Bakgrund: Telefonrådgivning är en växande verksamhet och utgör en stor del av distriktssköterskans arbete på vårdcentral. För vårdsökande innebär det att få råd, information och stöd för att öka tryggheten i vardagslivet. Det behövs ökad kunskap om äldres erfarenheter av telefonrådgivning för att bättre kunna förstå de vårdsökandes behov och för att vidare utveckla verksamheten. Syfte: Syftet är att beskriva äldre vårdsökandes erfarenheter av telefonrådgivning på vårdcentral. Metod: I studien har en kvalitativ deskriptiv design med induktiv ansats använts. Datainsamling har skett via tio intervjuer med äldre vårdsökare som har fått telefonrådgivning via vårdcentral och materialet analyserades med kvalitativ innehållsanalys. Resultat: I analysen framträdde två teman Få kontakt och Kommunikation.  I Få kontakt presenteras kategorierna: Telefonsystemet och Strategier för kontakt med tillhörande underkategorier. I Kommunikation presenteras kategorierna: Bemötande och Förutsättningar med tillhörande underkategorier. Slutsats: Telefonsystemet som används för att få kontakt kan ses både som en tillgång och ett hinder för kontakt. Äldre vårdsökande använder olika strategier för att underlätta kontakt med vårdcentral. Kommunikation mellan telefonsjuksköterskan och den äldre vårdsökanden kräver att det finns bra förutsättningar. Om kommunikationen dem emellan är god och den vårdsökande får vara i centrum blir vårdmötet tillfredsställande och den vårdsökande känner sig hjälpt. Om kommunikationen brister och den vårdsökande inte får vara i centrum kan vårdmötet bli otillfredsställande och leda till att vårdsökanden istället känner sig stjälpt. Slutsatsen är att telefonrådgivning på vårdcentralen kan både hjälpa och stjälpa den äldre vårdsökande. / Background: Telephone nursing is a large part of the nurse's work at the health center. The caller wants to get advice, information and support in everyday life. With this work we want to enhance the understanding of older people's experiences of telephone nursing at health center to further develop the telephone nursing from elderlies perspective. Aim: The aim is to describe the elderly caller’s experiences of telephone nursing at health center. Method: The study has a qualitative descriptive design with an inductive approach. Data was collected through 10 interviews with elderly callers who had received telephone nursing and the data was analyzed by a qualitative content analysis. Results: The analysis resulted in to two themes Get Contact and Communication. In Get Contact the following categories appeared: Phone system and Strategies for Contact with related subcategories. In term Communication the following categories appeared: Treatment and Conditions with related subcategories. Conclusion: The telephone system that is used for contact with the health center can be seen both as an asset and obstacle. Elderly callers use different strategies to facilitate the contact. It is important that there are good preconditions for the communication. If the communication between the nurse and elderly caller is good and the caller is in focus, the caller will feel helped and satisfied with the telephone meeting. If there is lack of communication and the caller is not in focus, the telephone meeting can be unsatisfied and lead to a feeling of being overturned.

