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Most patients who die in the intensive care unit do so after a withholding or withdrawing of life sustaining treatments (WWLST) decision. The implementation of formalized interdisciplinary team meetings for ethical deliberation in the ICU may improve nurses participation in WWLST decisions. The investigators decided to implement such team meetings in their ICU. At this occasion, the investigators will measure job satisfaction, job related frustration and ethical decision making climate climate.
Most patients who die in the intensive care unit do so after a withholding or withdrawing of life sustaining treatments (WWLST) decision. Because those decisions are value-laden, guidelines as well as french regulations recommend that they should involve not only medical doctors but also nurses. Despite that, nurses' involvement remains incomplete. Poor collaboration between doctors and nurses on ethical decisions is associated with job dissatisfaction, burnout and desire to quit. The implementation of formalized interdisciplinary team meetings for ethical deliberation in the ICU may improve nurses participation in WWLST decisions.
For those reasons the investigators decided to implement such team meetings in their ICU. At this occasion, the investigators will measure job satisfaction, job related frustration and ethical decision making climate climate.
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| Measure | Description | Time Frame |
|---|---|---|
| Change in nurses perception of ethical decision making climate in the ICU | Nurses answers to the questionnaire "Ethical Decision-Making Climate Questionnaire (7 factors evaluated, for each factor score ranges from 1 to 5, higher scores indicate a better climate)". | june 2023, january 2024 |
| Measure | Description | Time Frame |
|---|---|---|
| Change in nurses psychological well being at work | Nurses answers to the Index of psychological well being at work (5 factors, for each factor score ranges from 1 to 5, higher scores indicate more well being). | 2 evaluations: may 2023, january 2024 |
| Change in nurses frustration of job's related psychological needs |
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Inclusion Criteria:
Exclusion Criteria:
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All patients admitted in the ICU
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| Name | Affiliation | Role |
|---|---|---|
| ROMAIN MIGUEL MONTANES, MD | University Hospital of TOURS | Principal Investigator |
| Servane Barrault, PhD | University of Tours | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Trauma and surgical intensive care unit, Tours University Hospital | Tours | 37000 | France |
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| ID | Term |
|---|---|
| D033262 | Narration |
| ID | Term |
|---|---|
| D003142 | Communication |
| D001519 | Behavior |
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Nurses answers to the Job related psychological needs frustration score (3 factors, for each factor score ranges from 1 to 5, higher score indicate more frustration) |
| 2 evaluations: may 2023, january 2024 |
| Change in nurses desire to leave | Nurses answers to a one question questionnaire: "I have thoughts about leaving my current position/job" (lickert scale, score range from 1 to 5, higher score indicate a higher desire to leave) | 2 evaluations: may 2023, january 2024 |
| Non beneficial care | Duration of mechanical ventilation in patients who ultimately die (number of days) | January 2024 |