Keeping "small talk" small in health-care encounters: negotiating the boundaries between on- and off-task talk

Abstract

Healthcare interactions often involve social, relational, small-talk or ‘off-task’ sequences which are largely topically distinct from the institutional business of the setting. In this paper we examine data from pre-operative assessment sessions in a Scottish hospital in order to explore the transitions between on- and off-task talk. In the majority of instances the movement between social and medical talk is routine and unproblematic, and both nurse and patient orient to the boundaried nature of off-topic talk. However, occasionally patients’ social talk evolves into personal disclosure and troubles telling which may disrupt the institutional agenda and which can lead to difficulties in the negotiation of sequence closure. Data are in British English.