Marlot Kuiper

228 Connective Routines Then he leans towards the scrub nurse, to look over her shoulder and list the items that are on the board. “Are all materials ready?” he asks. The operating assistant nods and ticks off the boxes with the whiteboard marker she was chewing on. Dr. Huijs finishes the time-out by asking if the patient has any questions left. With a somewhat forced smile the patient replies: ‘Just let’s get it over with!’” As I did not yet understand what role the whiteboard played in the checklist procedure, I decided to ask the scrub nurse for more in-depth insights on this new artefact in the arrangement: I: “Who is responsible for the checklist board?” operating assistant: “That is very, very unclear. At first, they said anaesthesia is.. Some doctors do it themselves.. but actually, actually the scrub nurses took it as their task to fill out the checks on the board.” Indeed, in most instances, the scrub nurse was the actant that filled out the board during the performance of the checklist. In the observation note, the nurse confirms the item ‘materials ready’ before ticking off the box. But almost never, there was a conversation about what was actually filled out with the other team members, and in nearly all cases, almost directly afterwards the board was put to the side and never looked at again. In this way, filling out the board indeed became a matter ‘that the scrub nurses took on’, but it also was something they kept to themselves. As clinicians mostly did not see the added value of the whiteboards compared to registration in the software system, they left it aside and scrub nurses took it on as their task. It also happened however, that the board remained untouched on a table or stool at the side of the operating theatre; blanc. With the introduction of a new artefact, responsibilities were never re- negotiated, somehow they found their way in practice, but responsibilities got more complex and scattered. Throughout the observations in both hospitals, I came across different understandings of ‘responsibilities.’ What did become clear, is that the surgeon is responsible for the patient. As treating physician, they are responsible for what they usually call “their patient.” The abstract pattern of what this ‘general responsibility’ implies for further procedures surrounding the patient, is