Jokes and reassurance are not enough: ways in which nurses relate through conversation with elderly clients.

An ethnographic study was conducted into the style of conversation registered nurses used with elderly residents during activities of morning care. Speech was analysed into basic components of speech act categories (e.g. explanation, instruction, reassurance). Patterns of speech style were seen to vary in relation to the physical procedure being carried out, and to function as an adjunct to the smooth execution of this physical activity. However, they were also seen to have an important psychological function reflecting a particular way of relating. Some morning-care activities--the journey--were associated with a more personally engaging social interaction which appeared to be mutually beneficial to nurse and resident. Other approaches to morning care--the dissection--appeared to constrain the way the nurse interacted, producing a more formal style of relating. Findings were discussed in terms of optimal use of physical activities of nursing care to achieve greatest benefit in relation to the psychological needs of the resident, as addressed through verbal interaction.