The word ‘routine’ and surgical shorthand such as ‘TAH’ on an operating list belie the scope of perioperative nursing. The pressure to treat more patients, reduce waiting lists and maximise the use of resources allows us no time to consider the enormity of surgery as an experience for the patient and an exercise in nursing expertise. In this article, Denise O'Reilly takes a critical and analytical look at a common procedure, hysterectomy. Her analysis is astute and well supported, taking into account both ideology and reality. We could all do better if we tried, and this article may prompt you to think about some of those ‘routine’ operations you helped with today …