Abstract: This article examines the role of nurses working in intensive care units who may need to work with families as they face the death of a loved one. How the nurse communicates with relatives during these crucial hours prior to the death can have profound implications on their grief recovery. Universal needs for families in this situation have been identified in the literature, and include: hope; knowing that staff care about their loved one; and having honest information about their loved one's condition. A case study is used to illustrate key skills and techniques nurses can employ to help meet these universal needs. In the first stage of grief the bereaved is in shock and may feel a sense of numbness and denial. The bereaved may feel confused and will have difficulty concentrating and remembering instructions, and they may express strong emotions. Studies on families' needs show that honest answers to questions and information about their loved one are extremely important. It is often very difficult for the nurse to give honest information when the prognosis is poor. Good communication skills and techniques are discussed, in which hope is not offered at the expense of truthfulness, and the nurse facilitates the process of saying goodbye and expressing emotions. Practical techniques, such as including the family in basic care such as foot massaging and simple hygiene routines, may also be used to move the family from being bystanders to the impending death, to comforters.

Abstract: Details how the author employed focused ethnography in her doctoral research to investigate nurses' and parents' experience of emotional communication in the context of a children's unit of a regional hospital in NZ. Interviews 10 parents and 10 nurses after the children were discharged. Validates the ethnographic method as a means of inspecting the hidden as well as observable aspects of nurse-parent interaction.

Abstract: This paper describes an attempt at effecting change with specific relevance to the discharge planning of clients from a New Zealand inpatient mental health unit to a community setting. It explores how a team of community mental health nurses, practising in an urban/rural area, used the concepts of practice development to endeavour to bring about change while still retaining a client-centred focus. It describes how, in their enthusiasm, they embarked on the road to practice change without undertaking some of the essential ground work, Although they did not achieve all they set out to achieve, much was learnt in the process. In this paper, the authors outline their key learning points concerning the importance of engagement, communication, consistency and cooperation to the process and outcomes of practice change.

Abstract: Argues that the concept of cultural safety (CS) has been appropriated from an indigenous-led bicutural context to an inclusive cross-cultural framework for working with diverse patient populations. Investigates nurses' understanding of the 'Guidelines for Cultural Safety, the Treaty of Waitangi and Maori Health in Nursing Education and Practice' published in 2011 by the Nursing Council of NZ. Conducts a mixed-methods survey using both closed and open-ended questions to gauge nurses' confidence in applying the guidelines and their view of their relevance. Describes differences between NZ Registered Nurses (RN) and Internationally Qualified Nurses (IQN) in their understanding of CS. Argues that the CS model should be by Maori, for Maori.

Abstract: In the acute hospital setting, nurses provide care twenty-four hours a day, seven days a week. Due to the ever-changing nature of the patient's situation, nurses need quality information at the beginning of each eight-hour shift to plan and implement patient care effectively. It is claimed that handover is central for maintaining the continuity and the quality of patient care. This qualitative descriptive study was undertaken to identify what core information needs to be exchanged at nursing handover to ensure quality and continuity of patient care. Five consumers who had experience of recurrent hospital admissions shared their perceptions of handover practice through individual interviews. Three focus group meetings of seven nurses from a secondary care setting discussed handover practice from their professional perspectives. Both nursing and consumer voices are integral to the overall understanding of this study but the consumer voice is the privileged and dominant voice. Through the process of thematic content analysis the central themes of communication, continuity and competence emerged for the consumers. Consumers expect to be kept informed and involved in their healthcare. They want continuity of nurse, information and care and expect that nurses involved in the delivery of healthcare are competent to manage their situation. The 'importance of knowing' is the overarching construct generated in this research. Knowing is identified as the foundation on which quality and continuity of care is built and is discussed under the subheadings of: not knowing, knowing the patient as a person, knowing takes time, hidden knowing, knowing consumers' rights, oral knowing, knowing involves more than handing over patient care and knowing the economics. Recommendations have been developed for future research, nursing practice, education and management. These centre on ways to develop a more consumer-focused approach to contemporary healthcare.

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: Notes the lack of evidence-based guidance for use of humour by nurses. Uses a qualitative descriptive methodology to explore how surgical nurses determine when and how to employ humour with patients. Enrols 9 RNs working in a surgical ward within a tertiary hospital in semi-strutured interviews to discuss how they assess patient receptiveness, build connections with patients and protect their vulnerability.