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Humour is a tool that can build rapport, establish communication and enable a therapeutic relationship: all of which are essential skills for nurses. For nurses to use humour in their practice they need to know when it is appropriate and when it could be beneficial for patients. However, much of the literature on nursing humour focusses on when not to use humour or provides contradictory messages about the use of humour. This is problematic as with little guidance, nurses may be hesitant to deploy humour with patients, potentially missing important opportunities to deliver more effective care. The lack of evidence-based guidance about use of humour for nurses was a key driver for this study. Furthermore, with even less research in the surgical care setting, a stressful environment for patients and staff, the need to explore how and when humour is used in surgical nursing practice was important. A qualitative descriptive methodology was used to explore how registered nursing working in a surgical environment decide when and how to use humour within nurse-patient interactions, and the use of humour during nurse-patient communication is assessed. Data collection was carried out in two surgical wards within a single site tertiary hospital in New Zealand. Nine registered nurses participated in group or individual interviews that were conducted using an interview guide incorporating semi-structured questions. Data were analysed thematically. Findings demonstrate the humour is a significant feature of practice for surgical nurses with its use being purposeful and undertaken after careful consideration and assessment. Within three themes (assessing openness, building a connection, protection against vulnerability), humour was described as enabling nurses to quickly connect with patients and establish a therapeutic relationship. Humour facilitates communication, even under difficult circumstances, and provides an outlet for the perceived physical and emotional vulnerability

Background: Despite technological innovations and continuous improvement in evidence-based treatments, mortality in the intensive care unit (ICU) remains high. Consequently, a large group of family members may be in need of, and could benefit from, bereavement follow-up support. Aims and Objectives: To explore the elements, organization, and evaluation of ICU bereavement services in European countries. Specific objectives were to investigate: (a) the model of bereavement follow-up services (elements of support), (b) the workforce model (organization of staff), and (c) the evaluation model (evaluation strategies). Design: This was a cross-sectional survey of conference delegates. Methods: A paper-and-pen questionnaire, including a cover letter assuring the respondents of anonymity and confidentiality, was distributed to 250 delegates during the opening ceremony of the 2017 European federation of Critical Care Nurses associations Congress in Belfast. The questionnaire was developed from a previously validated tool describing bereavement care practices in ICUs, including questions about the content and organization of bereavement follow-up services. Frequencies were calculated using yes/no questions, and content analysis was applied in additional free-text comments. Results: We received 85 responses from publicly employed nurses, mainly in mixed adult ICUs. Respondents were 48 (56.5%) bedside nurses, and the remaining respondents represented clinical nurse specialists, researchers, managers, or academic nurses. Bereavement follow up had existed for about 1 to 15 years. Important follow-up elements were: viewing the deceased in the unit, 77 (90.6%); providing follow-up information, 67 (79.8%); sending a letter of sympathy, 17 (20%); and calling the family to arrange a meeting, 27 (31%). Conclusions: Bereavement follow up is common but variable in European ICUs. We recommend the development, implementation, and evaluation of evidence-based, but culture-specific, berea