Marlot Kuiper

110 Connective Routines Box 2: The Surgical team For non-clinicians to be able to interpret the findings of this study, some context of the surgical team and the surgical trajectory might be useful. Roles in the surgical team include: a surgeon, an assisting surgeon - who usually is a resident supervised by the surgeon - an anaesthesiologist, a nurse anaesthesiologist and nurses. In some cases, a fellow (a registered surgeon who is further specializing) and an intern (who is studying to become an elementary physician) are also part of the team. There are usually three scrub nurses in the team, who rotate their tasks during the day. One of them is assisting the surgeons during the intervention, for example by handing them equipment and holding clamps and sucking up body liquids. The other two are responsible for the materials. By working in teams of three, the scrub nurses can change shifts and therefore take breaks. For the surgeons and anaesthesiologist, there are no fixed breaks in the program, which means they on the spot have to decide to take a break. For rare or complex interventions, the team can be extended by for example a radiographer. In specialized areas of surgery like thoracic surgery, a specialist who operates the cardiopulmonary bypass machine is a stable member of the team, and so is an anaesthesiologist who is specialized in these surgeries. There is thus no stable amount of team members, but teams usually fluctuate between 8 to 12 people (figure 6). Figure 6: Composition of surgical teams