Marlot Kuiper

98 Connective Routines formal access to the setting, but one also has to gain acceptance (Hammersley & Atkinson 1995). A first absolute requisite to conduct an ethnographic study, is to gain access to the field. In conducting this ethnographic study, I noticed a clear difference between what I call informal and formal access. The gate-keeper played a key role in gaining informal access to the research field. I got in touch with various actors in the field who were open to conversations and observations. After this informal access was arranged however, formal access appeared a bit more complicated. The various respondents did consent with observations, as long as “things were arranged officially”. Formal approval for the study was obtained via the hospital board and the heads of the various departments. Further, at both research sites, the research proposal was presented to a research board that is concerned with considering possible ethical concerns. Since this study did not involve any interventions with patients, approval of the Medical Ethics Committee was not necessary. Still, as a researcher I did encounter patients throughout the process. The first hospital under study therefore required an appointment as ‘research assistant’, which included signing secrecy forms, obtaining a Certificate of Conduct (Verklaring Omtrent het Gedrag, VOG) and attending a Quality and Safety module for new employees. At the second research site, after the proposal passed the research board, a name tag stating the role ‘guest’ was sufficient. The second research site could rely on the experiences of the first research site with the research project, which could have caused that they did consent with the project more easily. Gaining formal access from the hospital board had been a bit of a hurdle, but once I got formal access and entered the field, professionals were more than willing to show me their work. It is noted that besides the formal access to the field, gaining acceptance is a crucial element in gaining in-depth insights. Burgess (1991) noted that gaining access is a continuous process of negotiating and renegotiating relationships. Though the gate-keeper made an invaluable contribution in gaining access to the field by promoting the project and virtues of the researcher, as Gill (2008, p. 84) nicely stated: “total reliance on this entrée into the field is naïve” since the researcher has to form and maintain meaningful interpersonal relationships in the field (Harrington, 2003).