Send message to Author

Paper short abstract

How is a form of ‘hospital consciousness’ being imagined and integrated into the Spanish public hospital through antimicrobial optimisation programmes? At the edge of intervention, where the limits of antimicrobial treatments are witnessed, collectivity offers professionals a shared medical project.

Paper long abstract

With the development of antimicrobial resistance (AMR) continuing to unsettle the foundations of medicine, antibiotic treatments may not fully respond, limiting the outcomes of otherwise routine hospital medicine. Healthcare professionals must find ways to adapt. They are not only innovating in drug treatment regimes and diagnostic processes. They are also actively rethinking how responsibility and hospital care are collectively understood. In this paper I argue that a form of ‘hospital consciousness’ is being imagined and integrated into the Spanish public hospital. At the edge of intervention, where the limits of antimicrobial governance are felt and witnessed, professionals experiment with doing the hospital otherwise. Based on a multi-sited ethnography, the story follows the everyday practices of interdisciplinary teams running Spain’s medical programmes dedicated to optimising antimicrobial drug treatments in public healthcare. I show how the Programas para la Optimización del Uso de Antimicrobianos (shortened to ‘PROA’) are less a technical solution to AMR, and more a social infrastructure through which clinicians, microbiologists, and pharmacists, among others, see themselves as belonging to a shared moral economy and a common epistemic project. Through an exploration of the affects and politics involved in building PROA interventions, and the historical dimensions of antimicrobial governance, this work problematises the hospital’s collective character. The case of PROA interventions demonstrates how collective work on a collective problem unfolds in a medical system otherwise organised around the individual—the individual patient, doctor, medical specialty, room, ward—; in turn producing crucial forms of professional belonging, ethical deliberation, and affective commitments.