Nutrição artificial em fim de vida: a tomada de decisão pelo enfermeiro

This report seeks to describe the formative course of acquisition and development of specialized skills in Medical-Surgical Nursing. It was framed in a training plan of the Master’s in Nursing of the Universidade Católica Portuguesa, Instituto de Ciências da Saúde. The training process involved the development of a traineeship in three different contexts, having in common the hospital space: General Emergency Service, Emergency Medical Car and Reanimation; In-hospital Support Team in Palliative Care, Home Support Unit and Intensive Care Unit. Thinking about the personal and professional development desired in the construction of a specialized care intervention was assumed the central and transversal theme: Artificial Nutrition at the End of Life: Nurses Decision-Making. This was addressed in a reflexive and critical process supported by Afaf Meleis and her Theory of Transitions and the Evidence-Based Practice Model by Mary Rosswurm and June Larrabee, as well as the contributions of an integrative review of the literature. Considering the palliative care philosophy in promoting comfort and quality of life in a period of transitions (Meleis, 2010), the nutritional deterioration means the proximity of death (Alves, 2013) so a multistep approach was developed: the construction of thematic file on artificial nutrition; the creation of a protocol for approaching end-of-life feeding; the development of training on the evaluation criteria of the person with artificial nutrition at the end of life and the design of an information poster on the same subject. This report presents the whole course of development considering the basic scientific component of the activities developed and contextualizing them throughout the three stages of the internship by explaining the defined objectives, reflective description of the activities developed and competences mobilized around the central theme.