Ten Lessons on Writing for Publication

Cheryl L. Mee, RN, C, MSN

All nurses have the potential to be an author. Each nurse can make wonderful contributions to the body of nursing literature, whether you are staff nurse, educator, manager, or even a student. Your perspective can help others gain insights into our profession. The biggest barrier to writing for a nursing journal is that nurses assume that authors easily come up with great ideas and write wonderful articles. That's not how it works! Investigation and preparation before writing play a large part in any successful author's work. This work is time-consuming, I admit, but if you do it, you'll be better prepared to write and you'll increase your chances of having your manuscript accepted by a journal. This article will help you write for both formal and informal style journals.

1. Be confident! You can be a nurse author.

Yes, most nurses can be nurse authors. But many don't even begin to write because they believe they don't have the knowledge or experience. This is a big mistake—and a waste of great experiences and lessons. Even students can get their work published in the right journal or newsletter—their writing reminds seasoned nurses of their ideals and experiences that brought them into the profession and of novice nurses' needs.

Writing is not just for nurses in academic settings—you can write about your practice and what you've learned. Nurses like to read about how other nurses in similar situations solve problems. It helps validate our work and our commitment to the profession. You have stories to tell and there are audiences for you.

When it comes to choosing a topic, don't assume that your ideas have already been written about or that your everyday knowledge is prominent in the literature. Your fresh, unique perspective on a well-known topic may not be well covered yet. But, even if your topic or focus already is covered in a journal article, don't be discouraged. There are more than 120 nursing journals, and the chances are good that your unique perspective will meet the needs of one of them. You have no excuse not to write...you can be a nurse author.

Quick tip: Talk to someone who is an experienced author. He or she can help and advise you and may even become your writing mentor.

2. Start small.

Another misconception is that you have to write about a big, broad clinical topic, such as "pneumonia." Not so. Big topics like these are more appropriate for a textbook chapter. Start smaller. You'll get your feet wet and you won't be discouraged by an immense project. Consider writing for nursing organization newsletters or doing a short journal piece, even a letter to the editor. Review nursing journals to see what short columns and departments they publish, such as a "Tips" department of small items about making nursing practice easier.

Don't forget your local newspaper, where news journalists highly value nurses' opinions on health care. We don't see many editorial opinions or letters to the editors in newspapers simply because nurses are not writing them. But we need to get our voices in these formats. Readers like to hear nurses' "in the trenches" stories and opinions. If you want to get published in your local newspaper, think about some healthcare issue that you feel strongly about, clarify your opinion, then develop your thoughts into a letter. You'll have a good chance of getting it published.

Quick tip: Read a newspaper or journal to find a topic you feel passionate about, then write your letter to the editor.

3. Topic development takes time and effort.

Many nurses are intimidated by the writing process because they are not sure what to write about. A common misconception is that the topic just pops in your head, like a light bulb over a cartoon character's head. Experienced authors work to develop their topic and focus. You might start with an idea or an area of expertise—perhaps IV therapy. But, that topic is too broad for a journal article, so you need to focus and refine it. Think of the particular aspects that you believe are important and should be covered, perhaps IV therapy in children. Look at the critical issues and focus in on specifics. Read up on what's been published recently on the topic (see the steps below for some help). With just a bit of searching, you'll learn more about your topic and you'll more clearly refine your article topic.

Quick tip: Set aside a designated time just to work on topic development. Make this a step in your process.

4. Gather more resources than you think you need.

Even if you are an expert in a particular topic, research the topic in books, journals, on the Internet, and with your colleagues. Read everything published recently on the topic. Ask colleagues about the topic, including some who specialize in the topic area, but also talk to other nurses who don't deal with it routinely or are new to it. Find out what they want to know about the topic and what they feel are the difficult concepts and issues.

Continue to gather information and read, read, read on the topic—immerse yourself in the topic. When you sit down to write, writing will be easier because you know the topic so well. But write from your own experience—not just what you read. Reading makes great background information and helps you paint the broad picture.

Quick tip: Physically gather and keep your resources in a system that works for you. Use folders, index cards, computer files, a notebook, or a tape recorder. I like to use a tape recorder when driving or traveling (I don't try to write while driving), and I keep a pad and pencil by my bed (we come up with good ideas at the weirdest times).

5. Know the journal.

There are more than 120 nursing journals, both general and specialty, to choose from. So which one do you send your article to? Look at the selection in your nursing library for starters, and pick out two or three journals that look promising, perhaps two general ones (such as Nursing 2001, American Journal of Nursing, RN) and a specialty journal or newsletter that relates to your topic.

Review three recent issues of the publications that you think are more appropriate for your work. Journals change over the years, so reviewing older issues may be a waste of your time. Review the journal cover to cover, paying close attention to the table of contents and titles and reading a good sampling of the articles. Pay particular attention to format, style, voice, and intended audience. Read the mission statement. Determine if the journal and its audience are right for you.

Look for the journal's annual index, either in the December issue or online at its Web site (the two most likely places to find it). Review the index, scanning article titles, to help you develop your article focus and point you to articles you need to read before you write your article. Read and follow the author guidelines (again, these may be published in an issue or available online, but you may need to request these; if so, go to http://members.aol.com/suzannehj/naed.htm/ and take advantage of the extensive list of nursing journals and contact information that Suzanne Hall Johnson has compiled). Some journals are very particular about details in the author guidelines, and if you don't follow them, the editor will notice. It could be a strike against you before your manuscript is even read.

