“Scissors, Please.” The Practical Accomplishment of Surgical Work in the Operating Theatre.

The focus of this article is on professional activity in the operating theater. We explore how surgeons and nurses organize their activities, how social interaction is used to help structure and define situations, and how differentials in knowledge are constructed and oriented to. We utilize some ideas and concepts from symbolic interactionism, ethnomethodology, and conversation analysis to analyze small clips of audio- and video-recorded interaction. Focusing on how surgeons and nurses request, provide, and apply surgical instruments, the analysis shows how surgical work is accomplished through talk and bodily conduct. We conclude that, examined in detail, the social interaction between surgeons and nurses is analytically inseparable from the “technical” demands of their work.

Read the full article: Bezemer, J., Murtagh, G., Cope., A., Kress, G. and Kneebone, R. (2011). “Scissors, Please” The Practical Accomplishment of Surgical Work in the Operating Theatre. Symbolic Interaction 34, 3, 398-414.

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“Do You Have Another Johan?” Negotiating Meaning in the Operating Theatre.

This paper discusses language use at a workplace in a context of instability and diversity. Its focus is on the operating theatre, where communication is an integral part of complex, collaborative tasks, impacting on patient-safety, staff well-being and overall quality of health care. In the operating theatre health care professionals gather to work on the recurring task of surgical operations, in teams that exist only for the duration or parts of the task. Not only do the members of these unstable teams have different professional backgrounds, such as surgery and nursing, they also draw on different, social, cultural and linguistic resources. The paper shows how this instability and diversity which is so characteristic of contemporary society plays out in the moment-by-moment use of language at the operating table. On the basis of prolonged fieldwork in a London hospital and a unique set of audio- and video-recordings we show how surgeons formulate requests and how nurses and surgical trainees disambiguate these requests on the basis of their prior experiences with surgical instruments and equipment, the surgical procedure, and, crucially, the surgeon’s ‘idiolect’. We analyze instances where this process of disambiguation is highly successful, as well as examples where it is not. We tease out the strategies that nurses and surgeons deploy to deal with this ambiguity and explore ways to deal with instability and diversity in professional communication.

Read the full article:: Bezemer, J., Cope., A., Kress, G. and Kneebone, R. (2011). “Do You Have Another Johan?” Negotiating Meaning in the Operating Theatre. Applied Linguistics Review 2, 313-334.

“Are you happy?” Collaborative decision making in the operating theatre

Decision making has become a key term in the endeavours of health professionals, patients, policy makers and researchers to describe clinical work and explain its outcomes. In this talk for the Social Science Research Forum, Queen Mary University, 27 March 2012, I explore how decisions are made in the operating theatre. I will report the initial findings of a detailed analysis of talk during 12 laparoscopic gall bladder removal operations. The focus will be on who says what to whom prior to the cutting of the cystic duct and the cystic artery. This is a critical moment in the operation as there is a risk of incorrect identification; the structures to be cut look like the main structures from which they branch off and which should not be damaged. Our analysis shows that in this data set the decision to cut the structures thought to be the cystic duct and cystic artery was always made in collaboration, irrespective of whether it was a consultant or a registrar who was operating. By asking, eg, “Are you happy?” the ‘operating’ surgeons sought confirmation from their (senior) colleagues prior to making the cuts. I will discuss the implications of this form of collaborative decision making, and place them in relation to current discourses, in the NHS and in society at large, about participation, sharing, agency, responsibility, and transparency.