Having worked their way through the standard routine of questions determined as necessary for a ward admission ( mentioned on the following appendix page 6 ), and given each other relevant information, ( answering to various queries on the way ) Anne and José therefore reached the closure phase ( Faulkner , 1992, p36 ) of this interview after little more than ten minutes conversation. Anne told José what to be expecting next while he was on the ward, so that he could be planning to make himself ready for the Doctors' round and subsequent need of preparation for theatre. After checking with her client that everything that could be thought of had indeed been covered for the time being, ( commonly referred to as a final "screening question" ) she closed the computer database, smiled and presented José with a copy of the ward's information sheet leaflet summarising salient points for patients; and then got up from her chair to go about further duties on the ward. José, looking pleased with this turn of events, also rose to his feet and walked back to the bed where he would be resting for the next few hours while receiving pre-operative care.

In conclusion then, it appears that a range of verbal and nonverbal skills were adopted both by the nurse and by the patient during the observed interactional interview on this Oldchurch ward ; and an overall assessment and evaluation of the nurse-client communication should bear in mind at least five criteria. ( Cohen et al , 1989 , p147 ). 1 The appropriateness of the communication was high because the content was closely relevant to meeting the desired outcome. 2 Adequacy of communication was apparent in that sufficient feedback to meet intended goals was correctly given and understood. 3 High efficiency was indicated through the use of direct and quite clear language by Anne and José without excess verbosity, gesticulation, waste of energy or time. 4 Flexibility was adequate as a fair balance was achieved between rigid adherence to systematic history-taking on the one hand and the permissiveness necessary for José on the other to be able to volunteer additional remarks and questions that Anne could answer to. 5 The interview was successful in so far as being deliberately willed to be effective by both nurse and client it was therefore relatively easy for Anne to record and to impart the information necessary for José to be properly admitted, and for José to raise any queries and be reassured about anything that might additionally concern him. Communication appeared to be congruent as the verbal , non-verbal , literal and meta-communications each appeared mutually reinforcing.

There is little that can be regarded as specifically 'bad' or lacking in the conduct of this interview. Perhaps it would be better if voice-dictation software were installed on the computer, so that the dyad could more directly interact without a need for the nurse to repeatedly look away whilst grappling with keyboard typing: - and one could criticise the apparent lack of privacy during an interview conducted at the nurses' station, where other staff and clients must be passing often nearby; (Fritz et al , 1984, p103) ( and indeeed the interviewer has to be even more alert and aware than if a separate interview room was available ) - yet in practice this does not seem to have noticeably disturbed anyone. Before clients are discharged from the ward they are given an audit form to fill in, on which they are asked to express an opinion on various aspects of service provided: thus if there was dissatisfaction with client admission interview procedure the fact would soon become known and could be addressed by the ward manager so as to make conditions more agreeable to future orthopaedics clients.

( Assignment total ~ 2200 words , excluding references following )