During later years, the primary care services are experiencing a heavier strain in terms of increasing expenses and higher demand for medical services. An increased awareness about pharmaceutical adverse effects and the global concern of antibiotic resistance has given self-care and active surveillance a stronger position within the primary care services. The management strategy for minor illnesses is important because care-seekers tend to repeat successful strategies from past events, and past experience with self-care drives future self-care practices. The overall aim of this thesis was to explore people’s experiences and needs when practicing self-care and receiving self-care advice for minor illnesses. This was achieved by studying people’s experiences with and knowledge of minor illnesses, self-care interventions and channels of information used when providing self-care for minor illness. Needs for confidence in self-care were studied, as well as supporting and obstructing factors in the practice of self-care. Satisfaction with telephone nursing and people’s experiences of reassurance in relation to the decision-making process in self-care for minor illness was explored. The results showed that experience correlated with self-rated knowledge of the condition, and the least common conditions most often generated a health care services consultation. To confidently practice self-care people needed good knowledge and understanding about obtaining symptom relief. Younger persons more often reported the need of having family or friends to talk to. Easy access to care was most often reported as a support in self-care, and a lack of knowledge about illnesses was most often reported as obstructing self-care. Care-seekers receiving self-care advice were less satisfied with the telephone nursing than care-seekers referred to medical care, and feeling reassured after the call was the most important factor influencing satisfaction. Self-care advice had a constricting influence on healthcare utilization, with 66.1% of the cases resulting in a lower level of care than first intended. The course of action that persons in self-care decided on was found to relate to uncertainty and perception of risk. Reassurance had the potential to allay doubts and fears to confidence, thereby influencing self-care and consultation behavior. In conclusion, symptoms of minor illness can cause uncertainty and concern, and reassurance is an important factor influencing people’s course of action when afflicted with minor illness. The nurse constitutes a calming force, and the encounter between the nurse and the care-seeker holds a unique possibility of reassurance and confidence that minor illness is self-limiting to its nature and that effective interventions can provide relief and comfort. Just as health is more than the absence of disease, self-care is more than the absence of medical care.

Bakgrund: Telefonrådgivning är ett komplext arbete, där sjuksköterskorna gör vårdbedömningar utan fysiskt möte. Stöd och råd ges till egenvård, samt hänvisar till adekvat vårdnivå. Inom telefonrådgivning krävs god kommunikationsförmåga och klinisk kompetens för att säkerställa patientsäkerhet. Sjuksköterskor kan uppleva tidspress, stress och trötthet på grund av långa telefonköer. De långa telefonköerna begränsar möjligheten till återhämtning. Telefonrådgivning innebär samtidig muntlig kommunikation och dokumentation, vilket kräver en hög koncentrationsnivå. Tidigare studier pekar på att nuvarande hjälpmedel och utbildning inte är tillräckligt adekvata för att förbereda sjuksköterskor för telefonrådgivning. Motiv: Telefonrådgivning är en viktig uppgift, men beskrivs som krävande, utmanade, ansvarsfullt och stressigt. Eftersom få studier om sjuksköterskors erfarenheter av telefonrådgivning gjorts inom primärvården i Finland, är det angeläget att beskriva sjuksköterskors upplevelser av arbetet som telefonrådgivare. Syfte: Syftet med studien är att belysa sjuksköterskors erfarenheter av att arbeta med telefonrådgivning på en hälsocentral. Metod: Semistrukturerade intervjuer genomfördes med sex hälsovårdare och tre sjuksköterskor i västra Finland. En tolkning av intervjudata genomfördes med kvalitativ innehållsanalys. Resultat: Resultatet av sjuksköterskornas upplevelser i telefonrådgivningen redovisas i fyra teman: Att dagligen ha utmanande telefonrådgivning, Att ha en krävande arbetssituation, Att ha bristande support och Att ha en underlättande arbetsmiljö. Konklusion: Telefonrådgivning på en hälsocentral är utmanande och komplext. Yrkeserfarenhet underlättar vid vårdbedömningar och rådgivning i olika situationer. En god arbetsgemenskap och stöd från arbetskollegor är viktigt för att orka med svåra samtal. Ett hinder för ovan nämnda främjande faktorer är personalbristen. Sjuksköterskorna upplever hög stress och otillräcklighet om telefonköerna är långa. För att underlätta vårdbedömningar samt förbättra vårdkvaliteten, vore det bra med ett vårdbedömningsprogram. / Background: Telephone nursing is a complex task, with nurses making care assessments without a physical encounter. Support and advice is given to self-care, and referrals are made to an adequate level of care. Good communication skills and clinical competence are required to ensure patient safety in telephone nursing. Nurses may experience time pressure, stress and fatigue due to long phone queues. The long phone queues limit the possibility of recovery. Telephone nursing involves simultaneous verbal communication and documentation, which requires a high level of concentration. Previous studies indicate that current aids and training are not adequate enough to prepare nurses for telephone nursing. Motive: Telephone nursing is an important task, but is described as demanding, challenging, responsible and stressful. Since few studies on nurses´ experiences of telephone nursing has been conducted in primary health care in Finland, it´s important to describe nurses´experiences of working with telephone nursing. Aim: The purpose of the study was to illuminate nurses´experience of working with telephone nursing at a primary healthcare center. Methods: Semi-structed interviews were conducted with six public health nurses and three nurses in western Finland. An analysis of interview data was performed with qualitative content analysis. Result: The results of the nurses´experiences are presented in four themes: To have challenging telephone nursing on a daily basis, To have a demanding work situation, To have a lack of support and To have a facilitating work environment. Conclusion: Telephone nursing at a primary healthcare center is challenging and complex. Professional experience facilitates nursing assessments and counseling in different situations. A good working community and support from colleagues is important for coping with difficult calls. A barrier to the above-mentioned facilitators is the lack of staff. Nurses experience high stress and inadequacy if phone queues are long. To facilitate nursing assessments and improve the quality of care, it would be useful to have a care assessment programme.

