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The “As-If” World of Nursing Practice

Nurses, Marketing, and Decision Making

Grundy, Quinn PhD, RN; Malone, Ruth E. PhD, RN, FAAN

doi: 10.1097/ANS.0000000000000143
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The “as-if” world of nursing is a well-constructed, institutionally preserved and defended myth that asserts clinicians who are “just nurses” do not make decisions in the absence of “doctor's orders.” Drawing on data from an ethnography exploring the interactions between nurses and industry, we explore the finding that many nurses did not identify as “decision makers” and were mystified by the attention of sales representatives. Many nurses experienced marketing as benign as there was no “decision” to sway. Nursing must deconstruct the “as-if” nondecisional myth by confronting conflicts of interest and owning fully its rightful clinical and advocacy roles. www.advancesinnursingscience.com

The “as-if” world of nursing is a well-constructed, institutionally preserved and defended myth that asserts clinicians who are “just nurses” do not make decisions in the absence of “doctor's orders.” Drawing on data from an ethnography exploring the interactions between nurses and industry, we explore the finding that many nurses did not identify as “decision makers” and were mystified by the attention of sales representatives. Many nurses experienced marketing as benign as there was no “decision” to sway. Nursing must deconstruct the “as-if” non-decisional myth by confronting conflicts of interest and owning fully its rightful clinical and advocacy roles.

Charles Perkins Centre, Faculty of Pharmacy, University of Sydney, New South Wales, Australia (Dr Grundy); and Department of Social and Behavioral Sciences, School of Nursing, University of California, San Francisco (Dr Malone).

Correspondence: Quinn Grundy, PhD, RN, Charles Perkins Centre, Faculty of Pharmacy, University of Sydney, D17, The Hub, 6th Floor, NSW, 2006, Australia (quinn.grundy@sydney.edu.au).

This work was funded by the Canadian Institutes of Health Research (CIHR) Doctoral Research Award and grant number R36HS022383 from the Agency for Healthcare Research and Quality. Dr Grundy was supported by the Graduate Dean's Health Science Fellowship, University of California, San Francisco.

The authors acknowledge Mollie Grundy, BScN, RN, Kate Horton, PhD, RN, and Lauren Kirby, BSN, RN, for their critical review and thoughtful comments on this manuscript.

The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.