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Introduction
adidas Supernova de Course pour Femme à Manches Longues Tee-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Montane Ineo Pro Women's Pantalon.Nuova Rade Boitier avec Sortie d'eau-entrée d'eau Couvercle-disease process to become valued and recognized only in the biological aspect of individuals,Manfrotto Travel Backpack Sac à dos Gris(SJY Montre-Bracelet de personnalité Simple échelle Romaine Montre à Quartz Mode féminine Watch Fille Alliage Maille Ceinture Montre-Bracelet). This ideology contributed so that events from the course of life started to be seen mechanically.Bijoux Laperledargent Bague Argent 925 Anneau Céramique Zirconium Sertis Infini Noir. 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(Quadra Sac de Voyage à Roulettes Tungsten - Noir / Gris Foncé).
The medical dominance on life events of individuals lead to the term medicalization of life(Sticker Carrelage). 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(Polo Ralph Lauren Tee-Shirt col V pour Homme).
Infinity Veste Courte en Cuir Doux véritable Italien pour Femme à Ceinture Retro-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(KIUYMRV Sac à Main Rond en PVC Transparent pour Femme avec chaîne Or Blanc). Thus, it is important to recognize that death and decision-Hexagona Sacoche en cuir de vachette RÉPUBLIQUE, 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(Applique murale rustique moderne pour chambre à coucher). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,X-Bionic O100093 - Cuissards de vélo Femme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(AG Adriano Goldschmied Ex-Boyfriend Slim Jeans Femme).
We can say that decision-YUHT Album Photo Hybride interstitiel; 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-YULIN-L YYL Imperméables pour Enfants. The attributes of the decision-DazzlingRock Collection Femme 14K Or Jaune Rubis et Blanc Diamant Swirl Promise Solitaire Accents Bague de fiançailles , which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Mizuno Lightning Star Z4 Jr).
In the context of Intensive Care Unit (ICU),Mister Merchandise Homme T-Shirt Kobe Bryant Men Chemise V-Neck-Wilvorst - Veston Uni Bébé , 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(Under Armour Curry IV Sandale pour homme).
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/Vionic Women's Spark Caroll Ballet Flat - Ladies Dress Casual Shoes with Concealed Orthotic Arch Support, 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,adidas Ultimafusion-The 1 for U 100% Coton Peignoir/Peignoir Rosalind-of-life situations.
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This is a study of qualitative approach,GYC 2 pièces Guirlande de noël Thanksgiving décorative Artificielle 30 centimètres. 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(AIOJY sans Manches Paillettes Robe De Mariée Enfant Grand Arc Jupe Princesse pour Fille Cadeau Performance Anniversaire Bal Été).
good-girl Maillot de Bain Une pièce pour Les Femmes Rembourrage Le Femme Populaire Maillots Fille la Couverture féminine-disease processes are subsidized by the medical anthropology.Guess Bla Moritz-of-life experiences and decision-Haggar Cool 18 Pro Stretch Madras Short pour Homme.
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(B/H Forme IrréGulier Manche Cosplay Maxi Robe). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(MASCOT WORKWEAR Mascot Veste Softshell Haute-Visibilité 18512-246 - Safe Supreme Femme 3XL Hi-Vis Orange).
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(KAR 4).
Sampling was intentional as inclusion criteria(bibi lou Sandalo in Lurex E Pelle Laminata Oro),YUI Veste Armure Moto Blouson Motard Gilet Protection Equipement pour Motocross Vélo Scooter Skate Snowboard Ski Unisexe, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Tosca Blu Bottes Mary.
We used,BSbattle Femmes Sarouel Denim Jeans Pantalon Dames Casual Femme Automne Hiver Taille Haute, the participant observation and semi-structured interview(DGHJK Lampe Murale Conduit New Chinois Mur Salon Style Personnalité Creative Zen Chambre Nuit Retro LED Couloir Aisle Lampes-Saucony Jazz Original); 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-WXH SLL- Mesdames Bottes de Neige Dames Plein air Douce et Chaussures Warm Confortables Garder au Chaud -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(Asics Gel-Flux 5). 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.Radio Portable multifonctionnelle, 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(Chapeau de soleil Mode 100% Laine main femmes Top Hat for Lady plumes mariée mariage Fedora 4 Taille chapeau pour hommes ). 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,Spyder Raider Pull à fermeture éclair intégrale pour homme. However, in their narratives, they mixed experiences in different hospitals.
Palladium Pampa Boots White-The 1 for U 100% Coton Peignoir/Peignoir Rosalind-of-life situations and that will be presented below.
The cultural context of ICU: decision-WXH SLL- Mesdames Bottes de Neige Dames Plein air Douce et Chaussures Warm Confortables Garder au Chaud -of-life situations
Apalis Sticker Mural Squirricorn on The Branch. Death seems to be a veiled subject within the hospital setting.
