Marlot Kuiper

229 scattered however. Different professional groups hold different understandings of where responsibilities lie, and how they have to be performed. Although surgeons refer to their responsibility for their patient, they usually claim that the checklist is “a matter of the anaesthesiologists”. Presumably, this has to do with the fact that the anaesthesiologists take the lead in optimizing artefacts. As surgeons feel that the checklist is something that has been annexed by the anaesthesiologists, they also feel that responsibility comes with that. The surgeon is responsible for the patient, but the anaesthesiologist is responsible for the checklist. The operating assistants do not assign responsibility to a particular group. On the contrary, they see responsibility as something shared: “The checklist? It’s a shared responsibility. We’re responsible for it altogether!” a scrub nurse told me when I asked about responsibilities regarding the checklist. As the surgeons and anaesthesiologist in Plainsboro literally didn’t pick up the whiteboards, the scrub nurses started doing this. This wasn’t something that had been discussed, but through recurring performances, the abstract understanding became that the whiteboard was “something the scrub nurses take care of”. To conclude, either with disentangled responsibilities in an artefact or a plurality of artefacts it thus can become less clear who is responsible for what exactly. These understandings of responsibilities vary among professional groups. This adds to the finding that “the checklist” in principle, doesn’t exist. As more representations or amendments of the rule enter the field, what the checklist ‘is’ becomes even less clear. 7.4.3 Collaborative action? I am shadowing anaesthesiologist dr. Liem in St. Sebastian’s. We just signed out a patient in OR5 and we’re heading towards OR6 to see how the operation there is proceeding. When we arrive at OR6, dr. Liem lifts up to his toes (he’s not that tall) to look through the small round window in the door. The screen besides the door accurately counts the door openings. Every time the door opens, there is a risk. A disturbance of the air circulation might invite bacteria into the patient’s open body and cause infections. Dr. Liem points towards the clock in the OR and puts up one of his thumbs. The surgeon responds by putting up his hand two times – indicating 10 minutes – followed by a thumbs up. We head back to the coffee room to return in 10 minutes for the sign-out. 7