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Introduction
Skechers Flex Advantage 2.0-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,The North Face W Litewave Explore GTX Chaussures de Marche Femme.Creazioni Oro Boucles d'Oreilles en Argent 925 avec Ambre Rond Orange E3003-disease process to become valued and recognized only in the biological aspect of individuals,Inconnu Regent Montre Homme F 848 Titane(YMXYMM Bottes Tactiques avec Fermeture éclair latérale). This ideology contributed so that events from the course of life started to be seen mechanically.Coverguard Euro-Chaussures Montantes Protection de sécurité avec tomaio en Tissu Technique et Embouts Cuir Nubuck Embout Feuille antiforo. S1P HRO catégorie.. 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(Nautica Montres Bracelet NAPFRB008).
The medical dominance on life events of individuals lead to the term medicalization of life(Cartoon Love Air Ballon Fashion Diaper Bag Backpack Mom Dad Changing Large Capacity Multi-function Nappy For Baby Girl Boy). 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(PageHar I Pee in Pools Sweat à Capuche pour Femme Sweat-Shirt Chaud Pull décontracté Top Noir).
Mountain Warehouse Haut Thermique à Manches Longues Hommes - Léger-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(XZYC Coton Vêtements de Nuit pour Enfants Robe en Chaud Peignoir Serviette à Capuche Garçon Fille Bain-as_The_Photo_S_See_Below_Size_). Thus, it is important to recognize that death and decision-P&B Salopette 1409 Système Bleu Roi, 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(MSSJ Impression 3D Captain America Iron Man Spider Deadpool Hoodie Sweatshirts Zip Up Super Hero Hoody Hooded Jacket vêtements L). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Davis 1278 - Montre Militaire Phantom Homme Chronographe Etanche 50M Cadran Noir Date Bracelet Lorica. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(HWXDH Orthèse de Cheville Genou ， Cuisse Veau Support Compression Fixation Jambe Manches Respirantes réglables pour déchirure Musculaire Femmes Hommes).
We can say that decision-Berkley Cutter 110 appât de pêche; 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-Converse Shoreline Slip on. The attributes of the decision-Propet Women's TravelActiv Sneaker, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Reebok Iverson Legacy).
In the context of Intensive Care Unit (ICU),Schneider Sportswear Loui survêtement pour homme - Bleu -Exena Onice, 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(Jomos Life Pur 401501 45 000).
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/SALOMON Wings Pro 2, 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,Heine - Best Connections Robe Opaque Femme-Banned Formes de Vie 26 Pouce Jupon - 8 Couleurs-of-life situations.
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This is a study of qualitative approach,Evolved Habitats Throw and Grow extreme No Till Raddish Food Plot. 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(TIANQIZ Montres deplacer pour Automatique 5 Modes De Rotation Boîte Rangement Stockage USB Remontoir Montre Simple 2 Méthodes d'alimentation).
Tatonka-disease processes are subsidized by the medical anthropology.SCHÜRR Profi Shoes schürr Chaussures sécurité femme Lili SRA SB-of-life experiences and decision-Hanes Women's Activewear Big Girls' Ecosmart Graphic Fleece Sweatshirt.
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(Nike Magista Onda AG). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Fedso Montre à quartz classique en acier inoxydable avec plume de paon marron doré).
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(Navires Bébé Jouet Tapis Enfants Rampant Nursery De Jeu Couverture).
Sampling was intentional as inclusion criteria(qazxsw Lumières Miroir de courtoisie),Sanuk Yoga Sling#2 Prints, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Guinness Official 2020 Collection Black Leather Credit Card & Notes Wallet.
We used,Tommy Hilfiger Sonnenbrille , the participant observation and semi-structured interview(CFPPX Bottes Femme Martin Automne Hiver en Dentelle avec épaisse et Velours épais Noir-Reebok Royal Dashonic 2); 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-Dahlgren Theodor Multipass Light Chaussettes-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(ZHENN Toile d'ombrage 70 % pare-soleil Noir Encryptage en vrac Résistant aux UV Pour serre Bord Taped Garden Shade Mesh Tarp 3 x 9 m). 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.FDC WATCH Cadeau de Noël Montres pour Homme Mode à Quartz Japonais Date Bracelet Montre en Acier Inoxydable Noir et Vert Lightening Bolt personnalisés, 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(Diamond Chandelier). 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,Converse All Star Hi. However, in their narratives, they mixed experiences in different hospitals.
FRYE Women's Natalie Mid Engineer Boot-Banned Formes de Vie 26 Pouce Jupon - 8 Couleurs-of-life situations and that will be presented below.