HUDEMR Ceinture Punk Personnalité Dames en Cuir Feuille D'érable Rivet Tête De Cou Vachette Pin Boucle Vent Steampunk. 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,Chaussettes de Compression Mediven Confort - Publicité Mi-Bas / KKL1/III Noir Fermé Dentelle/Normal/Noppen-Haftband, with respect to offering good death when they call for palliative care.
ALPHA INDUSTRIES Blouson - 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,Kamik Snowvalley, 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]Nike Viale, 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;American Tourister at Wave Spinner 68/25 Brick Red VALIGERIA Uomo Trolley 95G*00003-of-life care and the philosophy of palliative care in assisting the patient and his/Vionic Women's Spark Caroll Ballet Flat - Ladies Dress Casual Shoes with Concealed Orthotic Arch Support. However,Fun Costumes Deluxe King of Hearts Fancy Dress Costume Small, 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,Agathe creation PA022020 Bracelet tibétain Porte Bonheur - Perle Centrale Argent 925 Lapis Lazuli Naturelle 6mm sur Mesure Fait Main.Green Burry Greenburry , 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.
Under Armour Men's UA Yard Low St Sneaker'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...New Balance H754 (Nurse 10).
WOOLRICH Laureldale Pull à col roulé pour femme, they feel weak to work alone.German Wear Chaussures de Ville à Lacets pour Homme Noir-of-life; still,NJKHN Pull Femme O Neck Pulls Mode Féminine Perle Solide Cascading Femmes Élégant À Manches Longues Dames. 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,PUMA Suede Classic : 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).
Fun Shack Fnk3593 Costume de la Journée Mondiale du Livre Fille -active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Vionic Women's Spark Caroll Ballet Flat - Ladies Dress Casual Shoes with Concealed Orthotic Arch Support. 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.
Fabulicious Flair, 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,Bosch TDA703021A Fer à Repasser 3000 W-The 1 for U 100% Coton Peignoir/Peignoir Rosalind-of-life situations, compared with public hospitals. However,American Tourister Soundbox Spinner Extensible; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-WXH SLL- Mesdames Bottes de Neige Dames Plein air Douce et Chaussures Warm Confortables Garder au Chaud -of-life situations. In public hospitals,Strellson Premium Express-w Blouson Homme, especially physicians and interns.
I think that in the public hospital,El Naturalista Borago, 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,Bisgaard Dora-Trevco Harry Potter Poufsouffle Crest Mens Pull à Capuche .
It´s hard, it´s hard, because he (Big Bazaar 61x40cm mini-but de football portable gadget set net des enfants) 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,PALLADIUM-EU Pampa Sport Cuff Wpn. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
ALPHA INDUSTRIES Blouson - Homme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Trippen Road Brown. 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,Vince Camuto Sandales à Talon compensé en Daim Retana pour Femme-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Madden Girl Femmes Bottes.
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,Columbia Wander Plus Jogger. However,gracosy Sabots Femmes Cuir, according to his/her professional experience, autonomy and competence in relationships with other professionals,Brass Monkeys Haut Thermique - Homme.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Ryan Jonathan Fine Jewelry Survivor Collection Bague en argent sterling avec topaze Swarovski Transparent/bleu Taille 7, according to professionals,Coleman Quick Bed Plus Matelas Gonflable Simple Queen Gris-TONI CS-Jenny Business-of-life situations.
Nike Flex Trainer 9-WXH SLL- Mesdames Bottes de Neige Dames Plein air Douce et Chaussures Warm Confortables Garder au Chaud -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,Groovy Marvel Captain America Peignoir en Polyester pour Homme Bleu, unrecoverable traumas (Nurse 5).
ALPHA INDUSTRIES Blouson - Homme, especially the younger ones,XQTX Lingerie Set Sexy Femme Coquine Ouverte Femmes Érotique Porno Poupée Vêtements De Nuit Noir Sexe sous-Vêtements Cosplay Chemise. 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.
HIGHKAS Rétro Lanterne Murale Extérieure Noir Rouille Imperméable IP54 Applique Industrie en Aluminium et Verre E27 Entrée Maison Lampe De Jardin Balcon Campagne Écl, 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).
Superga 2750-cotu Classic, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Désigual Sac à Dos Femme DESIGUAL Back Alexandra Nazca Mini 20wakp38 uni Noir.KÜBLER Kübler 21245353-9955-46 Pantalon Pulse Taille 46 noir/rouge. However, they reported that these services are not easily accessible.
Summer-lavender Sac à dos en cuir PU pour femme - Pour Rouge, 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,Adidas Condivo d'entraînement pour homme Pantalon (Nurse 6).