Follow author guidelines for submitting topic queries (correspondence to determine if the editors are interested in your ideas). You can mail or e-mail topic queries to multiple journals to determine if the editors are interested in your topic, but send your manuscript to only one journal at a time. If the editors indicate in the author guidelines that they accept phone queries, take advantage of this opportunity to talk to them and find out what they want. They might even help you to clarify your focus or shift it enough to make it more appropriate for the journal—and more likely to be accepted. Or they might direct you to another journal that would be more appropriate for your article, especially if they've recently accepted two other manuscripts on the same topic.

Ready to start writing? Hold on...wait until you get a positive response to your query letter, then jump right in. Remember that the editors are saying only that they'd like to have the opportunity to review your manuscript, that the topic might be of interest to them. It's no guarantee that they will accept the article, especially if they happen to get other manuscripts on the topic before they get yours. Keep this in mind—journals are a business, and the editors have an obligation first and foremost to their readers. They'll choose the best articles they get, not just anything anyone writes on a topic, no matter how strong a topic it is. Timeliness is a critical factor in editorial planning decisions, so start writing.

Quick tip: Call an editor. Many will be happy to help you through the initial topic development process.

6. Do some planning—it will save time in the long run.

Don't forget this important step. A little planning smoothes the writing process and will save you time when you write. Your planning can be simple or elaborate—it's up to you how detailed you make this step. Here are a few steps that may help you.

• Write statements to keep you focused while you are writing. Write a summary or purpose statement that reflects what you want the reader to know. And follow this with a statement covering what you want the reader to do with this information. Refer to these statements as you write.
• Brainstorm for organization. Take 5 or 10 minutes to write down all of the major ideas you want to cover on the topic. Keep writing and don't stop. These ideas are the major part of your article that you can now organize.
• Organize your thoughts and ideas. Use whatever tools will help you picture the flow of your article—index cards, diagrams and drawings, a simple outline, or your computer's word-processing program, where you can easily move information with cut and paste tools.

7. Start writing in the middle.

Many authors develop writer's block because they waste time trying to develop great titles, opening lines, and paragraphs. Don't start there. Start with key vital core information and put words down on paper, creating a first draft. Make sure you write something about each item in your outline or plan; you can move them around and polish them later in the process. Don't worry about writing perfect sentences or polishing each line, just get all of your thoughts in black and white. After you later organize and edit, you'll find that your title and first paragraph will be simpler to write.

Quick tip: Just start anywhere to beat writer's block. Try moving your last paragraph up as your first paragraph—you may be surprised at how well it works up front.

8. Use active voice rather than passive voice.

Active voice connects with the reader and is authoritative (yes, it is okay to be authoritative in your writing). It uses "I" and "you" (yes, that is okay, too). In contrast, as you can see in the examples below, passive voice is indirect, makes your writing vague, creates a distance between you and the reader, and frequently contains more words, which can bog down the reader. You won't sound in command of the topic and won't attract the reader's attention or interest. Take a look at how active and passive voices compare.

Active: I sent the e-mail. (Passive: The e-mail was sent.)

Active: Joan picked up the IV bag. (Passive: The IV bag was picked up by Joan.)

Quick tip: Write as though you are talking directly to another nurse.

9. Multiple rewrites are the norm.

Once you finish your first draft, count on three full rewrites on your own where you edit each sentence and reorganize content for better flow. Such rewrites are a normal part of the writing process, not extra work. If you know up front that this is required, you'll be better prepared for the time and energy devoted to this step.

Read your first draft, saying each sentence out loud. Is it clear? See if you can eliminate at least one or two unnecessary words. You'll be surprised how many you find and how clear the new sentences sound.

If you have a block of tedious information that's difficult to grasp or very detailed, consider packaging it into a list or chart. Physically pull them out of the main body of the article (cut and paste to a separate file on your computer for now), then read back through the copy to see if it's easier to read or flows better. Once you're feeling comfortable with your rewrites and repackages, print out a few copies and ask two colleagues to read your article. Give each of them a clean copy to write their comments on, and encourage them to be very critical so you can make your article stronger.

Quick tip: Less is more, and shorter is better.

10. Pay attention to detail.

Again, follow author guidelines. Put together a neat, clean package to send, and sell yourself to the journal. Develop a concise introductory letter and consider enclosing a resume or curriculum vitae, especially if it clearly demonstrates your expertise in the topic area.

Be careful with grammar and spelling, not only in the manuscript but also in your cover letter to the editor. Careless errors undermine your credibility with editors—they aren't going to be confident that you've been any more careful with the content than you are with the presentation. Take the time with details—after all of your hard work, this extra effort is worth it.

Quick tip: Walk away and take a breather. You've worked hard to get to this point. Relax and refresh, then go back in a separate session to do this polishing.

In summary, plan time for each step and realize the work involved before you start. This knowledge helps you through the process. Following the above steps and breaking the work into stages with timelines will help. Best of luck in your writing.

Mark Twain said "Writing is easy, all you have to do is cross out the wrong words."