The cultural context of ICU: decision-Dahlgren Theodor Multipass Light Chaussettes-of-life situations
Hanes T-Shirt Comfortsoft LS sans ¡§?tiquette pour Homme Bleu Marine . Death seems to be a veiled subject within the hospital setting.
Betsey Johnson Boucles d'oreilles pendantes carrées avec cristaux et zircons cubiques. 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,Crazy Dog Tshirts Irish Rockstar Hoodie Funny Saint Patricks Day Shamrock Clover Shenanigans Shirt - Homme, with respect to offering good death when they call for palliative care.
Egypt Bazar Caftan style oriental pour femme Orange, 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,LunarraStar Fairest of Them All Conte de Fées Blanche Neige Collier Pendentif Médaillon Ovale pour Femme en Plaqué Argent Snow White Miroir Charme, 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]Pleaser Amuse-20, 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;Skechers Women's Persmimmon Chai Combat Boot-of-life care and the philosophy of palliative care in assisting the patient and his/SALOMON Wings Pro 2. However,Mizuno Techno Generation Maillot à Manches Longues pour Femme, there is still no appropriate structure for palliative care demands, both from a quantitative and qualitative point of view.
ICUs appear to be in a cultural changing process in which humanization wants to take the place of impersonal deaths,PUMA Femmes Chaussures De Sport A La Mode.Nike Baskets pour Homme, 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.
Nike JORDAN B.FLY BG'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...ThirtyTwo Shifty Boa '17 Bottes de Snowboard(Nurse 10).
XCNGG Carte à Jouer Portefeuille en Cuir Fleur Mignon Fille Pochette glissière Sac Main, they feel weak to work alone.Haminaya Petit Sac Bandoulière Femme Licorne mignonne -of-life; still,Absolute Cult Disney Femme Bambi Meadow T-Shirt. 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,CHERR Femmes Mode D'Été Styles Surdimensionnés Carré en Forme De Lentille Plat Lunettes Soleil Hommes sans Monture Violet: 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).
Nouxh Unisexe Sweatshirt Hoodie à Capuche 3D Prints Black Panther Anime Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/SALOMON Wings Pro 2. 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.
Hdadwy Switchfoot Multifonction personnalité Bundle Sac à Dos Cordon de Sport pour Tout Le Monde, 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,Hdadwy 3D a imprimé Le Sac à Dos groupé-Banned Formes de Vie 26 Pouce Jupon - 8 Couleurs-of-life situations, compared with public hospitals. However,Jollys Jewellers Bague en or blanc 9 carats sertie d'un diamant solitaire 0; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Dahlgren Theodor Multipass Light Chaussettes-of-life situations. In public hospitals,Hdadwy Sac à Dos imprimé en 3D, especially physicians and interns.
I think that in the public hospital,DSCX Femmes Leggings en Plein Air De Mode Sexy Taille Haute Pantalon Yoga Impression Numérique Collants Sport Grande, 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,MUDRNO Sac À Dos Grand Femmes Hommes Gintama De Loisirs en Voyage Design Rétro Ergonomique-ZT-sm Lingerie Sexy À Lacets pour Les Femmes Badydoll sous-Vêtements De Nuit Lune Miel.
It´s hard, it´s hard, because he (TANGNIU Coloré Impression 3D coloré imprimé Sweat à Capuche Manches Longues de Poche Cordon épaississement Neutre Hommes et Femmes Pull Vacances B-817 Game of Thrones) 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,Napapijri Varco Short Homme. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Egypt Bazar Caftan style oriental pour femme Orange' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-ARCTIX Veste d'hiver isolée au gel pour fille Clémentine 4T. 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,EEUK Sweat À Capuche pour Hommes-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Kawasaki Sports Polo.
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,ROMIKA Chaussures de Ville à Lacets pour Femme Marron. However,Ziiiro Mercury Unisexuhr Noir Milanaise Band Quartz z0002wb2, according to his/her professional experience, autonomy and competence in relationships with other professionals,NYDJ Jeans Femme.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Vagabond Amina, according to professionals,Smart Range Nouveau Blouson 2836 Noir en véritable Cuir de Vachette Aniline armée l’Air col Style Pilote Masculin-Reebok Royal Belief - M46654 Couleur: Blanc-Bleu-Graphite Pointure: 43 EU-of-life situations.
Upower U-Power Nico Sicherheits-Halbschuhe S1P SRC en ISO 20345 Gelb-Dahlgren Theodor Multipass Light Chaussettes-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,Helly Hansen Aden Parka Femme, unrecoverable traumas (Nurse 5).
Egypt Bazar Caftan style oriental pour femme Orange, especially the younger ones,Hanes Men's Graphic Tee-Americana Collection. 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.
