Ethnography Defining the Scene the Term Paper

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Having experienced firsthand the reprieve his profession offers, the barometer of his success is simple, if there was no pain and no lingering side effects, then there was success.

Surgical Technologist

I was also able to interview the surgical technologist. She occupied many of the duties I had always believed were held by the head nurse. In fact the role of the surgical technologist entails not only having a detailed knowledge of the procedure in order to assist, but also an ability to anticipate a surgeon's need for different tools, set up the table of tools in precise order, and ensure that in the event of an emergency access to the necessary corrective instruments and supplies is as close to immediate as possible. After the insight I was provided with about the function of the surgical team I was excited to hear how she would explain the meaning in her position within that social scene. "Well, what I do, is not terribly glamorous and doesn't come with a great title. Lots of times people think I'm like a dental technician. Really though, I like to think that I lay the immediate groundwork for the procedure. I get everything ready and set it up. The highest compliment I can be paid is if the surgeons and other experts in the room never have to look for an instrument before they grab it, never have to ask for an instrument because it's always there waiting." I thought this was interesting, rather than emphasizing the knowledge necessary, Miss Allen prided herself on people not actually noticing the results of her job. Perhaps it really is she who is in control in the room. Without her attention to detail and emphasis on first time perfection, the procedure would take longer and perhaps be markedly less successful.

A day in the life informants Perspective

Speaking with these three key participants I was able to see that really there was no room for ego in the operating room. Each participant knew their role and understood the significance of working seamlessly with the rest of the team. In the people I was able to interview, there was no indication that they were filling these positions in search of glory. They spent years working towards being able to work quickly and effectively to correct a physiological problem with as little inconvenience and discomfort to the patient as possible. Each compelled by a personal barometer of success to be the very best they are able every single time they walk into the room. No participant apparently unaware of the very tangible very precious commodity which complete strangers entrust to their expert care every single day.

Vignette

I was able to secure permission from the Dean of Medicine to sit in on any surgical procedure for which she received consent from the patient during the time slots allocated for my visit. A man with a badly fractured leg was en route to the hospital as I arrived and checked in at the office. What followed was a complex surgical resetting of the bone. The informants I was able to interview were those participants in the surgery. It was interesting that I was able to watch them work first and interview them afterward. Below is my impression of the procedure from the surgical viewing theater.

Observation

On the morning I was able to view the procedure I checked in at the administrative offices and was rushed immediately to the viewing theatre situated slightly above the operating room. Closed off from the room I had visual and auditory access without the ability to impede or interfere in any way. Standing at the glass I was able to see the concentration as all those "scrubbing in" prepared. The patient was wheeled into the room already under sedation. The surgical technologist and scrub nurse cleared and sterilized the area which would be cut into during the procedure. The operation involved the setting of a badly fractured leg. The individual had been involved in a road accident of some sort and his femur would require setting and pinning in place.

The orthopedic trauma surgeon walked in, he took a moment to consult the x-rays on the light board and then walked over to the patient looking down and taking a deep breath before holding his hand out for the first instrument. The surgical technologist had the instrument, a scalpel, in his hand seemingly before his hand was even extended all the way. Without looking back the surgeon set to work opening the injured limb and beginning to irrigate the incision. The anesthesiologist kept his eyes fixed on the array of lights and electronic read outs before him, monitoring a host of diverse vital statistics occasionally adjusting one chemical level or another. Reporting various values to the surgeon when asked his whole attention focused on the patient.

The secondary surgeon stood opposite the primary surgeon assisting in the placement of bones back in alignment, as well as ensuring that no arteries, or blood vessels were violated, ensuring the potentially deadly marrow of the broken bone was contained entirely. It was nearly like listening to another language when the participants communicated with each other. Clipped efficient sentences capitalizing on handy abbreviations for nearly everything it was clear throughout the length of the ninety minute procedure that every single person in that room knew what each other person was supposed to be doing.

The surgical assistant and technologist moved as two limbs of the same creature handing in instruments moving to a position of assistance when one might be needed, their hand reaching the clamp or the irrigation tube or the external braces before the surgeon could even ask, the surgeon able to rely on that preemptive expertise and confidence to just move onto the next part of the procedure without having to check that what was necessary was being done.

The ninety minutes of the procedure flew by, literally it felt as though I had only just walked into the viewing theatre when the primary surgeon left the room after a rushed thanks leaving the suchering to the secondary surgeon. The anesthesiologist, scrub nurse, surgical technologist, and surgical assistant continuing seemingly unhindered by the sudden departure of the primary surgeon who moments earlier was directing their every movement. The surgical assistant moving into the place where the primary surgeon had originally stood in seconds it is as though he were never there. As each participant completed their specific role, they left the scene without waiting for thanks or to hear whether or not everything went well. They trusted wholly in their team, knowing they would work tirelessly to affect the desired outcome. Their part completed they were already thinking about the next case before they finished removing their scrubs.

Discussion of Observation

Though only occasional co-workers the degree of trust and reliance between the participants I was able to observe was almost unbelievable, as though the entire procedure had been practiced for weeks before actually being performed. However, the patient had only been ambulanced in immediately before my arrival. The team was called together and essentially thrown into this social scene with very little notice. Again though, they performed flawlessly. All working quickly and efficiently as a single minded organism whose continued existence depended on the success of the procedure at hand.

Fieldwork Methods

Reason for scene Selection

I chose the operating theatre because it is a setting in which I hope to work one day. The excitement and diversity of a career in general surgery, working in emergency situations is a position which is not only my dream but the place in which I feel that I will be able to do the most good. The opportunity to observe two procedures from the viewing theatre was incredible, it indicated to me without fail that that was where I belong. What was unexpected though was the lingering fascination with the role of surgical technologist which I am left with after my interviews. Perhaps, if in the course of my study, I realize that becoming a surgeon is no longer a possibility, a career as a surgical technologist is a way that I might be able to fulfill my dream of working in the operating room. Ultimately what I took away from the experience was that the stereotype of surgeons with "god complexes" was utterly, at least in the context of those I observed, false. These were hard working professionals who held themselves to the harshest standard of all.

Gaining Entry

In order to gain access to the operating theatre I approached the director of the hospital arranging an appointment through her secretary. In the meeting I brought a letter of attendance confirmation with evidence of my course of study as well as a letter obtained from my professor…[continue]

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