Marlot Kuiper

186 Connective Routines We are halfway through the programme in the operating theatre where four gynaecology operations are planned today. To resume the programme, the surgeon needs the anaesthesiologist for epidural anaesthesia and the time-out. The assistant calls the anaesthesiologist to ask if he will come to the theatre for the time-out. The anaesthesiologist answers that he is still very busy at the other theatre, where his task is complicated and will take a few more minutes. If they can wait a little longer, he will be there as soon as he can. A fewminutes pass by, in which the surgeon checks the clock several times. She sighs. “Come on, hurry up! I have more to do today! And you know what, if the programme isn’t finished in time, who has to inform the last patient that the surgery is postponed?! Me!” To the nurse anaesthetist: “Can’t you call one of the other anaesthesiologists? There might be someone wandering around, right?” The nurse anaesthetist calls the staff room to see if someone is available. She hangs up the phone, and, satisfied, she says, “There will be someone any minute!” Again, a few minutes pass by. Then the second anaesthesiologist who was called enters the theatre and prepares for the epidural. Within seconds, the other anaesthesiologist enters the room. “What are you doing here?” And then, annoyed: “You should have called me if you didn’t need me anymore. Now I have been working my ass off and rescheduled to be here, and for what? For nothing!” The anaesthesiologist is not able to perform epidural anaesthesia in the two theatres at the same time. However, in the best way he can, he tries to manage these two processes anyway. This response involves informing the others to manage their expectations and prioritizing the different tasks. By giving priority to finishing the first task, the processes in the other operating theatre are put ‘on hold’. For the surgeon, this means that her series of routines gets disturbed. To keep the process going she tries to find a replacement for the anaesthesiologist, which again requires a lot of adjustment. In the end, the various professional routines seem to ‘clash’ rather than ‘connect’. A conversation with the surgeon later on revealed some ideas about the ostensive dimension of the checklist routine. She