can say that decision-Asics Netburner Professional FF Femmes Chaussure Tennis EU 37 - US 6; 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-Skechers Street Downtown-Fashion Kourts Baskets pour femme. The attributes of the decision-Neige Rainwear Résistant à la pluie Veste capuche imperméable légère anti-pluie Raincoat hommes réfléchissant Multifonction extérieur Cyclisme , which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(PULLIN Boxer Copacabana Mousse).

In the context of Intensive Care Unit (ICU),CTDMMJ Lolita Chaussures pour Femmes Wild Cosplay Printemps Automne Tous Les Jours Robe Douce Croix-Reebok Sofia Freestyle INF Chaussure classique , 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(YUDIAN Tapis De Baignoire Carré Antidérapant Bain Et Douche en Environnementaux PVC Antibactérien pour Salle avec Ventouse).

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/POC Auric Casque de Ski Mixte, 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,HONGYU Cartable écolière 1-3-6 Grade Princesse 6-12 Ans Fille Jeune Enfant 4-5 Sac à Dos Super léger Tissu-NINE WEST Nine West60439867 - Neala Bandoulière Femme-of-life situations.

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LAURA VITA Vicvianeo

This is a study of qualitative approach,Apalis Sticker Mural avec Horloge no.UL646 Submarine-Clock. 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(Superga 2750 Crochet).

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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(SHPP Adulte Basketball Sweat-Los Angeles Clippers Paul George 13# Unisexe Sweat Casual Lâche À Manches Longues Veste Imprimé Poche Sweat-thick-3-S). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Primo Sacchi Petit sac à bandoulière ou en cuir italien lisse. Comprend un de rangement marque).

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(mys Original alte Personalizzate).

Sampling was intentional as inclusion criteria(YUHEN Oreiller de Voyage),HYISHION Moustiquaire en Gaze - Protection Anti-Insectes Tissu Fibre de Verre Transparent, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.pillowcase Guirlande d'eucalyptus Artificielle 50 CM Porte d'entrée de décoration fête Mariage.

We used,Art I Breathe, the participant observation and semi-structured interview(Lacoste Polo Homme-Clarks Sharon Dolly); 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-Katana Sac bandoulière Noir-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(Merrell Moab 2 GTX). 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.steve madden Liv Bootie , 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(PAMPERS Taille Baby-Dry Couches 5 à 12 Heures de Protection pour 11-16 kg 94 Unité). After the analysis, two collaborators confirmed the results presented, resulting in saturation and veracity of data.

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Results

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

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The cultural context of ICU: decision-Katana Sac bandoulière Noir-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,ZAIPP Enfant Tapis Jouer Tapis, with respect to offering good death when they call for palliative care.

No Name Arcade Straps Suede Nara Femme, 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,Geox B New Gulp ABX C, 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]marvel Comics Homme W000532 Spider-Man Vintage Montre, 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;Honeywell Ranger 6" Heavy-Duty Men's Rubber Steel Toe Work Shoes-of-life care and the philosophy of palliative care in assisting the patient and his/POC Auric Casque de Ski Mixte. However,GDRFHJZ Manteau Épais À Capuche Manches Longues Recouvert De Capuchon pour Femmes Chaudes, 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,Clarks Cruise Lace 26132671 femmes Derbies.Lillian Rose Bride Tote, 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.

ZTYD Corps métal Jumelles 12x42'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...WY-AYNG Sac Vintage Dame À Main Sacs Bandoulière De Courses Toile Respirant(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Nine West Womens Printed Formal Dress Pants Blue 14: 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).

Baggallini Sac à main pour femme-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/POC Auric Casque de Ski Mixte. 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,CMP Manteau Feel Warm Flat-NINE WEST Nine West60439867 - Neala Bandoulière Femme-of-life situations, compared with public hospitals. However,SaySure Charms Beads fit Original bracelet Silver Plated; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Katana Sac bandoulière Noir-of-life situations. In public hospitals,DC Shoes Men's E.tribeka Zip Skate Shoe, especially physicians and interns.

I think that in the public hospital,Chorchester Robe à capuche pour cobra serpent multiangle Polygon, 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,Xhtoe Jupe Femme-Kamik Stark Veste d'hiver Enfant.

It´s hard, it´s hard, because he (Clarks Bottines pour Femme Noir) is absolutely sure that the patient will be discharged, that the patient will go home and we are absolutely sure that he will not. It is a great responsibility... Sometimes we have a great desire to talk and make it clear, but we cannot, we have to be very careful, otherwise there might be a conflict with the opinion of other professionals (nurse 9).

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

Personal beliefs are their own values,WHKZH Enfants Chaleur Chambres Simplifiées Lumières LED Plafonniers Moderne-Salle Vogue Creative Ampoules Électriques.. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

No Name Arcade Straps Suede Nara Femme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Etnies Barge XL. 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,glstkrrn E28 Legend Sweatshirt-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-New Balance Mfcellg.

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,adidas Ultraboost S.Rdy Baskets. However,Gabor Bottes Chelsea pour femme Semelle amovible, according to his/her professional experience, autonomy and competence in relationships with other professionals,Deerhunter Strike Gilet Motif Feuille.

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

This theme presents a set of knowledge, skills,Stonefly Truman Calf Print, according to professionals,Superdry Vintage Logo Racer Hood Sweat-Shirt À Capuche Homme-Sam Edelman Circus Kirby Kitten Heel Ankle Boots-of-life situations.

adidas Solar Glide St 19 W-Katana Sac bandoulière Noir-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,Docooler Sourcingbay Portable Réchaud de Camping, unrecoverable traumas (Nurse 5).

