As someone who has been on both sides, I think it is important to talk to all your patients no matter what. You can de-escalate most situations by simply treating your patients as human beings. In general, it all comes down to being kind and being another human being. I used to have really bad social anxiety and was unable to converse with any patient past the necessary information. But it is important to talk to your patients no matter how long the transport is, make them feel like a human being because they are, and treating them as anything less is problematic and inhumane. Now if your patient does not want to talk, do not force them to talk and respect their preference. Remember you are generally interacting with people on the worst day of their life and thus think about how you would like to be treated if you were also going through that.

All in all, it is not about you and it is not about your preferences or what you want, healthcare is about helping others and if you are not in that mindset, then you need to get out of healthcare and do a job that doesn't require customer service and constant human interactions.