Abstrakt Bakgrund: Hälsocentraler i Sverige har erbjudit telefonrådgivning i årtionden och det är främst en distriktssköterska som erbjuder sådana tjänster. Telefonrådgivning handlar främst om triagering, ge professionell rådgivning och hänvisa till andra vårdinstanser. I tidigare studier finns det beskrivet både möjligheter och svårigheter med telefonrådgivning.   Motiv: Telefonrådgivning ur en svensk primärvårdskontext och utifrån distriktssköterskors profession är inte väl beskriven i den vetenskapliga litteraturen. Det är därför viktigt att få en ökad kunskap om hur distriktssköterskor i Sverige upplever telefonrådgivning på en hälsocentral så att arbetet och arbetsmiljön kan utvecklas och förbättras.    Syfte: Syftet med studien var att belysa distriktssköterskors erfarenheter av telefonrådgivning på en hälsocentral.      Metod: Semistrukturerade intervjuer genomfördes med åtta distriktssköterskor inom regionerna Västerbotten och Västernorrland. En kvalitativ innehållsanalys genomfördes på den insamlade intervjudatan.    Resultat: Resultatet redovisas i fyra kategorier som berör rollen som telefonrådgivare, relationen med patienten i telefon, utmaningar i kommunikation via telefon och slutligen organisationen kring telefonrådgivningen. Konklusion: Telefonrådgivning anses öka tillgängligheten till sjukvården. Yrkeserfarenhet och ett personcentrerat förhållningssätt upplevs vara viktigt för en bra bedömning och god patientrelation via telefon. Hinder som att inte se patienten samt tidspress och personalbrist kan påverka bedömningsförmågan och hota patientsäkerheten. Verksamheten behöver förbättra arbetsmiljön för distriktssköterskor i telefonrådgivning samt erbjuda kontinuerlig utbildning för att de ska ha bättre förutsättningar att hjälpa patienten på bästa sätt. / Abstract  Background: Primary healthcare centers in Sweden have been offering telephone nursing for decades and it is mainly a district nurse who offers such services. Telephone nursing is mainly about triaging, giving professional advice and referring to other care facilities. Previous studies describe both possibilities and difficulties of telephone nursing.        Motive: Telephone nursing from a Swedish primary healthcare context and based on the profession of district nurses´ is not well described in the literature. It is therefore important to increase the knowledge about how district nurses in Sweden experience telephone nursing at a healthcare center so that the work and work environment can be developed and improved.        Aim: The aim of the study was to illuminate district nurses´experience of telephone nursing at a primary healthcare center.        Methods: Semi-structured interviews with eight district nurses´ were conducted within region Västerbotten and region Västernorrland. Qualitative content analysis was used to analyze the gathered interview data.    Result: The results are reported in four categories that concern the role of telephone counselor, the relationship with the patient by telephone, challenges in communication via telephone and finally the organization around telephone nursing.  Conclusion: Telephone nursing is considered to increase accessibility to healthcare. Professional experience and a person-centered approach are perceived to be important for a good assessment and a good patient relationship by telephone. Obstacles such as not seeing the patient, time pressure and staff shortages can affect the ability to assess and threat patient safety. The primary healthcare organization needs to improve the working environment for district nurses´ in telephone nursing and offer continuous training so that they have better conditions to help the patient in the best way.

