"When it's over, it's over": the characterization of death in an intensive care unit in Rio de Janeiro

The intensive care unit was created to care for seriously ill patients who are at risk of death. For this purpose, it provides uninterrupted medical and nursing care, with specialized human resources and access to sophisticated diagnosis and therapy equipment in order to maintain life. This article presents a reflection around the different possibilities for the dying process in an intensive care unit, based on ethnographic research at a university public hospital in the city of Rio de Janeiro. Despite having frequent contact with the dying process, in certain situations some intensivists demonstrated tension and/or difficulty accepting death, especially in cases of "sudden death". In this type of situation, some professionals expressed feelings, especially those who had been in contact with the patient for a longer period of time. As for "expected death" situations, professionals are expecting the event and are thus less affected by feelings. Since the unit's routine must not be disrupted, strategies are constructed and activated to deal with these situations. This study revealed the use of humor, including euphemisms and jokes, to relieve any tension that may establish itself in the intensive care unit environment, where death is an everyday occurrence.

intensive care; emotions; life/death; death; cardiorespiratory arrest