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'Our small acts against antimicrobial resistance can help make a difference'

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Small acts can have large impacts. Within nursing this is so ingrained that it can often seem invisible.

Colin MacDuff

Colin Macduff

The touch on your back to steady and say “we are here”; a pause to wash hands; or kind words to your anxious loved ones. Over time, seemingly small acts add up to form a bigger picture, which we hope is the visible embodiment of high-quality care.

But what happens when small, well-intentioned acts of commission and omission add up over time with unintended consequences?

As the largest group of health professionals in the world, nursing is necessarily part of a collective global problem, where many of our microscopic pathogens have become resistant to the antibiotic treatments developed over the last 90 years.

With every small episode of inappropriate antibiotic use, or missed opportunity to prevent infections occurring, we have inadvertently helped to grow the bigger problem of antimicrobial resistance (AMR).

Now the prospect of few – or any – effective antibiotics overshadows the future of many taken-for-granted treatments. So how can we, as nurses, help to bring in some light?

As ever, big impact can come from attention to seemingly small details. While colleagues in science and pharmaceuticals seek big breakthroughs for new antibiotics, we can turn the microscope on our own practice with patients, families and communities to see how best to build in stewardship of our existing ones.

However, recent surveys of nurses in the UK and beyond suggest that to date, nursing’s engagement to address this challenge has been limited and mostly involves top-down approaches.

Our new small-scale research project, RIPEN (Re-envisaging Infection Practice Ecologies in Nursing), is looking to start from where nurses are in terms of daily practice and use the lens of the arts and humanities to help with engagement and development.

Starting from June, over the next year we will hold workshops in London for community nurses and in Glasgow for hospital nurses. Rather than tell you what is the right thing to do for your own practice, we will work with you to develop ideas creatively and collectively. Between times we will share ideas via a web space.

We will draw on ideas on visualisation and infection prevention (for example VisionOn and VREIA) and explore what can be learnt from nursing’s history. In considering practice in a possible future with few or no effective antibiotics, we will also draw on film, prose, poetry and drama.

As such, the project will explore different ways of thinking and seeing, all of which are highly relevant to professional development and Nursing and Midwifery Council revalidation.

No particular knowledge of the arts, humanities, or AMR are required to take part. Rather, we are looking for nurses who would be keen to explore the issue and solutions together, so that our small acts can collectively help to make a big difference.

Dr Colin Macduff is senior research fellow, School of Design, Glasgow School of Art

To take part in RIPEN (, please contact Colin Macduff:

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