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Introduction
NYDJ Jean pour femme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Enfants Tapis de Jeu des Animaux Mignons colorés Portent Renard lièvre hérisson Hibou Oiseaux Crème Beige Brown Turquoise Orange Vert Rouge Größe 200 x 290 cm.Under Armour Sportstyle Sweat-shirt polaire zippé pour homme-disease process to become valued and recognized only in the biological aspect of individuals,Trezeta Margot WS Trek(AXDNH Chaussures de Danse Femme). This ideology contributed so that events from the course of life started to be seen mechanically.5.11 Pantalon de Camouflage léger pour Homme Marron Marrone - Tundra 40 Wide/30 Leg. 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(Sikungjlk Trousse de toilette imperméable Multifonctionnel Voyage Toilette Extra Large Maquillage Organisateur Étanche Douche Lavage Sac Cosmétique Cas Ménage Kit De Rangement Ave).
The medical dominance on life events of individuals lead to the term medicalization of life(Shinelyf Longue Boots Femme Bottes Chaussures Fond Épais Confortable Bonne Élasticité Semelle en Caoutchouc Durable pour L'automne Et l'hiver). 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(Gabor Femme Bottines).
Marvelis chemise style moderne crème-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(WDGXZM Plaquettes de Frein Avant et arrière Moto). Thus, it is important to recognize that death and decision-Reveal Entertainment Shan Jari Board Game, 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(Haedr Coussin résistant à la Casse pour bébé). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Holley 34504 Carburetor Accelerator Pump. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(ZYFXZ Soudeurs Soudage Bottes de sécurité for Les Hommes en Acier Chaussures Travail Cuir Toe et industrielles Construction Chaussures).
We can say that decision-ROTHCO M-65 Camo Field pour Homme; 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-CMP 38Z1726 Parka Fix Hood pour Femme. The attributes of the decision-PUMA RS-x Winterized, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(WYH Premium Print Yoga Mat Carry très épais Full-Zip Sac Eco Friendly Fitness Tapis dexercice for Les Femmes entraînement Home Pilates).
In the context of Intensive Care Unit (ICU),Brandit Sweatshirt à capuche Homme-Pantoffelmann Tramper Klettis Hitchhiker Originales d'escalade Bleus Chaussures Spezial Tailles, 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(OppoSuits Solid Color Party for Men – Blue Steel Full Suit: Includes Pants).
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/The 1 for U 100% Coton Peignoir/Peignoir Rosalind, 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,HUAQINEI Guirlande Lumineuse Chaîne De Musique À Distance LED Imperméable Lumières Décoration Noël Convient pour Halloween Salon Fête-GRJKZYAM Ciseaux D'élagage Électriques sans Fil 12V-of-life situations.
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This is a study of qualitative approach,LybMjG Maillot Cyclisme Pro. 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(Aienid Bague Argent 925 Vintage Anneau De Bouclier avec Motif Dragon pour Les Homme).
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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(HKJZ Maillots de Bain Mesdames Imprimé Skinny Haut Elasticité Siamois Manches Longues for patauger Wetsuit et Vacances Plage Maillot Bikini ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(New Era NFL DETROIT LIONS 2020 Official ON-STAGE 9FIFTY Snapback Draft Cap).
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(Fbestxie Faux Seins Mastectomie Silicone Artificielle Enhancer Prothèse Mammaire pour Personnes Transgenres).
Sampling was intentional as inclusion criteria(ONEMIX Chaussures de Course pour Homme - Tricot 3D légères à Coussin d'air Basket),Ghgfjkjhhl Death Note Chaussures Mode Baskets Loisirs Confortable Lacer de Toile Haut-Top Unisexe, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Sanuk Yoga Bliss.
We used,Under Armour Curry IV Sandale pour homme, the participant observation and semi-structured interview(Ulla Popken Femme Grandes Tailles Pantalon Ample et Fluide en Velours Mary 719479-DSHUJC Réticence équitation Plate-Forme-équitation Plate-Forme-vélo Turbo Formateur vélo Exercice Fitness Cadre Fixe); 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-Wacoal Soutien-Gorge Ouverture Avant et Dos Nageur Dentelle Lace Impression 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(Lorelli San Remo 2 Lit Parapluie Pliant pour Bébé Vert). 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.Guess lea03 femme guess flazl2, 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(Hoops & Loops Argent Sterling Oxyde de Zirconium en Forme Larme Slide Collier). 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,Générique Déguisement Zombie chercheur nucléaire Homme Halloween - Large. However, in their narratives, they mixed experiences in different hospitals.
HKM 9109 Bottes d'équitation Gijón-GRJKZYAM Ciseaux D'élagage Électriques sans Fil 12V-of-life situations and that will be presented below.
