The paper develops the concept of language awareness (LA) by considering the material-social-discursive nexus of the communicative situation that affords professional practice. It also presents a mixed-methods study that provides a deeper and multi-layered understanding of LA in action and sets out a methodological framework for similar research in healthcare communication. Our study addresses: (i) the need for LA (re)conceptualisation in research on healthcare contexts, (ii) the ways in which a mixed-methods approach provides a deeper understanding of both implicit and explicit LA and (iii) the opportunities raised for reflection on practice through researcher-practitioner contact. Drawing on our linguistic ethnography of nurse shift-change handover meetings in a hospital unit, we draw on and expand van Lier's model by demonstrating the shortcomings of limiting LA to awareness of language as system rather than as activity embedded in particular socio-discursive situations. Regarding nursing handovers, we argue that handover practice and ongoing patient safety not only require the implementation of communication protocols, but also depend on nurses' reflective practice as the different types of interactions address crucially different levels of awareness. We conclude by discussing the theoretical and methodological contribution of our study to the fields of LA and healthcare communication.