Abstract: This thesis represents an appreciative enquiry to identify features of effective verbal communication between nurses and patients. Using a method developed by the Language in the Workplace Project (Stubbe 1998) two nurse participants recorded a small sample of their conversations with patients as they occurred naturally in clinical practice. These six conversations constitute the main body of raw data for the study. The data was analysed using a combination of discourse and ethnographic analysis. Experience in nursing, particularly insider knowledge of the context of district nursing, helped me to uncover the richness of meaning in the conversations. The subtle interconnections and nuances could easily have been missed by an outside observer. The study has shown that in their interactions with patients, expert nurses follow a pattern in terms of the structure and content of the conversations and it is possible to identify specific features of effective nurse-patient communication within these conversations. The most significant of these are the repertoire of linguistic skills available to nurses, the importance of small talk and the attention paid by nurses to building a working relationship with patients, in part, through conversation. The findings have implications for nursing education and professional development.

Abstract: This article examines influences that impact on the work of the Emergency Departments (EDs). EDs are noticing increased attendance of patients with minor or non-urgent conditions. This increase in patient volume, together with on-going fiscal constraints and restructuring, has placed an added strain on the functioning of EDs. New Zealand nurses need to question the role currently given to EDs and identify the issues surrounding the increased use of these departments for primary health care.

Abstract: A study to examine the effects of pre- information ( what a Nurse learns about a patient before they meet) on clinical inference and Nursing actions, in a simulated Nurse- Patient situation. It was hypothesized that the nature of the pre-information will influence the way the patient is perceived and the resulting Nursing actions. The research was conducted in an obstetrical setting. There were 55 subjects within three groups. Two groups comprised student midwives and the third group was of second year comprehensive Nursing students near completion of clinical experience in maternal and child health nursing. A 5 minute videotape sequence of a role played post natal patient was made for use in the research. All subjects were given the same initial pre-information, viewed the videotape and gave written description of what they saw on the videotape and their response ( as the Nurse in the situation). This data provided a base line for each subject. Subject were then given additional pre-information concerning the patient's physical condition, her baby's condition or formed part of the control group ( receiving no additional information) The procedure was repeated. These responses were then compared with the base line for each subject. Responses were coded by means of content analysis. Group data was analysed using multivariate one way analysis of variance graphical display. The results indicated support of the hypothesis that the nature of the pre-information does influence the way in which a Nurse perceives a patient and resulting Nursing actions. Implications of these findings for Nurses are discussed

Abstract: Research paper presented as part of the requirements for Nursing Studies component of a B.A. Degree Wellington Victoria University, Wellington

Abstract: This is a descriptive study of the characteristics of depression in a sample of 121 adolescents attending an outpatient specialist adolescent mental health service in New Zealand. The adolescents were required to complete two self-report measures to assess presence of depressive symptoms, severity of depression, and particular characteristics of the depression. The findings revealed that irritability was the most common characteristic along with other interpersonal and thought processing symptoms. It is important that mental health nurses are able to identify the specific characteristics of adolescent depression that may differ from adult depression in order to manage this patient population effectively.

Abstract: This paper reports a study exploring people's perceptions of disclosure about lesbian, gay and bisexual identity to their primary healthcare providers. Disclosure of sexual identity to healthcare professionals is integral to attending to the health needs of lesbian, gay and bisexual populations, as non-disclosure has been shown to have a negative impact on the health of these people. From April to July 2004, a national survey of lesbian, gay and bisexual persons was carried out in New Zealand. Participants were recruited through mainstream and lesbian, gay and bisexual media and venues, and 2269 people completed the questionnaire, either electronically or via hard copy. The 133-item instrument included a range of closed-response questions in a variety of domains of interest. In this paper, we report results from the health and well-being domain. More women than men identified that the practitioner's attitude toward their non-heterosexual identity was important when choosing a primary healthcare provider. Statistically significantly more women than men reported that their healthcare provider usually or always presumed that they were heterosexual and in addition more women had disclosed their sexual identity to their healthcare provider. The authors advise that nurses reconsider their approach to all users of healthcare services by not assuming everyone is heterosexual, integrating questions about sexual identity into health interviews and ensuring that all other aspects of the assessment process are appropriate and safe for lesbian, gay and bisexual people.