Marlot Kuiper

85 The gate-keeper the site. The support of the gate-keeper may have stemmed from his genuine desire to see this research being conducted, but it was supported by the tentative personal relationship that was fostered through our exploratory conversations about research. These conversations were not limited to my initial plans for this dissertation, but involved wider explorations of possible research projects that could be conducted in the healthcare field, combining insights from healthcare, public admin and organisation science. The gate-keeper was my entrée to the closed world of surgery. In the next chapter ‘On ethnographying’, I provide more details on what I call the difference between gaining informal and formal access, but I can underline that the gate-keeper has been crucial in gaining both. He did not put any restrictions on who I would contact, and he actively tried to find different colleagues to participate; juniors, seniors, those known as ‘in favour of standardization’, those known as ‘hesitant’ or ‘against change’. In that way, we tried to create a balanced and representative group of respondents for shadowing. With his enthusiasm for the project, the gate-keeper convinced both his direct colleagues from Plainsboro, as well as ‘colleagues’ from St. Sebastian’s to take part in the study. To get a sense of the fieldwork, getting to know the surgical department and explore how the analytical frame worked out, I decided to start off with shadowing the gate-keeper. Naturally, he had more background knowledge about the project than the other respondents would have. I still remember that initially, the situation was a bit ‘uncomfy’; we had been discussing clinical work, checklists and routines, and now the time was there to actually ‘see’. At the start of the day, the gate-keeper told me: “I will to try to act as usual” and a bit later: “I will act as normal in a while anyway” (that’s the thing with routines, you easily get back to routines as they provide guidance.) Interestingly, the gate-keeper got reflective; he was doing things as he was always doing, but started to reflect upon them. He started to apologize: “I noticed that when in a hurry, I can be very direct, and not always kind”. Of course, that’s exactly what I wanted to see; professional work being carried out within context. But, as I got to know the field a bit after a couple of days, and the gate-keeper had in-depth knowledge about the project, it was time to shadow other respondents. Shadowing other respondents did not mean that the role of the gate-keeper was eliminated. Rather, the gate-keeper functioned throughout the process as ‘sparring partner’ and ‘member check’. The conversations we had were extremely valuable. The gate-keeper provided contextual knowledge, helped me out with