Bakgrund: Telefonrådgivning på vårdcentral utgör en stor del av distriktssköterskors arbete. När distriktssköterskor saknar visuell kontakt med vårdsökare i telefonen ställs andra krav på kommunikationen mellan distriktssköterskor och vårdsökande. I takt med den ökade invandringen i Sverige träffar distriktssköterskor på utlandsfödda vårdsökande med språkförbistring i allt större utsträckning. Det behövs därför mer forskning inom detta område. Syfte: Syftet med denna studie är att beskriva distriktssköterskors erfarenheter av telefonrådgivning på vårdcentral till vårdsökande som inte har svenska som modersmål. Metod: Designen på studien är en kvalitativ deskriptiv intervjustudie med induktiv ansats. Datamaterialet utgjordes av tio intervjuer med distriktssköterskor på vårdcentral. Analys gjordes med hjälp av kvalitativ innehållsanalys. Resultat: Ur analysen framträder fyra kategorier Att främja samspel i kommunikationen, Att träffa på svårigheter/ hinder i samtalet, Att använda organisatoriska strategier, Att använda sin kompetens. Slutsats: Att nå överensstämmelse i kommunikationen ansågs som något av det viktigaste i arbetet med telefonrådgivning.  Kulturella skillnader och språkförbistring gjorde telefonrådgivningen utmanande. Andrahandsinformation gjorde det svårt att veta att korrekt information gavs samt att sekretessen upprätthölls. Distriktssköterskorna beskrev oro för felbedömning vid samtal med uppringare med språkförbistring. Att förmedla trygghet ansågs viktigt vid telefonrådgivning till utlandsfödda vårdsökare. Distriktssköterskorna i studien eftersökte organisatoriskt stöd och utbildning för att lättare kunna arbeta med telefonrådgivning. / Background: Telephone advice and triage at health care centers constitutes a big part of the daily tasks a district nurse perform. As the tele nurses lacks visual contact with their patients, there are greater demands in the communication as opposed to face-to-face encounters. As the immigration increases in Sweden, the district nurse encounters an increasing amount of foreign born callers with language barriers. Therefore, more research in this area is necessary. Aim: The aim of this study is to describe distric nurses experiences of telephone nursing to healthcare seekers with other native language than Swedish. Method: The study design is a qualitative descriptive interview study with an inductive approach. Data was collected through ten individual interviews with district nurses in health center and the data was analyzed by content analysis. Results: Four categories emerged from the analysis: To encourage synergetic communication, To encounter obstacles in the conversation, To practice organizational strategies, To utilize one's competence. Conclusion: To pursue mutuality in communication and to conclude a common decision was seen among the most important aspects of the telephone nursing advisory. Cultural differences and language barriers caused the telephone nursing to become a challenging task for the nurses. Secondary information received through friends and relatives introduced an uncertainty to determine information correctness and whether the secrecy remained upheld. The district nurses expressed concern of misjudgment during conversations with callers who showed language inabilities. To bring security was noted as crucial in telephone nursing for foreign born callers. Furthermore, the district nurse needs to be confident in oneself. The district nurses in this study sought for organizational support and education.