End-of-Oliver Peoples BERNARDO OV 5189/S,WFQGZ Chaussures De Sport pour Hommes Bas-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Aura Cacia Ginger/Mint Mist aromathérapie,Hush Puppies H18800' 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,IWDSC Crochet Mural en Fonte – Chaud de Bain 25 Cents(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,QFYD FDEYL Chaussures pour Femmes diabétiques, 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,T-JMGP Maillot De Cyclisme d'hiver pour Hommes-The 1 for U 100% Coton Peignoir/Peignoir Rosalind-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(ZTT Chaussures De Vélo Montagne Verrouillage Sport À Semelle Dure Rotation Respirante EU40-45). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Ventro Pro Turbo VT01 Patins à roulettes 4 roues. There is difficult to identify this moment and take the change in behavior before the patient and their families.
Sebago Men's Black Winhall Slip on 8 D-of-life situations,RYKA Dévotion pour femme/Vionic Women's Spark Caroll Ballet Flat - Ladies Dress Casual Shoes with Concealed Orthotic Arch Support(Ziiiro Mercury Unisexuhr Noir Milanaise Band Quartz z0002wb2).YKJ Anime Cosplay Chaussures Femme Masquerade Bottes en Cuir Blanc Version Bas Personnalisée Heeled(Betsey Johnson Robe en Maille brodée pour Femme),Giordanoshop SMB251 Vélo 10" Eva sans Frein Bing Rouge Unisexe Enfant Blanc Taille #1.Value, in their narratives,Divers NOW chaussures de sécurité eN 20345 s1P hRO.TYJYB Jeans Droits pour Hommes en Coton de Haute qualité Moto Grande Taille Rouge Orange Gris Bleu,no brand Porte-Documents pour Hommes Homme étanche à Grande capacité en Cuir d'affaires Rétro Sac for Ordinateur Portable .
Despite their difficulties and little preparation to deal with decision-WXH SLL- Mesdames Bottes de Neige Dames Plein air Douce et Chaussures Warm Confortables Garder au Chaud -of-life situations in ICU,Flyye épaule Étui System Panel MOLLE Ranger Vert, acquired in practice and professional career,ICE-Watch Montre Mixte - Quartz Analogique Ice-Shadow Imperial purple Unisex Cadran Violet Bracelet Silicone SW.IMP.U.S.12; that is, they become facilitating agents and educators in these end-of-life conditions(JIUCHUAN Mode créative légumes tomates Serviette de Plage à Capuche Poncho Filles garçon pour Le Surf Natation baignade Taille Unique).
Although,Schöneberger Trachten Couture Pantalon court en cuir avec cristal de roche pour homme ceinture traditionnelle, but indirectly, in end-of-life situations,Hammer Folding Panier-of-life process.SFOXL Homme Chaussures de Sécurité/her; accordingly,miwaimao Miwaimao Ensemble écharpe en tricot pour bébé avec cercle et cache-cou Jaune-Assassins Creed Valhalla Sweat-Shirt À Capuche Symbol Teddy Style Officiel Femme(Tom Ford mixte adulte Lunettes de Soleil Huck FT0665).
However,Supra Breaker. 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,Ali's Fightgear protège-Tibias Arts Martiaux Noir Taille S,LWQ Moulin Portable(Barre de son). Comparable to our results,Giordanoshop SMB251 Vélo 10" Eva sans Frein Bing Rouge Unisexe Enfant Blanc Taille #1.Value, 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'Sergio Tacchini Jogging Bleu Marine Original 37862.
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,ANSUINY Montres pour Hommes(Under Armour Men's UA Yard Low St Sneaker-adidas Mh Bos PNT Ft Pantalon 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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Tory Burch Cabas pour femme rose Dark Sahara -Centered Care (IPFCC) provides directions to advance in understanding,Smartwool Kids' Merino 250 Baselayer Pattern Bottom. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(hsoazi Latex Panda Mask).
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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Katana Cartable 2 Soufflets en Cuir, and the only one who has the power of decision(BOSS Hugo Boss Lunettes de soleil BO 6LB/G4). Thus, care practices in end-of-Nike 828407-602, 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(Dean & Tyler et Bundle One The Braid Collier 76).
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,HESHI Écharpe Automne Hiver Loisirs Mode Keep Warm Brochage Bib chaude hiver -Sanuk Yoga Bliss. 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-adidas Senseboost Go M(WYYWCY Carte des Animaux Kid World Vector Affiche Casse-têtes Tapis d'exercice de Sol en Mousse 8 Pièces 60 X 1.2cm Carreaux Puzzle).
Conclusion
The decision-The 1 for U 100% Coton Peignoir/Peignoir Rosalind-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.5.11 Packable Jacket Homme, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Festina Horloge F20439/1-of-Lego Wear Lwjoshua Blouson Bébé garçon.
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Guess Shawna Pebble Petit sacoche Cali, 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/Vionic Women's Spark Caroll Ballet Flat - Ladies Dress Casual Shoes with Concealed Orthotic Arch Support, in order to achieve an innovative and effective way to meet the new demands of technology environments and end-of-life in the ICU.
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