Writing in the Profession of Nursing Christina Ly Northeastern University

2 WRITING IN THE PROFESSION OF NURSING Nurses play a very important role in the healthcare system! Generally, they are the first health care professionals to see a patient—from in a primary physician’s office or an emergency room, where nurses are the first to assess a patient, to a hospital unit floor, where a nurse is involved in the direct transfer of a patient. Moreover, this is just the beginning of the role of a nurse. In reality, this role may not be fully understood until a person or a family member has experienced the care from a nurse first-hand. Indeed, nurses are a patient’s greatest advocate and often are the ones to spend the most time with a patient in the medical community. Although to promote a patient’s full recovery and healing process, it requires the efforts of many other health care professionals working together. Thus, communication is vital—between fellow nurses, physicians, physical therapists, pharmacists, as well as other allied health care professionals, and most importantly communication with the patients! As a nursing student, I also know that the world of nursing is constantly changing. One experience that shaped this conclusion is from clinical where my clinical instructor spoke of some old-school nursing ways and encouraged us to try to continuously learn about the latest technology, medications, and researched practices. For example, the nursing intervention of turning patients in bed every two hours during our shifts to prevent bed-ridden patients from developing pressure ulcers is very well-known. However, when asked about the reasoning behind that time interval, none of us knew why—we just knew that it was the rule. Apparently, it took Florence Nightingale, the founder of modern nursing, two hours to travel from patient to patient before she could turn them, and thus the rule of repositioning a patient every two hours came into play. Nowadays, it would make sense that with more available help that more frequent repositioning would be more beneficial, but the rule of thumb for every two hours still stands in place. However, the future of nursing lies within our hands and nursing is changing

3 WRITING IN THE PROFESSION OF NURSING towards more evidence-based practices. In retrospect, somewhere from the time of Florence Nightingale until modern day nursing, this type of information about our nursing interventions has been passed down and continues to be passed down, showing just how significant communication is! Without a doubt, in order to provide quality care to patient, communication continues to be the most important aspect in the field of nursing, but this is especially so since the best effective patient care involves the interdisciplinary involvement of other health care professionals as well. This only enforces the requirement for nurses to learn to communicate with a wide range of audiences. In fact, as a nursing student, I have learned about utilizing a system called SBAR, a standardized way to share patient information when on the phone to other health care professionals. The system is an acronym for situation, background, assessment, and recommendation, which is as its name implies, the order in which we give patient information. Signs reminding nurses about SBAR are almost always found at the nurses’ station, a reminder to just how imperative an organized and structured way of oral communication is, in order to convey information efficiently and accurately as well as promote patient safety. On the other hand, a perfect example of an effective and organized delivery of written information can be found on the American Nurses Association (ANA) website, an organization which also promotes nurse and patient safety. By all means, there are many sources of communication that exist in the field of nursing. Between the passing off and continuing care of patients, there is usually oral communication between nurses and different health care professionals. Taking into account the fact that patients have to quickly trust these unfamiliar faces who are supposed take care of them, this collaborative communication is very important for a safe and satisfactory experience. On the

4 WRITING IN THE PROFESSION OF NURSING account that nurses are resources for information and are the educators to patients and their family members, they should be very knowledgeable. In addition to the oral communication by nurses in the clinical setting, in order to continue their education, nurses should be constantly exposing themselves to different types of written communication such as research articles, lectures, seminars, news articles, online webpages, and books pertaining to nursing and healthcare. Certainly, as the web domain suggests, the American Nurses Association (ANA) website offers a vast amount of written information and resources pertaining to the nursing world. The ANA website describes the association as the only full-service professional organization representing the interests of the 3.1 million registered nurses in the United States (About ANA, 2014). The specific audience targeted is obviously nursing professionals. Its texts are written to equal members of the community, covering the whole spectrum of nursing. There are different tabs at the top that target different subgroups of nursing professionals, a good sign that this a resourceful site with different tools and information for student nurses, staff nurses, advanced practice nurses, nurse managers, nurse researchers, and nurse educators. This source seeks to inform its target audience of nurses about current news and issues in health care as well as provide readings for professional growth and links to connect nurses with peers through workshops, social network, and periodicals. These links are found on the side and at the bottom of the page. This organization’s website gives us a good idea on the values and goals that should be fostered and promoted in nursing. ANA works to further the nursing profession and the standards of the nursing practice, promote the rights of nurses in the workplace, and lobby Congress and regulatory agencies on health care issues affecting nurses and the public (About