Telefonrådgivning har ersatt en stor del av traditionella vårdbesök, nationellt och internationellt. Tillgängligheten och enkelheten gör det till en uppskattad funktion av vårdsökande. För att kunna utveckla telefonrådgivning och för att implementera personcentrerad vård är det viktigt att lära sig hur telefonsjuksköterskor och vårdsökande upplever samtalen. Syfte: Att beskriva upplevelser av rådgivande telefonsamtal på en hälsocentral utifrån telefonsjuksköterskors och vårdsökandes perspektiv. Metod: Kvalitativa semistrukturerade intervjuer utfördes under hösten 2017. Deltagare: Fem vårdsökande och fem telefonsjuksköterskor. Analys: Telefonsjuksköterskors och vårdsökandes intervjuer analyserades för sig. Materialet analyserades med hjälp av kvalitativ innehållsanalys med induktiv ansats. Resultat: Telefonsjuksköterskors intervjuer gav tre slutgiltiga kategorier; oro för att stressfaktorer ska påverka kvaliteten och arbetstillfredsställelsen, närvaro och förståelse är viktigt för att göra bra bedömningar samt känslor och förväntningar kan vara svåra att bemöta. Vårdsökandes intervjuer resulterade i tre kategorier; Att inte alltid bli förstådd och rädsla för felbedömningar, ett respektfullt bemötande skapar en känsla av att tas på allvar samt att önska sig enklare och tryggare tillvägagångssätt. Slutligen skapades en kategori utifrån de båda perspektiven: Egenskaper som kännetecknar det bra samt det mindre bra samtalet. Konklusion: Telefonrådgivning är komplext och telefonsjuksköterskor upplevde svårigheter i arbetet. Vårdsökande var överlag nöjda med telefonrådgivningen men upplevde problem med förtroende och ansvar. Telefonrådgivning upplevs överlag fungera bra. Vårdsökande upplever den som en trygghet men även som en nödvändighet vilket ger orsak till att fortsätta förbättra kvaliteten och minimera riskerna. / Telephone nursing has replaced a large part of traditional health care visits, nationally and internationally. The availability and accessibility makes it an appreciated service for health seekers. In order to develop telephone nursing and for implementation of person centered care it is important to learn how phone nurses and care-seekers experience the calls. Aim: To describe experiences of telephone nursing in primary care from the perspectives of telephone nurses and care seekers. Participants: Five telephone nurses and five care seekers. Method: Qualitative individual semi structured interviews were conducted during autumn of 2017. Analysis: Interviews of telephone nurses and care seekers were analyzed separately using qualitative content analysis with an inductive approach.  Results: Three final categories for telephone nurses were found; concern that stress factors can affect assessment quality and work satisfaction, presence and understanding is of importance in making correct assessments, emotions and expectations can be difficult to account. Three categories for care-seekers; not always being understood and fear of misjudgments, respectfulness can create feelings of being taken seriously and wishing for easier and securer accessibility. In the end a final category was created that included views from both perspectives regarding the good respective the difficult call.  Conclusion: Telephone nursing is complex and telephone nurses experienced work difficulties. Care seekers were generally pleased with the service provided but still had issues concerning trust and liability. Telephone nursing is generally well functioning. Care seekers look to it as a security and as a necessity which is cause to keep improving quality and eliminating risks.

