MUERTE Y MORIR: COMPRENSIÓN, ACEPTACIÓN Y BARRERAS DEL EQUIPO DE ENFERMERÍA DEATH AND DYING: UNDERSTANDING, ACCEPTANCE AND BARRIERS OF THE NURSING TEAM MORTE E MORRER: COMPREENSÃO, ACEITAÇÃO E ENTRAVES DA EQUIPE DE ENFERMAGEM

s, incomplete texts, theses, dissertations, monographs, technical reports, and other forms of publication other than full scientific articles. Also excluded were 45 unavailable articles, 51 articles outside the time frame, 06 studies not conducted with humans, 12 duplicate articles, and 74 did not meet the guiding question. The analysis for selection of studies was carried out in two phases, namely: in the first, the studies were pre-selected according to the inclusion and exclusion criteria and according to the search strategy of each database. Thirty-eight (38) studies were found as a general search in the BVS, and limiting the search to full-text articles carried out with humans in the last 10 years, twenty-six (26) studies were found. In the PUBMED database, the total search found one hundred and sixty-two (162) studies, applying the filter that limits the search by full text of the last 10 years with humans, seventy-two (72) studies were obtained, titles and abstracts were analyzed and the final result was two (02) studies. In the second phase, the studies were analyzed for potential participation in the study, evaluating the fulfillment of the research question, as well as the type of investigation, objectives, sample, method, outcomes, results and conclusion, resulting in twelve (12) articles. In the end, 12 articles met the guiding question and were added to the study. We opted for an analysis in statistical form and in text form, using mathematical calculations and inferences, which will be presented in charts to facilitate visualization and understanding. The research took into consideration the ethical aspects regarding the citation of studies, respecting the authorship of the ideas, concepts, and definitions present in the articles included in the review. The scientific evidence was classified according to the levels and degrees of recommendation of the study proposed by the author.

The training of professional nurses is of paramount importance, some authors cite that unpreparedness in academia brings out the negative feelings towards death. In this sense, the exclusion of the theme of death during the training process of health professionals makes them unprepared to deal with the situation. Most of the academic training is focused on the process of preserving life and curing diseases, identifying a gap in the knowledge of these professionals (2) . Therefore, it is essential for health professionals to understand and learn about the concepts of death and dying, so that during nursing care they know how to deal with the situation. It is known that most professionals bring to their assistance religion as a strong instrument for the acceptance of death, to become an explicable fact (3) .
The difficulty in facing the death/death process is almost inevitable, especially when the experience is with the death of the "other" who is being cared for, along with the accompaniment, sometimes of the terminal phase and the permanence of the family facing this reality generating feelings of helplessness, discomfort, pain, anguish, emotional fatigue and fear, requiring extensive psychological effort from those who provide care for someone who is dying (4) .
The present work is justified by the issues inherent in the process of death and dying that

METHODS
The present study is a bibliographic research of the integrative literature review type.
This procedure was chosen because it allows the synthesis and analysis of the scientific knowledge already produced on the theme "Death and dying: understanding, acceptance and obstacles of the nursing team". This review used the methodology proposed in the study by author (5) . The PICo strategy was used, which is an acronym for Patient (P), Intervention (I), Context (Co), through the guiding question: "What scientific evidence points to the understanding and acceptance of the process of death and dying and the obstacles encountered by the nursing team in this process? After this process, the following descriptors were found: "Death", "Understanding" and "nursing care".
The BIREME databases were used, finding 38 results, filtering 26 and selecting 10, and PUBMED, finding 162 results and selecting only 02. The terms used during the search were classified and combined in the databases, resulting in specific strategies for each database, as shown in Chart 1. and conclusion, resulting in twelve (12) articles.
In the end, 12 articles met the guiding question and were added to the study. We opted for an analysis in statistical form and in text form,

RESULTS
Of the twelve studies included in this review, eight (08) were in Portuguese (66.

BIREME
The process of death and dying for intensive care nursing staff. Author (7) Case control/ Evidence level 4.
Describe the perceptions of team from intensive care center nurses abot the process of death and dying and its implications for nursing care.
It was possible to discuss the perceptions of nursing professionals about the process of death and dying and show that despite the emergence of negative feelings about death, there were no major repercussions on the care provided by them. Thus, the study obtained a grade B recommendation.

