Aim. To describe patients' experiences of counselling, defined as information giving and advice by nursing staff, in the emergency department. A particular focus was on the waiting period and on the importance of family participation in counselling. Background. Counselling is a widely studied topic in nursing. Too little is known about counselling in emergency departments and especially about participation of family members and suitability of counselling for the patient's life situation. Design. Descriptive quantitative study. Methods. Data were collected by questionnaires from patients (n = 107) visiting a hospital emergency department. The data were subjected to statistical analysis. Results. Forty-two per cent of patients arrived at the emergency department with a family member: spouse or cohabiting partner, mother, father or daughter. Patients were fairly satisfied with the counselling. The presence of a family member was important to the majority of patients (75%). About half of the patients wanted information concerning their illness, condition and treatment to be given to their family members. Those visiting the department with a family member were more satisfied with counselling and felt that it promoted their participation in care. Conclusion. It is to encourage patients' family members to participate in counselling situations in emergency departments. However, the type of information passed on to family members should be carefully discussed and prepared. Relevance to clinical practice. Patients' family members seem to be important partners in counselling situations. The presence of family members supports patients in the emergency department during the waiting period and helps them orientate in their situation. When family members are present, issues which patients wish to discuss should be carefully planned. Family presence should be encouraged in emergency departments.Key words: acute care, counselling, emergency care, emergency department, family nursing Accepted for publication: 9 July 2008 BackgroundAcute illness may give rise to feelings of helplessness, uncertainty and fear in patients when they arrive at the emergency department. An acute illness amidst unfamiliar surroundings and medical equipment can cause stress (Fredriksen & Ringsberg 2007). Acute illness often comes on suddenly and is characterised by unpredictability and uncontrollability. Patients' perceptions are also influenced by how much the illness changes their life situation. The more feelings of relinquishment and loss they experience, the more anxious and vulnerable they are. A perceived lack of control over the situation and separation from family are also perceived as threatening (Fredriksen & Ringsberg 2007 Because of the patient's vulnerability, the nursing staff providing patient counselling in the emergency department need to show special sensitivity (Towle & Weston 2006). In this study counselling is defined as information giving and advice concerning illness and care.Acutely ill patients expect to receive safe care. They...