Timely management in pre-hospital emergency care enhances the chances of patients' survival or clinical outcomes of an Acute Coronary Syndrome (ACS). In Botswana nurses serve in the frontline of pre-hospital emergency services as the initial recipients of the emergency reports and situations. Knowledge of the patient's characteristics will assist the nurses as well as the family/others to understand the patient's responses during an ACS situation and therefore enable prompt patient assessment and facilitation of early access to appropriate care. Patient and family involvement in care during cardiac emergencies also influences the patient outcomes. This is a non-experimental, quantitative, exploratory and descriptive study, designed to explore and describe the characteristics of patients with the experience of an ACS, and the available resources during the pre-hospital phase of emergency care, with the aim of improving patients' clinical outcomes. The results indicated that optimal care by nurses is essential in the chain of care influencing patients' chances of surviving ACS. / Health Studies / M.A. (Health Studies)

Timely management in pre-hospital emergency care enhances the chances of patients' survival or clinical outcomes of an Acute Coronary Syndrome (ACS). In Botswana nurses serve in the frontline of pre-hospital emergency services as the initial recipients of the emergency reports and situations. Knowledge of the patient's characteristics will assist the nurses as well as the family/others to understand the patient's responses during an ACS situation and therefore enable prompt patient assessment and facilitation of early access to appropriate care. Patient and family involvement in care during cardiac emergencies also influences the patient outcomes. This is a non-experimental, quantitative, exploratory and descriptive study, designed to explore and describe the characteristics of patients with the experience of an ACS, and the available resources during the pre-hospital phase of emergency care, with the aim of improving patients' clinical outcomes. The results indicated that optimal care by nurses is essential in the chain of care influencing patients' chances of surviving ACS. / Health Studies / M.A. (Health Studies)

Ce mémoire est un des segments d'une recherche de plus grande envergure sur le service Info-Santé, et qui se déroule au Centre de Santé et de Services sociaux de Laval. / Les services téléphoniques de consultation en soins infirmiers sont en progression partout dans le monde. On sait que les infirmières qui possèdent une plus longue expérience de pratique au téléphone obtiennent davantage d’informations sur la condition de santé du client qui les consulte que celles qui comptent moins d’années d’expérience. Nous pouvons présumer que les niveaux d’expertise décrits par Benner (1984) expliquent cette différence. Toutefois aucune étude à ce jour ne décrit comment se manifeste cette différence entre les niveaux d’expertise dans la conversation au cours d’une intervention entre l’infirmière et l’appelant. Le but de cette étude descriptive était d’identifier les manifestations de cette expertise dans la communication, lors de la consultation téléphonique. À l’aide du Roter Interaction Analysis System (RIAS), 190 enregistrements d’appels, entre infirmières (N = 15), de divers niveaux de compétence selon la nomenclature de Benner (1984) et les appelants qui les ont consultées, ont été analysés. Les appels étudiés, issus d’une étude de plus grande envergure, devaient être faits par le parent d’un enfant de moins de cinq ans, et devaient faire l’objet d’une première consultation. Il a été possible de nommer des caractéristiques, des forces et des faiblesses communes aux infirmières de chaque niveau d'expertise à l’étude. Bien qu’il existe des différences entre les moins expérimentées et celles qui ont une longue expérience clinique au téléphone, les résultats semblent indiquer que les infirmières de tous les niveaux d’expertise sont fortement centrées sur la tâche d’évaluation de la situation de santé de l’appelant, mais que leurs interventions incluent peu d’énoncés orientés vers l’établissement d’un réel partenariat avec l’appelant. Les résultats obtenus fournissent des informations qui pourraient être utilisées pour élaborer des stratégies de développement professionnel, et guider les administrateurs de ce service dans le choix des indicateurs d’évaluation de la qualité du service et de ses retombés sur sa clientèle. Toutefois un plus grand nombre d’infirmières participantes et un plus grand nombre d’appels permettraient de confirmer les résultats obtenus à partir de ces 190 appels. / Nurse telephone consultation services are rapidly progressing throughout the world. It is known that nurses with a greater experience in telephone practise obtain more information on the client’s health condition when in consultation, than nurses with less experience. We can presume that Patricia Benner’s «levels of nursing experience», (1984), will provide us with an explanation for these differences. Yet, to this day, no study describes how these differences between levels of experience are manifested in conversation during an intervention between the nurse and the client. The object of this descriptive study was to identify the manifestations of this communication expertise during a telephone consultation. Using the Roter interaction analysis system (RIAS), 190 recorded calls between nurses (N = 15) with differing levels of expertise, according to Benner’ nomenclature (1984), and the callers who have consulted them were analyzed. The calls that were studied, from a larger study, were first calls from parents regarding their child aged five years or less. It was possible to observe characteristics, strengths, and weaknesses common to nurses within each level of expertise in this study. Despite the fact that there are differences between nurses with fewer years of experience and nurses with more clinical telephone experience, results seem to indicate that, regardless of their experience, nurses are strongly centered on the task of assessing the caller’s health situation; however, their interventions include few phrases aimed at establishing a true partnership with the caller. Results obtained provide information that could be used to elaborate professional developmental strategies, and guide administrators in their choice of indicators when evaluating service quality and its effect on clientele. Nevertheless, an increased number of nurse participants and a greater number of calls would enable us to confirm the results obtained from these 190 calls.

