Writing as Scholar, Writing as Practitioner: Nursing as a Case Study in Flexibility

This post is dedicated to all the Walden DNP students who are heading to Dallas, TX for their Capstone Intensive retreat this week. You can learn much more by checking out the Walden Capstone Intensive homepage by following this link.

An old adage states, “Practice makes perfect.” The concept is simple: If you perform an action many times, you get better at it. If you do an exercise many times, you get stronger at it. If you frequently write in a specific way, you get better at writing in that specific way.

Most people practice writing the same way that they practice walking: They just do it without thinking about it. Do you write a lot of emails? That’s practice writing. Text messages? Same thing. Reports? Poems? Medical charts? When you do a type of writing regularly, you get a lot of practice writing in that specific genre and in that specific style. If you start writing in a different genre, like academic writing, it’s very important to understand how your writing style might need to change based on the needs of your reader.

Let’s take nurses as an example. No other profession exemplifies Walden's mission of creating scholar/practitioners quite like this one. In the Writing Center, we see lots of nurses working on advanced degrees like the MSN and the DNP, and many times these students have years of experience writing as a nursing professional. Hospital nurses write a lot: Each patient has a chart that’s updated with information such as

• observations,
• diagnoses,
• measurements,
• test results,
• medications that have prescribed (including dosage), and
• medications that have been given to the patient (also including dosage).

Hospital nurses write in this form with a specific audience in mind: the future nurse assigned to this patient. To make the future audience's job easier, medical charts are usually written in a special shorthand with lots of short statements like 

• “No fever.” Translation: “The patient did not have a fever.”
• “Sipped juice” Translation: “The patient drank a small amount of juice.”
• “330 sleeping” Translation: “The patient was asleep when I checked on them at 3:30 AM.”
• “Pain 3 out of 10” Translation: “The patient rated their pain as a ‘3’ on a scale of 1 to 10, 10 being highest.”

These abbreviations may be confusing to an outside reader, but they make perfect sense to the other medical professionals who read them because they’re familiar with the abbreviations, the style, and how to fill in the gaps.

Writing in Academic American English using APA style can seem very different from writing in a medical chart. The basic idea, however, is the same: You want to tell the reader exactly what they need to know without confusing them.

Here are some of the key differences when writing in APA vs. writing as a nurse on the job. In APA, you need to

• write full, grammatically complete sentences,
• make clear arguments supported by evidence,
• identify the sources of any information that you present,
• ground your observations with sources as much as possible,
• not rely on “common knowledge”,
• use the form and structure of your writing to organize information, and
• follow the specific APA formatting guidelines.

Just like writing in a medical chart, however, you shouldn’t include information that’s not relevant. For example, the color of a patient’s shirt isn’t relevant while they’re in the hospital – so that kind of detail shouldn’t be written in their chart or described in a paper where you’re discussing the patient’s health. The thickness of a patient’s shirt might be important if they report being hot or cold, but it should always be clear why you’re mentioning the information that you do.

Here’s an example of text in a medical chart:

Alert, awake, oriented to person and situation. Confused as to time and place. Stated name and asked to go home. Was reoriented to time and place. Skin warm, dry, pale but without pallor or cyanosis. Asked again about time and place. Applied skin lotion.

When you switch to writing this information in a scholarly way, you must make different choices about your writing. Depending on what you want your reader to focus on – the purpose of your writing – some of these details should stay and some should be commented on. For example:

[Paragraph focusing on mental state] Patient X was alert and awake, and recognized their own name and that they were ill. However, they did not know what day it was or recognize that they were in a hospital. After being reoriented, they did not retain memories of the time or place. These symptoms are associated with mild neurocognitive disorder (American Psychiatric Association, 2013).

[Paragraph focusing on skin condition] Patient X’s skin was pale but without showing an ill pallor or cyanosis. I applied a skin lotion due to the dryness of their skin, as recommended by Smith (2015).

As you can see, the details that are transferred to the academic paper version depend on the purpose of that specific paragraph. There will always be more information that you could write about, but what you should do is focus on describing, explaining, and supporting the argument that you are making in an appropriate way for your reader.

So as you are filling out your charts, remember, practice makes perfect. Many of the skills you develop on the job can transfer over into your coursework here at Walden U. Your responsibility as the skillful writer is to understand your new audience and make choices depending on its needs. 

Basil Considine is a Dissertation Editor and Contributing Faculty in the Walden University Academic Skills Center and School of Management. Outside of Walden, Basil is the artistic director of Really Spicy Opera, a chamber opera company specializing in new musical works for the theatrical stage.

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