In the hospital, routines carry us through our days and lend a semblance of structure to the chaos of lives disrupted by illness. Some routines happen on a large scale—weekly gatherings of departments for Grand Rounds, hospital leadership meetings for safety huddles, the hustle of getting a cadre of operating rooms started nearly simultaneously in the predawn. Other routines are more intimate—the sequenced process of doing a sterile central line dressing change, the donning and doffing of PPE outside a patient’s room, the one-one-one nursing handoff at shift change.
In her Field Notes essay “Faith in Nursing,” (Fall 2018 Intima) Sarah Christensen weaves together the rituals of Ash Wednesday and the intimate moments of bedside nursing on a pediatric oncology floor. That death is a part of life is a fact felt many places in the hospital but often brought into painful focus among children robbed of time by cancer. On the day of the church year that Christians set aside to acknowledge our mortality, Christensen is faced with the death of patient. As she goes through the routines of nursing that day, she carries her patient’s memory with her and her tasks take on greater meaning.
Ascribing meaning to our daily routines in healthcare, elevating our patterned tasks to ritual, helps us connect more meaningfully with our work and patients. Whereas a routine can be performed rote, ritual is performed with intentionality and thought. In my Field Notes essay “Lauds,” (Fall 2021 Intima) I explore the routines that mark the beginning of a day in the operating room. Lauds refers to the canonical hour of dawn set aside for prayer at the start of each day. Part of the operating room ritual is communal with the team, but there is also a special moment of solitary prayer at the scrub sink. What could be a mindless task is transformed into a moment of prayer, a surgeon’s preparation for the solemn responsibility of caring for a surgical patient. By living into the ritual of the moment, caregivers can experience deeper connection to their work in healthcare.
Kristen A. Zeller is a pediatric surgeon in Winston Salem, NC. She earned a Bachelor of Arts in English from Augustana College (now University) in Sioux Falls, SD before earning her medical degree at the University of South Carolina. Focus on her surgical career pulled her away from writing, but she’s finding her way back and is enjoying the restoration found in the creative process. Her life as a surgeon and writer is buoyed by the support of her husband, three children and the family dog.