BIREME
Process of die at Unit Intensive Care (ICU) pediatric.
To discuss how professionals deal with the process of death and dying, and to identify the the impacts caused in the assistance in intensive care units pediatric.
The participants answers evidenced how the nursing professionals feel during the process of death and dying, such as difficulties in living with the patient and the family, helplessness in the face of death/acceptance, acceptance of death already expected, sadness and anguish, difficulties in expressing the feelings, the understanding of the cause of death differs at each professional level and also affects the work climate. The death/death process is extremely painful, both for the grieving family and the professionals who deal with the situation on a daily basis. The results indicated a degree of recommendation B.

BIREME
Nursing professionals' perspective on death in the emergency room professionals nursing on death in Author (9) Series of cases/ Evidence Level 4.
Know perspective of nursing professionals, who work in the emergency room, about the process of death and dying.
The professionals understand that death is part of the process of living, but feel sadness, frustration and helplessness, especially when the patient stays longer in the emergency room. The study indicated grade B recommendation. emergency. d profissionais de enfermagem sobre a morte na emergência 4 BIREME Child with cancer proces of dying and its family: the nursing team's face of the nursing staff.
Describe the specifics of nursing care and the team's performance facing the child with cancer in the process of dying and his family.
It was evidenced that death is understood as a loss and sometimes a relief. The team has difficulty in experiencing the child's dying process and establishes coping strategies such as not letting the child die alone, separating the professional from the emotional, neutralizing feelings and never showing weakness. The nursing team presents difficulties in dealing with the death of the child with cancer in the process of dying and supporting the family. Obtaining a degree of recommendation B.

BIREME
Terminality of child life: perceptions and feelings of nurses Autor (11) Series of cases/ Evidence Level 4.
To understand the perceptions and feelings of professional nurses when facing the process of infant death and dying.
Besides the difficult acceptance, confrontation and assimilation of the finitude of infant life by nurses, nursing care is essential at this moment.
The emotional unpreparedness of nurses and the lack of support, both in academic training and in their continuing education, as well as the lack of therapeutic support in health institutions to deal with the situation. Identified grade of recommendation B in the present study.

BIREME
The Meaning the death of the surgical patient experienced by team nursing staff.
Understand the meaning of death of the surgical patient on everyday life from team from nursing.
Even though being considered a However, the feelings of the team that takes care of the surgical patient's recovery can be both of relief from suffering and of fulfillment of their competencies. Having grade B for study recommendation. Nursing Assistants (CNAs) who reported that their resident was "aware of dying" or "in pain" expressed higher levels of emotional and informational preparation. CNAs who endorsed an end-of-life care preference of wanting all possible treatments, regardless of the chances of recovery, were likely to report less emotional preparation. The more gentlemanly CNAs, with respect to both age and tenure, reported higher levels of preparedness. Greater support from co-workers and involvement in palliative care REVIEW ARTICLE information.

PUBMED
were also associated with higher levels of both facets of preparedness, the latter in particular when palliative care was viewed positively by the CNA. Thus, the study was rated B for recommendation.

BIREME
Meanings attributed by the pediatric ICU nursing team pediatric ICU to the process of death and dying.
To understand the feelings experienced by nurses when facing the death of pediatric patients.
The results showed that facing death is a delicate situation, requiring a cautious approach that considers the needs of all involved: child, family and team. It was evident that the theme of death remains little explored and discussed during professional training and that the organization of specific support services in institutions could contribute to a more qualified attention in these contexts. Therefore, obtaining a grade B of recommendation.

BIREME
Experiences of nurses facing death in the ICU Neonatal.
Know the experiences of nurses regarding to process dying/death process from child admitted to the neonatal intensive care unit.
From the analyses of the interviews, three categories emerged: The conflict between the idealized and the experienced for feeling that one has failed and for professional failure, for thinking that he was not competent. The experience of negative feelings such as fear, guilt, sadness and others; The sharing of the death process with the family, sadness at the suffering that death will generate in them. It was possible to verify that this unit is a critical place for the professionals who work there in the daily coexistence with the limit between life and death.
The study indicates recommendation grade B for research. Author (17) Literature Review/ Evidence Level 5

Reactions
Analyze in articles published in Portuguese and Spanish how nursing experiences process of dying and death in the ICU.
The ICU influences the nursing experience in the face of death, it is common for professionals to experience suffering and other feelings, develop defense mechanisms as a way to compensate for the emotional unpreparedness. Thus, the study had recommendation grade B.

