Writing effectively
Article Outline
What is good writing? Some people would say it is like good art, “I know it when I see it.” Good—or more correctly—effective writing can be defined, however: it is writing that communicates effectively to the reader. In other words, the reader gains an understanding of the message of the article—what the author wants the reader to think, do, or feel.
A simple formula developed by communications expert Wilbur L. Schramm in the 1950s states that the extent of effective communication depends on this ratio: expectation of reward versus effort required.1 Ideally, the expectation of reward is high and the effort required is low.
Think about the nursing textbooks you read as a student. You struggled with some of them, but you could understand others more easily. Your reward was gaining the information and knowledge you needed to become a nurse. Your effort was reduced when the author used clear, concise sentences combined with graphics (eg, tables, figures) that reinforced key points in the text.
Your task as a writer is to increase the level of reward for readers while decreasing the effort they must exert to understand the material. You can increase reward by choosing topics of interest to nurses, and you can decrease effort by writing in a way that is easy to understand. When you write, consider the four Cs of effective communication: clear, concise, correct, and compelling.
Clear
Writing clearly means choosing the right words and crafting your sentences and paragraphs with care. Do not use long words to impress readers when simpler words will do. If your readers must turn to the dictionary every few sentences, you will surely lose them. Use adjectives and adverbs like a pungent seasoning—sparingly—and avoid “ize” words such as “utilize,” which are poor substitutes for their clearer counterparts, in this case “use.”
As you develop sentences, think about giving your readers all the information they need. For example, which of these sentences will readers find more useful?
Although their intent is the same, the second sentence clearly provides more information.
Active voice. Use active voice rather than passive voice. Active voice clearly conveys what action took place and who was involved.
Jargon and acronyms. Avoid using jargon such as “surg tech” for “surgical technologist” or “labs” for “laboratory tests,” and always spell out acronyms the first time they appear in your text, even if you think the meaning should be common knowledge. For example, in the context of your article, the acronym CNS may stand for “central nervous system,” “clinical nurse specialist,” or “coagulase-negative staphylococci.” Do not make your readers guess which one you mean.
Avoid using too many acronyms (eg, JCAHO requires RNs to perform an FRN w/I 24H of admission) or acronyms that will be unfamiliar to readers. You do not want your readers to have to flip back in the text to refresh their memories about what a certain group of letters means.
Ambiguous wording. The following sentence contains ambiguous wording that readers could easily misinterpret: “One study reported that perioperative nurses were more likely to communicate effectively with physicians than nurses in other specialties.” One reader may take this to mean that perioperative nurses communicate more effectively with physicians than other nurses do. Another reader may assume that perioperative nurses communicate more effectively with physicians than they do with other nurses. If you have to reread a sentence or paragraph to understand it, your reader will too. Decrease the readers' effort by rewriting the section to make it clear. In addition, when using nonspecific words such as it, this, and that, make sure the reader can determine to what subject these words refer.
Tone. Tone refers to the level of formality in writing. For example, you should strike a different tone when writing for the AORN Journal than you would if you were writing for Oprah magazine. Tone includes whether you use the first person, which incorporates the pronouns “I,” “we,” and “our”; second person, which uses “you”; or third person, which identifies the individual such as “the circulating nurse” or “the surgeon.” Most nursing journals have a formal tone, which requires the use of the third person and thus identifies the responsible individual for the readers.
King, S. On Writing—A Memoir of the Craft (New York: Pocket Books, 2002).
Nicol, A A M; Pexman, P M. Displaying Your Findings: A Practical Guide for Creating Figures, Posters, and Presentations (Washington, DC: American Psychological Association, 2003).
Oermann, M H. Writing for Publication in Nursing (Philadelphia: Lippincott, 2002).
Strunk, W; White, E B. The Elements of Style, fourth ed (New York: Longman, 2000).
Zeiger M. Essentials of Writing Biomedical Research Papers, second ed (London: McGraw-Hill, 1999).
Zinsser, W K. On Writing Well: The Classic Guide to Writing Nonfiction (New York: Quill, 2001).
When your sentences are clear, you are ready to move on to compilations of sentences, or paragraphs. The first paragraph should draw the reader into the article by explaining why it is important. Each paragraph should have a main sentence, and the subsequent sentences should build on that idea. Be sure that you lead the reader from one topic to another in a logical way.
Vary the length of your sentences and paragraphs to generate interest, but try to avoid writing extremely long sentences. As a test, read long sentences out loud. If you are out of breath by the end of a sentence, it may be too long.