5 WRITING IN THE PROFESSION OF NURSING ANA, 2014). This makes a lot of sense, since advancing nursing would improve the health for all (About ANA, 2014). With no other, irrelevant advertisements surrounding the website, the interface looks clean and very well organized. The text is easy to read with appropriate larger font headers, bullet points, and bolded titles to signify importance. On the contrary, to imagine the opposite—a webpage filled with a long body of text without any appropriate spacing or change in font size, it would surely not be as engaging and effective at getting information across. This is an important point nurses should keep in mind when handing patients educational packets. On co-op, I had assisted nurses in the placement of peripherally inserted central catheters (PICCs) which is a consented procedure. Before obtaining a signed consent, not only is there a verbal pitch for the catheter, but we also reinforce this teaching by providing an educational booklet. Although 8 pages in length, it is an easy read for the patients, written at supposedly an 8th grade level. It contains frequently asked questions and answers about the procedure, with each question spaced and aligned evenly and in large font. Looking at the way information is communicated through the ANA website, the content found on the ANA website is specific, once a topic is chosen in the drop-down menu selections. The writing is easy to understand, at a probable 12th grade level, which is appropriate. An internet search on the “understaffing nursing problem,” a legitimate concern for nurses and nursing students, brings viewers to a page found within ANA, titled “Nursing Staffing.” As I had indicated earlier, if there is enough help, we would be able to reposition patients more frequently, but what if the opposite were to occur in terms of not enough able bodies to help even maintain that standard. On this page, my eyes were immediately drawn to an easy-to-read infographic outlined in red, with bolded red text, situated at the top right hand corner. It displays the statistics of nurses

6 WRITING IN THE PROFESSION OF NURSING who reported being short staffed with insufficient time with patients, fatigue at the beginning of their shifts, increases in overtime, excessive workloads, and long shifts. The rest of the page is a body of text comprised of both long and short sentences, with varied sentence structures. The writing stands in favor of nurses, reporting how “registered nurses have long acknowledged and continue to emphasize that staffing issues are an ongoing concern, one that influences the safety of both the patient and the nurse,” written in third person (Nurse Staffing, 2014). An active voice is dominant in this text, indicating what role nurses, hospitals, and health care leaders have played in response to this issue. With an active voice, the information and message is conveyed clearly to the readers. In fact, the intended audience can include applicable nursing professionals, sympathetic health care professionals, concerned patients and the general public. Adequate nurse staffing is an issue that should be addressed since they indicate that finding an optical nurse-topatient ration has been a national challenge (Nurse Staffing, 2014). The writing is unbiased in that it reports the understandable reasons for the challenge: increased patient acuity or complexity and shortened hospital stays which creates a greater workload. Instead of pointing fingers for the blame, the organization offers to persuade readers about the benefits to adequate staffing such as less medical errors, patient complications and deaths, and improvements in patient and nursing job satisfaction. It encourages health care leaders to be innovative and work collaboratively in offering solutions for safer environment for patients and nurses, in the long run. Below this main body of text are other resources that relate to this topic such as links to research studies on staffing, the safe staffing bill introduced in Congress from last year, and tools to promote optimal work environments. The tone reveals hopefulness and belief in nursing and in our other health care professionals, my discourse community, to take the lead in creating change for better working environments in term of

7 WRITING IN THE PROFESSION OF NURSING staffing and changing the world of nursing and healthcare. The particular style and tone of language used on the “Nursing Staffing” page of the ANA website is what keeps the community of nurses and health care professionals going! Again, communication within this field is indispensable, for quality care to patients and the gradual improvements in the future of nursing.

8 WRITING IN THE PROFESSION OF NURSING References American Nurses Association. (2014). About ANA. Retrieved from American Nurses Association. (2014). The Practice of Professional Nursing: Nurse Staffing. Retrieved from urseStaffing/default.aspx

Note: This may be a good fit for my professional portfolio. This assignment allowed me to explore the importance of communication and writing is in the field of nursing. I was also able to learn to analyze a piece of writing.