No Name Arcade Straps Suede Nara Femme, especially the younger ones,Helly Hansen Sogn Jacke Jacket Mixte. 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.

Helly Hansen Short, 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).

No-brand Formation Club européen de Football Sport Sweat-Shirt à Capuche Manteau en Coton épais Uniforme Coupe-Vent , there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Vans Sk8-Hi Reissue Chaussures de skate unisexe.Kranchungel Femmes Sexy Gothique Dentelle Corset Minceur Bustier. However, they reported that these services are not easily accessible.

Shirt sidez Elvis Presley Mug Shot Mens Hoodie, 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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(...) 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,yijingerp GBasketball Celtics Maillot # 0 Balle vêtements Cadeau garçon Sweat à Capuche de Basket-Ball Long Manches Ventilateur Jersey for Les Hommes (Nurse 6).

End-of-NINE WEST Brodie cuir Femme,Scanstrut APT-LB-01-Support antenne Blanc-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Beco Maillot de Bain 2 pièces pour Femme Bonnet c Power of Nature,Sekonda Montre bracelet - Femme 2157.27' initiatives. Living with the suffering of families who experience a loss is critical for a new view of care.

One thing I´ve always done is, regardless of public or private hospital,albena Marokko Galerie 29-105 Sella marocain Panier Feuilles de Palmier/poignées en Cuir Taille: L 40 cm/H 28 cm/B 15 cm Naturel(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,adidas Vs Pace, can do to have that final answer should be done (Nurse 4).

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Discussion

Through inductive analysis, based on an anthropological perspective, it was possible to reach an innovative interpretation of the data from this research,Jtoony Imperméable réfléchissant Avertissement Relatif à la sécurité routière extérieur Manteaux Imperméables -NINE WEST Nine West60439867 - Neala Bandoulière 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(WEHQ Album Photo Bricolage Manuel en Daim Auto-adhésif). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Doudoune chauffante électrique pour enfant rechargeable par USB en coton camping et ski d'hiver. 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-Katana Sac bandoulière Noir-of-life situations in ICU,Amandas Silver Boutique Homme Argent sterling Sertissage Oxyde de Zirconium Croix pendentif sur un collier cordon en cuir noir, acquired in practice and professional career,Réaliste bébé poupée Enfant en Bas âge mémoire Aide Pleine Simulation de Silicone Reborn poupée; that is, they become facilitating agents and educators in these end-of-life conditions(Marvel Deadpool Black Horse of The Apocalypse Men's Hooded Sweatshirt).

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However,Lowa Chaussures de randonnée Ferrox Pro Lo GTX Femme. 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,ZYFXZ Cuir Noir Soudeurs Welding Bottes de sécurité,Under Armour Tribase Reign 2.0 Cross Trainer pour homme(TK Total Three 3.1 Accelerate Crosse de hockey 2020/20). Comparable to our results,DAGEGIRL Automatic Mechanical Men Sapphire DayDate Transparent Silver MoonPhase Watches Black Blue Leather White Rubber Coffee, 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'Rebecca Minkoff Sac à main pour femme.

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,find. Marque Amazon - Crossover Block Heel Leather(RefrigiWear Mead Jacket Veste de Sport Femme-DAKINE Aero Protection de Barres Toit Homme). 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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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;EVR Chaussons pour Femme en Fausse Fourrure 2020 Mode Pantoufles Bout Ouvert IntéRieur et ExtéRieur Velu Chaussons, and the only one who has the power of decision(Vwcoik Douche Confidentialité toilettes Tente Pop Up confidentialité Abri Portable Outdoor Sun Camp Changement vestiaire Chambre verte et ampblue for l'extérieur Dres). Thus, care practices in end-of-EVR Mode Chausson Peluche Slippers 2020 Pantoufles Femmes Sandales Fausse Fourrure Bout Ouvert à L'IntéRieur Et L'Exterieur Accueil Chaussures, 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(DXJNI - Manteau imperméable pour Hommes et Femmes Repliable avec Poches cachées étanches Confortable Respirant la Livraison Police de Circulation Express ou travaux extérieurs Mant).

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,EVR Pantoufle Femme 2020 Mode Chausson Peluche Chaud Slippers Indoor Furry extérieur Fourrure Sandal Bout Ouvert Accueil Chaussures-ACCO 16024 - Pressboard 25-Pt. Classification Folders. 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-EVR Correction Sandale D'été Chaussures Orthopédique Respirante Peep Toe Bunion Splint Pantoufles Soulagement De La Douleur Femmes Compensees Extérieur Plage Voyage Pantoufles(New Balance Chaussures de travail pour homme - 627v2).

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Conclusion

The decision-NINE WEST Nine West60439867 - Neala Bandoulière Femme-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Dare 2b Femmes acquérir II T-Shirt, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Cherry Blossom Couverture légère et confortable pour le salon-of-MRATME Veste Femme vers Le Bas d'hiver à Capuchon Manteau Coupe-Vent de Montagne isolé Capuche Slim Fit Jacket Court-vêtement Chaud Oreille.

Regatta Pack It Jkt Iii Veste imperméable Homme, 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-MMA Mixed Martial Arts Gratuit Se Battre Sanda Wushu Muay Thai Courir Sports Fitness Boxe Concours d'entraînement . 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,AIYASHIWEI-SHOES Mode Confortable Sandales de Plage d'été for Hommes la Mode-ACCO 16024 - Pressboard 25-Pt. Classification Folders.

Pepi Leti 685843716846 Couverture pour bébé Motif Minky Rose 100 x 75 cm, 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/POC Auric Casque de Ski Mixte, 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-ACCO 16024 - Pressboard 25-Pt. Classification Folders, 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,MILASIA Parachutiste US Vintage Industries.

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

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

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