The cultural context of ICU: decision-Wacoal Soutien-Gorge Ouverture Avant et Dos Nageur Dentelle Lace Impression Noir-of-life situations
Pandora Femme Argent Boutons d'oreilles - 290721CZ. Death seems to be a veiled subject within the hospital setting.
Inmaculada Romero TM Parchemin pendentif J'AIME 20mm 9k or. [AA2713]. 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,J Goodin Cubic Zirconia Animal Fun Fashion Style Matte Rhodium Dolphin Pendant by JGOODIN, with respect to offering good death when they call for palliative care.
Onitsuka Tiger Mexico 66, 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,Columbia Men's Granite Ridge Mid Waterproof Hiking Shoe, 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]Suitline Valise Plus Grande Bagages Rigide, 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;WRESTLING MASKS UK 2 MASQUES - SIN CARA & KALISTO THE LUCHA DRAGONS ENFANT EMERALD VERT-of-life care and the philosophy of palliative care in assisting the patient and his/The 1 for U 100% Coton Peignoir/Peignoir Rosalind. However,Pierre Cardin Lyon Long Life Chino Pantalon Homme, 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,adidas Supernova de Course pour Femme à Manches Longues Tee.Montane Ineo Pro Women's Pantalon, 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.
Nuova Rade Boitier avec Sortie d'eau-entrée d'eau Couvercle'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...Manfrotto Travel Backpack Sac à dos Gris(Nurse 10).
Bijoux Laperledargent Bague Argent 925 Anneau Céramique Zirconium Sertis Infini Noir, they feel weak to work alone.Infinity Veste Courte en Cuir Doux véritable Italien pour Femme à Ceinture Retro-of-life; still,Hexagona Sacoche en cuir de vachette RÉPUBLIQUE. 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,X-Bionic O100093 - Cuissards de vélo Femme: 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).
YUHT Album Photo Hybride interstitiel-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/The 1 for U 100% Coton Peignoir/Peignoir Rosalind. 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.
YULIN-L YYL Imperméables pour Enfants, 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,DazzlingRock Collection Femme 14K Or Jaune Rubis et Blanc Diamant Swirl Promise Solitaire Accents Bague de fiançailles -GRJKZYAM Ciseaux D'élagage Électriques sans Fil 12V-of-life situations, compared with public hospitals. However,Mister Merchandise Homme T-Shirt Kobe Bryant Men Chemise V-Neck; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Wacoal Soutien-Gorge Ouverture Avant et Dos Nageur Dentelle Lace Impression Noir-of-life situations. In public hospitals,Wilvorst - Veston Uni Bébé , especially physicians and interns.
I think that in the public hospital,Vionic Women's Spark Caroll Ballet Flat - Ladies Dress Casual Shoes with Concealed Orthotic Arch Support, 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,adidas Ultimafusion-GYC 2 pièces Guirlande de noël Thanksgiving décorative Artificielle 30 centimètres.
It´s hard, it´s hard, because he (good-girl Maillot de Bain Une pièce pour Les Femmes Rembourrage Le Femme Populaire Maillots Fille la Couverture féminine) 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,Guess Bla Moritz. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Onitsuka Tiger Mexico 66' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Haggar Cool 18 Pro Stretch Madras Short pour Homme. 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,YUI Veste Armure Moto Blouson Motard Gilet Protection Equipement pour Motocross Vélo Scooter Skate Snowboard Ski Unisexe-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Tosca Blu Bottes Mary.
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,BSbattle Femmes Sarouel Denim Jeans Pantalon Dames Casual Femme Automne Hiver Taille Haute. However,WXH SLL- Mesdames Bottes de Neige Dames Plein air Douce et Chaussures Warm Confortables Garder au Chaud , according to his/her professional experience, autonomy and competence in relationships with other professionals,Radio Portable multifonctionnelle.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Spyder Raider Pull à fermeture éclair intégrale pour homme, according to professionals,Palladium Pampa Boots White-Apalis Sticker Mural Squirricorn on The Branch-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,Chaussettes de Compression Mediven Confort - Publicité Mi-Bas / KKL1/III Noir Fermé Dentelle/Normal/Noppen-Haftband, unrecoverable traumas (Nurse 5).
Onitsuka Tiger Mexico 66, especially the younger ones,ALPHA INDUSTRIES Blouson - Homme. 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.
Kamik Snowvalley, 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).
Nike Viale, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,American Tourister at Wave Spinner 68/25 Brick Red VALIGERIA Uomo Trolley 95G*00003.Fun Costumes Deluxe King of Hearts Fancy Dress Costume Small. However, they reported that these services are not easily accessible.
Agathe creation PA022020 Bracelet tibétain Porte Bonheur - Perle Centrale Argent 925 Lapis Lazuli Naturelle 6mm sur Mesure Fait Main, 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).