Concise
Think about conciseness on the macro and micro levels. On the macro level, use headings and subheadings to organize the article. Consider using graphics to present information more concisely and effectively. For example, the demographics for a research study would work better as a table than as a long list of numbers in paragraph form. Flow charts present readers with an easy way to follow a process. For example, in the AORN Journal article “Using a monitored sip test to assess risk of aspiration in postoperative patients,” the authors used one flow chart to show how to perform the test and a second flow chart to show the protocol for cautious introduction of fluids.2
Do not try to tell your readers everything you know. Focus on “need to know” versus “nice to know.” Constant use of news “crawls,” e-mail newsletters, blogs, and other electronic forms of communication have shortened the attention span of most readers.
On the micro level, omit extraneous words that can slow the reader down. For example, the phrases “in order to” and “due to the fact that” are almost always unnecessary.
Sometimes in an effort to be concise, writers overcompensate, however. For example, the sentence “The new shorter smaller catheter is superior to the one used now” is concise but unclear because of the word string: “new, shorter, smaller.” A better way to write it is: “The new catheter is shorter and smaller, which makes it easier to insert into the hepatic vein of older adult patients.” The reader of the first sentence is likely to wonder how the new catheter is superior, and in the revised version, that answer is supplied. It is a good idea to anticipate your readers' questions.
Correct
Check your facts carefully to ensure their accuracy. Nothing is more embarrassing for an editor—or an author—than having to publish a correction. Worse, even one mistake can diminish your credibility in the readers' eyes.
Numbers. Statistics are an easy source of error in a research article. If you are reporting your research study, ask someone you trust to go through the manuscript and check each statistic with the original documentation. Errors also can occur when you are reporting specific medication dosages. These must be accurate because the article could be used as the basis for a patient care plan.
References. Do not forget to check references, not only for the accuracy of the information, but also for completeness of the citation. You do not want your reader to be frustrated when trying to locate a reference you cited. Again, this can affect your credibility.
Grammar and spelling. A simple way to check grammar and spelling is to use the built-in utility in your word-processing program. It will not catch every error, but it is a good starting point. Do not substitute an electronic grammar and spell check program for proof reading, however. An article riddled with grammatical and spelling errors may lead the editor to believe that it contains content errors as well. This could hurt your chances of getting published.
Compelling
If you provide information that is useful to readers in a way that they can absorb it, you will have produced a compelling article. One way to ensure that an article is compelling is to challenge yourself. Look for gaps in logic and again, anticipate readers' questions. Beware of general statements such as, “A robotics nurse specialist provides an important service.” Instead, add more substance by providing specifics: “A robotics nurse specialist acts as a resource for the staff and surgeons on the safe use and maintenance of robotic equipment.”
Self-editing
You will likely write several drafts of your article. Be non-judgmental on your first draft, but judgmental on your last. Nurses can be their own worse critics. Do not critique as you write the first draft; simply get the information written down. Then, devote yourself to rewriting. When you believe you are done writing and are working on the final edit, put on your “judgment hat” and then critique.
You can build a good relationship with your editor—and avoid having to make major revisions later—by taking time to edit your work before submission. First ask, yourself, “Did I adhere to my summary statement3 and achieve my objectives?” If not, start revising. Then use an editing checklist such as the four Cs of editing (Table 1).
Table 1. The 4 Cs of Editing
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Clear Is the tone consistent and appropriate for the readers? Are the sentences written in active voice? Are transitions used to move from one paragraph to another? Concise Is the article focused on “need-to-know” information with “nice-to-know” information kept to a minimum? Is the organization of the article logical? Have you eliminated extraneous words? Correct Are grammar and spelling correct? Are references used when appropriate, and does each have a complete citation? Compelling Is the article easy to read? Does the article fulfill your intended purpose? Does it contain enough information to fully address the topic? Are there any gaps in logic or unanswered questions for the reader? |
Words of Encouragement
This article contains a lot of advice about writing, so it is useful to put it all in perspective. You will not master all of these skills with your first article. It takes time and the experience of learning from expert feedback to mature into a good writer. Just as you have mentors for your nursing career, consider seeking mentors to help with your writing. These mentors may be individuals who have written for publication or editors on the staff of the journal where your article is published.
As a fledgling writer, remember to give the reader compelling information that is applicable to practice, and present it clearly, concisely, and correctly. Everything else flows from these basics.
Notes
- . “How communication works,” . In: Schramm WL editors. The Process and Effects of Mass Communication . Urbana, Ill: The University of Illinois Press; 1961;
- “Using a monitored sip test to assess risk of aspiration in postoperative patients,” . AORN Journal . April 2006;83:908–928
- . “Finding and refining an article topic,” . AORN Journal . April 2006;83:829–832
Editor's note: This is the fourth in a series of articles on writing for publication. The first article was published in the March 2006 issue of the Journal.
PII: S0001-2092(06)60146-4
doi:10.1016/S0001-2092(06)60146-4
© 2006 AORN, Inc. Published by Elsevier Inc All rights reserved.