Les services téléphoniques de consultation en soins infirmiers sont en progression partout dans le monde. On sait que les infirmières qui possèdent une plus longue expérience de pratique au téléphone obtiennent davantage d’informations sur la condition de santé du client qui les consulte que celles qui comptent moins d’années d’expérience. Nous pouvons présumer que les niveaux d’expertise décrits par Benner (1984) expliquent cette différence. Toutefois aucune étude à ce jour ne décrit comment se manifeste cette différence entre les niveaux d’expertise dans la conversation au cours d’une intervention entre l’infirmière et l’appelant. Le but de cette étude descriptive était d’identifier les manifestations de cette expertise dans la communication, lors de la consultation téléphonique. À l’aide du Roter Interaction Analysis System (RIAS), 190 enregistrements d’appels, entre infirmières (N = 15), de divers niveaux de compétence selon la nomenclature de Benner (1984) et les appelants qui les ont consultées, ont été analysés. Les appels étudiés, issus d’une étude de plus grande envergure, devaient être faits par le parent d’un enfant de moins de cinq ans, et devaient faire l’objet d’une première consultation. Il a été possible de nommer des caractéristiques, des forces et des faiblesses communes aux infirmières de chaque niveau d'expertise à l’étude. Bien qu’il existe des différences entre les moins expérimentées et celles qui ont une longue expérience clinique au téléphone, les résultats semblent indiquer que les infirmières de tous les niveaux d’expertise sont fortement centrées sur la tâche d’évaluation de la situation de santé de l’appelant, mais que leurs interventions incluent peu d’énoncés orientés vers l’établissement d’un réel partenariat avec l’appelant. Les résultats obtenus fournissent des informations qui pourraient être utilisées pour élaborer des stratégies de développement professionnel, et guider les administrateurs de ce service dans le choix des indicateurs d’évaluation de la qualité du service et de ses retombés sur sa clientèle. Toutefois un plus grand nombre d’infirmières participantes et un plus grand nombre d’appels permettraient de confirmer les résultats obtenus à partir de ces 190 appels. / Nurse telephone consultation services are rapidly progressing throughout the world. It is known that nurses with a greater experience in telephone practise obtain more information on the client’s health condition when in consultation, than nurses with less experience. We can presume that Patricia Benner’s «levels of nursing experience», (1984), will provide us with an explanation for these differences. Yet, to this day, no study describes how these differences between levels of experience are manifested in conversation during an intervention between the nurse and the client. The object of this descriptive study was to identify the manifestations of this communication expertise during a telephone consultation. Using the Roter interaction analysis system (RIAS), 190 recorded calls between nurses (N = 15) with differing levels of expertise, according to Benner’ nomenclature (1984), and the callers who have consulted them were analyzed. The calls that were studied, from a larger study, were first calls from parents regarding their child aged five years or less. It was possible to observe characteristics, strengths, and weaknesses common to nurses within each level of expertise in this study. Despite the fact that there are differences between nurses with fewer years of experience and nurses with more clinical telephone experience, results seem to indicate that, regardless of their experience, nurses are strongly centered on the task of assessing the caller’s health situation; however, their interventions include few phrases aimed at establishing a true partnership with the caller. Results obtained provide information that could be used to elaborate professional developmental strategies, and guide administrators in their choice of indicators when evaluating service quality and its effect on clientele. Nevertheless, an increased number of nurse participants and a greater number of calls would enable us to confirm the results obtained from these 190 calls. / Ce mémoire est un des segments d'une recherche de plus grande envergure sur le service Info-Santé, et qui se déroule au Centre de Santé et de Services sociaux de Laval.