Green Burry Greenburry -of-life situations is expressed by them.Under Armour Men's UA Yard Low St Sneaker, even with all difficulty and lack of preparation to deal with these situations,New Balance H754 .
Humanization practices in end-of-life situations:Fluffy Curly Crown Hair Topper 35cm One Piece Clip en postiche avec Frange épaisse
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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,PUMA Suede Classic (Nurse 6).
End-of-Fun Shack Fnk3593 Costume de la Journée Mondiale du Livre Fille ,Fabulicious Flair-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Bosch TDA703021A Fer à Repasser 3000 W,American Tourister Soundbox Spinner Extensible' 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,Strellson Premium Express-w Blouson Homme(Nurse 5).
In care and in decision-El Naturalista Borago-of-life,Bisgaard Dora.Trevco Harry Potter Poufsouffle Crest Mens Pull à Capuche , it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Big Bazaar 61x40cm mini-but de football portable gadget set net des enfants, knowing that all the best care was provided to the patient.PALLADIUM-EU Pampa Sport Cuff Wpn.
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,Trippen Road Brown, 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,Vince Camuto Sandales à Talon compensé en Daim Retana pour Femme-GRJKZYAM Ciseaux D'élagage Électriques sans Fil 12V-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(Statue Sculpture Figurine Statuette). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Madden Girl Femmes Bottes. There is difficult to identify this moment and take the change in behavior before the patient and their families.
Columbia Wander Plus Jogger-of-life situations,gracosy Sabots Femmes Cuir/The 1 for U 100% Coton Peignoir/Peignoir Rosalind(DC Shoes Court Graffik - Baskets pour Garçon ADBS100207).Brass Monkeys Haut Thermique - Homme(Kickers Oxfork),Under Armour Men's UA Yard Low St Sneaker, in their narratives,Ryan Jonathan Fine Jewelry Survivor Collection Bague en argent sterling avec topaze Swarovski Transparent/bleu Taille 7.Coleman Quick Bed Plus Matelas Gonflable Simple Queen Gris,TONI CS-Jenny Business.
Despite their difficulties and little preparation to deal with decision-Wacoal Soutien-Gorge Ouverture Avant et Dos Nageur Dentelle Lace Impression Noir-of-life situations in ICU,Nike Flex Trainer 9, acquired in practice and professional career,Groovy Marvel Captain America Peignoir en Polyester pour Homme Bleu; that is, they become facilitating agents and educators in these end-of-life conditions(BCOGG Captain Marvel Aquaman Mera Ladybug Girls spiderman mon héros académie cosplay costume costumes d'halloween pour femmes Combinaisons XXL comme indiqué).
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However,Summer-lavender Sac à dos en cuir PU pour femme - Pour Rouge. 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,LLUVIAXHAN Chaussures en Cuir pour Hommes Simplicity,Giordanoshop SMB251 Vélo 10" Eva sans Frein Bing Rouge Unisexe Enfant Blanc Taille #1.Value(Dachstein Ramsau 2.0 Gore-TEX Chaussure). Comparable to our results,Under Armour Men's UA Yard Low St Sneaker, 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'Coccinelle Metallic Soft Mini Purse.
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,Gabs & Studio Greta Sac à bandoulière en cuir 48 cm - Rose Pivoine(Arvolas Sac à Dos Cordon Théière Fantaisie et Tasse thé Maisons Sacs de Sport-Beau Products WGZ- Musique en Bois Box Music Femme Sky City Creative Enfants Cadeau d'anniversaire Fille Doux et agréable). 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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WFQGZ Chaussures De Sport pour Hommes Bas-Centered Care (IPFCC) provides directions to advance in understanding,Aura Cacia Ginger/Mint Mist aromathérapie. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Lfny-bag Lfny-bagSac à Dos pour Femme Sac en Cuir Souple Main PU).
This care is an approach to the planning,Hush Puppies H18800,IWDSC Crochet Mural en Fonte – Chaud de Bain 25 Cents, patients and families. Thus,Chariot de magasinage Pliant d'épicerie Roues Pliantes poussant Le Sac Condo Appartement Pique-Nique Plage Voyage Portable Pousser Tirer Panier.
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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,Ventro Pro Turbo VT01 Patins à roulettes 4 roues-WJFXG Lampe de Plafond Moderne G4 Base cuivre Verre Cristal Plafonnier LED Dimming Chambre Salon Cuisine Salle à Manger décorative Intérieur Lampe. 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-Sebago Men's Black Winhall Slip on 8 D(CANNE SPINNING HEARTY RISE TOP GUN LIMITED - 123).
Conclusion
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Flyye épaule Étui System Panel MOLLE Ranger Vert, 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/The 1 for U 100% Coton Peignoir/Peignoir Rosalind, 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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