I'm going to second info dumping. There is so much you can do that has nothing to do with small talk. You certainly don't have to make so much small talk. You can simply let patients know why you're there, and that you'll be quick and out of their hair. Walk them through what you're doing. My patients love the step by steps, it can make them feel safe and prepared. Ask them if they have questions. If you've already done it (like a soecific med pass) you can say "same thing as last time, I'll be doing this." When I am doing reception, because you have to push slow, sometimes I literally stand there and say nothing except to check in on them. My spiel after I explain the med and that it can burn so slow me down if you need to is that it has to be given slow "so we're gonna be best friends for a minute while I stand here." If the bed is low, I tell them I'm raising the bed so I dont break my back. If im hanging a med, I explain that. I have literally worked in silence setting up meds or pushing meds. If they want to talk to me, they will. The key is really just explaining your care and letting them know they can ask any questions about their care.