The Zentensivist Manifesto. Defining the Art of Critical Care

Dying to be better: Outlining the growing benefits of palliative care training in intensive care medicine

A core part of an intensivist's work involves navigating the challenges of End of Life Care. While rates of survival from critical illness have gradually improved, 15%-20% of our patients die during their hospital admission, and a further 20% die within a year. 80% of our patients lack capacity to express their wishes with regard to treatment escalation planning. The critical care unit can be an excellent place to provide a good death, however the very nature of critical illness provides some obstacles to this. Prognostic uncertainty, time-pressured critical decision making, and lack of meaningful contact with a patient and their loved ones are but a few. In this article, we compare the ethos of critical care and palliative care medicine and explore how training in both of these specialities could be brought closer together and more formalised such that the intensivists of the future are more strongly equipped with the skills to shape a critical care unit to overcome these challenges and provide the best care to these patients, many of whom may be in the final phase of their life.

Transpersonal Caritas Relationship: A new concept from the unitary caring science framework of Jean Watson

Objective

To analyze deeply the concept of the transpersonal caring relationship as the core of the theory of Caring Science proposed by Jean Watson. To present a historical evolution and to introduce the Transpersonal Caritas Relationship construct.

Methods

Methodological Study to support the central concept measured by the Watson Caritas patient instrument. We designed a focus group with four nursing scholars to develop the "Transpersonal Caritas Relationship" construct. We recount the history of the concept of the transpersonal caring relationship, then analyze this concept in terms of Watson's theory. We reviewed the concept with Dr. Jean Watson, presented her with the construct, and discussed our considerations.

Results

This article introduces a transitional adaptation of the concept of transpersonal relationship to Caritas' transpersonal relationship. Transpersonal Caritas Relationship is the foundation of evolved Caritas nursing, recognizing that mutual caring affects the universal field we all belong to Caritas' consciousness and action affect the energy field when the nurse relates with the other, making it possible to awaken the compassionate heart, which is the foundation of Evolved Caritas Nursing Universal love and in this way evolve to the Caritas consciousness that allows recognizing the other with loving kindness in the practice of careful. This is the proposed central concept measured in the caring approach using the Watson Caritas Patient.

Conclusion

This article introduces a transitional adaptation of the concept of transpersonal relationship to the Caritas transpersonal relationship, which is the foundation of Caritas Evolved Nursing.

Military Soft Skills Applicable to the ICU

To describe how soft skills acquired during military service can be applied to the practice of critical care medicine.

DATA SOURCES

A systematic search was performed in PubMed.

STUDY SELECTION

We selected all studies that addressed soft skills in medicine.

DATA EXTRACTION

Information present in published articles was analyzed by the authors and incorporated in the article if relevant to the practice of critical care medicine.

DATA SYNTHESIS

Integrative review of 15 articles combined with the authors' clinical experience practicing military medicine in country and overseas while also practicing academic intensive care medicine.

CONCLUSIONS

Soft skills used in the military have potential applications to modern intensive care medicine. Teaching soft skills in parallel with the technical aspects of intensive care medicine should be an integral part of critical care fellowships.