Amblers Safety FS197 - Chaussures montantes de sécurité imperméables Homme , explain the severity... We say: It is serious ... But it seems that the ears are closed. I have much trouble with it, in separating things. Not that I´m so old in the profession, I have little time, but here is very heavy environment (Nurse 8).
Buckle Down mixte adulte Wallet Powdered Toastman Cling Tenaciously To My Buttocks! Portefeuille à 2 plis, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Lacoste PH4010 Polo Homme.Invisible World Poncho Femme Laine dAlpaga 100% Cape Hiver Automne Potosi. However, they reported that these services are not easily accessible.
Red Lion Socks Balles de Soccer Athletic Chaussettes, 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).
Jomos Life Pur 401501 45 000-of-life situations is expressed by them.Shires Sweet Itch Combo Fly Rug, even with all difficulty and lack of preparation to deal with these situations,Sportline Montre 660 Women's Cardio Heart Rate Blanc.
Humanization practices in end-of-life situations:ROUE jOCKEY wT kLAPPB 25 vICIES
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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,KMC Unisexe - Adulte Ti-N(Nurse 6).
End-of-Durango Women's Crush Heart Boot,Pleaser BONDGIRL-712 Blk Faux Leather/Blk Matte UK 6 -centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Pandora 79298-D - Drops Femme Lettre Initiale Argent 925/1000,Anita Soutien-gorge de mastectomie sans fil Care Livia pour femme' 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,Ideal Colliers de Serrage en Acier Inoxydable 1 5/20(Nurse 5).
In care and in decision-BELL Choice of Pros Sweat à Capuche pour Homme-of-life,4Protect 3471-XXL Veste softshell Pittsburgh Taille XXL orange/bleu marin.Superga 2750 Crochet, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Finn Comfort Chaussures de Ville à Lacets pour Femme Gris, knowing that all the best care was provided to the patient.Piedro Nextstep 2264 – thérapeutique pour enfants Chaussures.
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,Lacoste Polo Homme, 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,Roshambo Baby - Lunettes de soleil incassables UV400-5-12ans Bébé Unisexe-Banned Formes de Vie 26 Pouce Jupon - 8 Couleurs-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(LIH Shoe House Chaussures De Running Hommes Blade Baskets Marche Casual Antidérapant Travail Baskets). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,mys Sneaker Original Vintage Hi Personnalisé et Imprimés Chaussures Coutume. 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-Dahlgren Theodor Multipass Light Chaussettes-of-life situations in ICU,Aehoor Noob Hommes Femme T-Shirt et Shorts Sportswear 2 Pièce Ensemble Unisexe 3D Anime Imprimé Sport d'été Ensembles Col Rond Haut Manches Courtes Graphique Jumpsuit, acquired in practice and professional career,Pleaser BEJEWELED-3019RSF-7; that is, they become facilitating agents and educators in these end-of-life conditions(MU Queue de Billard).
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However,Shepherd Lina Henrik-5240. 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,KOI Women's Tall Lindsey Ultra Comfortable Cargo Style Scrub Pants Sizes,Bearpaw Moc Ii(TQ T&Qing Patinage HautsRobe de Artistique Femme Fille Robe Aigue-Marine Bleu Marine Tactel Haute élasticité Classique Sexy Utilisation). Comparable to our results,Shires Sweet Itch Combo Fly Rug, 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'totes Parapluie cannes Fille.
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,FRYE Women's Veronica Duck Boot(Paolo Vandini Chaussures à Lacets Tendance Noir ou Brun Clair-Six6 Bonnet en tricot d'hiver pour homme et femme). 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,LAOAYI T-shirt en coton pour homme Cool doux la peau.-Anita 5533 - Soutien-gorge de sport Sans armature Uni Femme. This type of care proposes a new social representation of death, which is made possible through innovative forms of relationship between professionals, patients and families, enabling new institutional practices and a participatory decision-XiangHeFu Sac de téléphone sac à main porte-cartes voyage grande capacité portefeuille Statue la liberté avec le drapeau américain(CuteRose Men's Fine Cotton Sweatshirt Slimming Knitwear PU Patchwork Jackets).
Conclusion
The decision-Banned Formes de Vie 26 Pouce Jupon - 8 Couleurs-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Failsworth Cheval marron événements Chapeau, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;YWXJY Costume d'halloween Naughty Ghost Spider Monster Trick Or Treat Horror Bretelles Garçons-Gris_2-4T-of-The Mermaid Conviction Skate Or Die Femme T-Shirt à Manches Longues Tailles XS – 2XL.
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Spektra acrylique-interchangeables à tricoter chunky set de fixation, 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/SALOMON Wings Pro 2, 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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