Bibliographic record
Abstract
Discontinuing life-sustaining interventions requires an artful skill perhaps even more challenging than providing life-sustaining treatments. Critical care nurses require advanced skills to provide comfort care and, ultimately, a "good death" that encompasses the family and patient. Educational focus has been placed on maintaining the living, but with increasing palliation in critical care, education must include comfort care. This article focuses on the art of discontinuing life-sustaining treatment and providing a seamless, comfortable transition for patient and family. Included in it are seven steps, derived from my own experiences, that are meant to assist new practitioners in their beginning journeys of providing a "good death". The seven steps are interconnected and, depending on the context, will flow back and forth, as needed. The seven steps are: talk with the family, ensure orders are written, prepare drugs, to extubate or not, what about the monitor, ensure readiness, and proceed.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.025 |
| Meta-epidemiology (narrow) | 0.002 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.005 | 0.003 |
| Scholarly communication | 0.003 | 0.005 |
| Open science | 0.002 | 0.005 |
| Research integrity | 0.007 | 0.011 |
| Insufficient payload (model declined to judge) | 0.021 | 0.008 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".