Gatekeeping practices of nurses in operating rooms

This paper explores the gatekeeping practices used by operating room nurses to control information flow in their everyday clinical practice. In nursing, gatekeeping appears only sporadically in the literature and usually emerges as a secondary concept rather than being the primary focus of studies. As gatekeeping is a communication practice that has the potential to impact directly on patient safety, a more in-depth exploration of its pervasiveness and effect needs to be undertaken. Accordingly, in this paper we aim to provide an in-depth understanding about gatekeeping practices in operating room nursing by drawing on a 'network' model of gatekeeping to highlight the power relationships between stakeholders and how information is controlled. To illustrate our points, we provide four different examples of gatekeeping at an interpersonal level of interaction. Data are drawn from an ethnographic study in Australia that explored nurse-nurse and nurse-doctor communication at three different operating room departments. We explore the impact of gatekeeping on social and professional relationships as well as how it has practical and ethical ramifications for patient care and the organisation of clinical work. The findings show that nurses are selective in their use of gatekeeping, depending on the perceived impact on patient care and the benefit that is accrued to nurses themselves.