Sign reading: making sense of what is going on in the ward

When entering a ward the environment observed can be perceived in one of two ways: either from the perspective of 'background', this being the backdrop against which events take place, or as the main focus of attention, thereby alerting the observer to what is going on in the setting. Whilst undertaking their work nurses emit signs which patients, relatives and other staff interpret and through which they gain an understanding of the type of work about to be undertaken at the clinical interface. The themes of private work, showdown work and tragic plight work, which were generated from an observational study in a surgical ward, are discussed in this article. Findings show that, despite nurses attempts to hide the gravity of a message from patients, they in fact give more away than they hide.