BIREME
Feeling and perceptions of the nursing team facing death and the dying process in the ICU.
Author (18) Series of cases/ Evidence Level 4 To identify the feelings and reactions of the nursing staff to death and the dying process in the ICU.
It was possible to verify that death is still seen as an enigma and that the nursing team experiences feelings of incompetence, anguish and unpreparedness in dealing with patients in the process of death and dying, even living routinely with this situation. This suggests the need for clarification of how to deal with death and the dying process in the training of health professionals, in order to provide assistance to patients in the process of death and dying qualified and integral. Thus, obtaining recommendation grade B.
Source: direct research. The professionals understand that death is part of the process of living, but feel sadness, frustration, and powerlessness, especially when the patient stays longer in the emergency room.
Many professionals, despite allowing the interview to take place to take place in another location, did not accept that it take place outside the environment.
It is believed that this study can contribute to professionals being motivated to reflect and discuss more humane and supportive care in the hospital emergency department.

A8; A9; A14
To care for children with cancer and their families, the nursing staff must understand the dying process, There is a need for continuing education/capacity building on the theme of "death" in order to of better prepare these professionals to deal with the death of the target of their care.
It is emphasized that humanized care in intensive care must be the main factor conditionant of the multidisciplinary health team's performance, and emphasizes the holistic view of the patient, since it seeks to meet all the patient's needs and contributes as much as possible to improve the patient's quality of life.

A10; A12; A18
For some professionals death is a natural procedure of life, for the unfolding of health process-disease may direct the patient toward the end. In this way, there is a greater naturalness in dealing with death, which does not exempt the presence of feelings in the process, being this, however, faced with more serenity.
A he team nursing team crucial in the care of these patients, making sure that they get the best possible assistance when facing a situation of death.
In the surgical context the word death brings countless feelings that are mostly negative, because what is expected after a surgery is the patient's recovery. Thus, the subject is considered taboo, tending to be masked in order to avoid being discussed and faced openly.
It is necessary to prepare the professionals of nursing so that they can provide authentic care to those who experience the process of death and know how to recognize the patient as a human being who is in this process, understanding the multiple experiences in this crucial moment.  and  uncertainties  that  permeate it, provides, on the other hand, a review of the concepts and feelings of this professional about death, allowing a necessary reflection a construction of their own coping strategies.
The appreciation of life in its unfolding, of the child as a symbol of something to come, reveals the need of the human community to protect its own future and to renew the hope of the new generations.
Professionals health are more exposed to psychological health professionals are more exposed by their daily occupational in unhealthy environments and dangerous, and especially, in function of experience a repetitive routine and a close proximity to pain and death.
The pain and suffering, in these cases, although present, allow the gradual elaboration of strategies for its management; and the perspective of death becomes, thus, a constant companion in the daily life of the family members and professionals involved.

A14; A17; A18
The professionals also suffer in this process because talking about death and the dying process demands great cognitive effort from them. Cognitive efforte emotional, Therefore, it is necessary to talk about death, be it without dialogue, death will remain a potency close to the other, but distant from us and silenced in the process of care as a The studies selected for this integrative review focus on themes pertinent to the area of the study of death and the end-of-life process, thanatology, and point to the need for training health professionals in death education and acceptance of the end of the life cycle (9,10) .
According to the results when death happens in old age it is a natural and acceptable fact, in adulthood it is frustrating because it makes the elderly phase impossible and when it is a child's death the difficulty of accepting the feelings and frustrations present themselves with greater intensity (7,12) .
The studies pointed out that information does not have the desired effect on the episode of death, making it necessary to provide caregivers with adequate support, oversight, and role delimitation to reduce the challenges identified (15,16) .
The evidence provided points out that home palliative care can help by increasing the chance of the patient dying at home and reducing their symptom burden, without having much impact on the caregiver (14) .
However, there is a need to create spaces to discuss the theme of death among professionals, due to their difficulty and suffering when communicating bad news and the development of new measures of coping and support for the professional who lives this process every day and tries to develop an emotional blunting in relation to this process of death/death (4) . the professional has seen the lack of preparation on the subject during academic training (19) .

CHARACTERIZATION
Corroborating with the author above, another author states in his study that professionals understand that death is part of the process of living, but that they can not stop during their professional practice (23) .
It is worth mentioning that the most current curricula, inserted within an anthropological and psychological perspective, value disciplines and moments in which the student, with his personal issues, has space to manifest his principles in order to mature his view of reality. However, despite this configuration expressed in the documents that guide the pedagogical praxis, currently, it is still perceived that the professionals who work in the practice, as they have not had this look and this foundation, leave a disproportionate gap in the daily work (20) .
In the daily professional life of nurses, care permeates and consolidates their practice, however, this is a remarkable process in the development of coping actions and improvements, attitudes and behaviors based on scientific knowledge, experience, intuition and critical thinking performed for and with the patient, with the intention of improving the care provided, promoting, maintaining or recovering their dignity and human whole (24) .

CONCLUDING REMARKS
This study sought to highlight the theme