Marlot Kuiper

184 Connective Routines his four planned surgeries. She calls the fellow 21 and a gynaecologist who together are going to do the surgeries. A third-year gynaecology resident will be assisting. When the secretary explains that I was going to shadow dr. Nieman today, they agree that I will be shadowing them instead. The secretary says to me: “That is also interesting for you, now you can see how things go when they suddenly change!” It already is 8.10am. We quickly change into our operating suit in the staff room to save time. Meanwhile, the two operators are making up a plan. The patients have to be notified that dr. Nieman will not be operating today, and they have to consent that two more junior professionals are taking over the surgery. They decide that the two operators are going to inform the patients and together run through the paperwork as prepared by dr. Nieman. I join the resident to the operating theatre for the briefing. When we enter the OR, he apologizes for the delay and explains the situation. The other teammembers show understanding. The resident leads the briefing. And then, they wait. It is 8.30 when the operators are entering the theatre. The fellow who is going to operate the first patient does the time-out. Out of memory, she checks the patient’s identity, the intervention, and allergies. Then, they quickly get started. This observation note shows how professionals have to act on the spot when things suddenly change. That doctors get sick too, is a given. Still, the occurrence of such situations is always unexpected. When different activities require professionals’ attention, they have to prioritize. In this specific case, professionals who did not prepare the surgery themselves – as this had been done by dr. Nieman who was about to perform the intervention – they have to read into the intervention and the patients’ condition and decide how to go about the surgery. The gynaecologist and fellow decided to inform the patients and prepare the surgeries based on the information sheet prepared by dr. Nieman, at the expense of their attendance at the briefing where the equipment and position of the patient is discussed. As there also was a gynaecology resident available, this task was delegated. To put 21 A fellow is a physician who has completed residency and chooses to complete further training within a subfield of her specialty.