Marlot Kuiper

111 On Ethnography ing Box 3: The surgical trajectory The surgical trajectory encompasses more than the surgery itself. Hence, the surgical department encompasses more than operating theatres. To interpret the findings of this study, I’ll provide some background concerning the surgical trajectory and the surgical department. A first important thing to note is that there is both inpatient and outpatient surgery. Inpatient surgery takes place in the hospital’s surgery department, and the patient usually stays at least one night in the hospital after surgery. Outpatient surgery occurs in a another department of the hospital, and the patient is discharged the same day. Most fieldwork for this dissertation was done at the inpatient surgery department, but to get a comprehensive overview of surgical, observations were also conducted at the outpatient clinic, and even at the emergency department. Patients enter the surgery department at the pre-operative holding. They can enter the holding either from home or one of the surgical wards. The holding is the place where the patient changes for OR clothing and is asked to confirm details about the surgery. The surgeon marks the surgical side and site. The patient gets a IV line for the administration of pre-operative medication like antibiotics, and in some cases the anaesthesiologist performs local anaesthesia. From the holding, the patient is taken to operating theatre where the actual intervention takes place. All three parts of the Surgical Safety Checklist have to be performed in the theatre; at the start of the day, before incision and before the patient leaves the theatre. After the operation is finished, the patient is handed over to the recovery unit. Here, the patient is closely monitored. When the patient is considered recovered from anaesthesia, he/she is either transferred to a surgical ward elsewhere in the hospital or discharged home. Figure 5 visualizes the surgical trajectory. Figure 7: The surgical trajectory 4