Managing information, interaction and team building in nurse shift-change handovers

Abstract

Whilst there is a wealth of literature on medical handovers, discourse analytic work based on recorded interactional data on these pivotal speech events in health care is less prevalent. This case study of a shift-change nursing handover at a UK hospital Medical Assessment Unit (MAU) takes a microanalytical perspective on nurses’ talk and interaction, which enables us to examine its structural and functional complexity at utterance level. Our methodological approach comprises observations, one semi-structured interview with senior nursing staff (and many informal conversations with various staff), and in total twelve audio-recordings of interactions during, and around, the twice-daily shift-change handovers. By adopting ‘a multiple goals in discourse’ perspective and the framework of activity analysis, we demonstrate the nurses’ interactional management of multiple discourse and activity roles and pursuance of goals that transcend the medically and institutionally crucial transmission of information. This shows the nurses’ orientation to the handover task as not only a structured institutionally regulated event, but also one that tolerates more spontaneous activities that can potentially contribute to team cohesion and staff well-being.