Keeping “Small Talk” Small in Health-Care Encounters: Negotiating the Boundaries Between On- and Off-Task Talk

Abstract

Health-care interactions often involve social, relational, small-talk, or “off-task” sequences that are largely topically distinct from the institutional business of the setting. In this article we examine data from preoperative 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 that may disrupt the institutional agenda and that can lead to difficulties in the negotiation of sequence closure. Data are in British English.