From stall to start: Don’t let fear stop you from writing

From stall to start: Don’t let fear stop you from writing

By Kathleen T. Heinrich

Stymied when you try to write? Can’t get your thoughts on paper? Break the writing barrier by applying these proven strategies. Stories? Do nurses have stories! So, with all the writing material we accumulate in a day, why don’t more of us write about the amazing things we do?  We say we lack the time or the credentials (Steefel, 2007), when really what we lack is self-confidence, know-how or support (Heinrich, 2008). Whether you want to write a narrative for clinical advancement, an article for publication or an abstract for a conference presentation, find out what’s slowing your progress. Kelley, Rhett and Jennifer are three nurses who are seeking ways to move their writing projects from stall to start. In the stories that follow, note how their fondest wishes and their greatest fears unmask specific writing challenges. What helps them overcome roadblocks to writing just might work for you. KelleyKelley’s been a nurse for 10 years, and her manager is encouraging her to pursue clinical advancement. Kelley’s stumbling block is writing a clinical narrative that showcases her nursing care. She tells her manager: “Every time I think of a story, I get all excited. Then I ask myself, ‘What did I do for that patient and family that any nurse wouldn’t do?’ Poof! My excitement’s gone and I’m back to square one.” Kelley’s fondest wish: If I could pinpoint what’s special about the care I give, it would be easier to write my clinical narrative.  Her greatest fear: I know I’m a good nurse, but I’m afraid I won’t be able to find the words to convince reviewers that my practice merits clinical advancement. Kelley’s writing challenge is lack of confidence in her ability to do verbal justice to the quality of her nursing care. RhettNursing is a second career for Rhett. After trying his hand at real estate, he returned to school and recently graduated with his BSN. Not only is it a relief for Rhett to have a steady paycheck and regular hours, but he’s also loving his first nursing job. A journalist from the local newspaper asks him to write a short piece about finding a new career in tough economic times. Rhett knows he’s the perfect person to write the article; he’s just not sure where to begin. Rhett’s fondest wish: If I just had a framework to follow, writing this article could be fun. His greatest fear: I’ll spin my wheels, and all I’ll have to show for it is a wastebasket full of crummy drafts that never get published. Rhett’s not lacking self-confidence. His writing challenge is lack of know-how. He doesn’t have a systematic approach to writing. JenniferJennifer is an energetic school nurse who is passionate about “green cleaning.” She wants to present a poster at her state organization’s upcoming conference to help school nurses educate students about safe environmental practices that keep their carbon footprints small and their health strong. The only hitch is writing the one-page abstract that sells conference planners on her poster idea. Jennifer knows that, if she spoke with them for five minutes, they’d be begging for her poster, but her problem is writing an abstract that’s irresistible.  Jennifer’s fondest wish: If I could talk my ideas out with someone, I might be able to write an abstract that’s persuasive enough to be accepted. Her greatest fear: I won’t be able to get the word out about something I really care about, because I can’t write like I speak. Jennifer’s writing challenge is lack of support from colleagues or friends. What’s your writing challenge?As you read about these nurses’ writing projects, whose wish sounded the most like yours? Was it Kelley’s search for what makes her nursing care special, Rhett’s desire for a systematic approach or Jennifer’s yearning for someone to listen? What, in other words, is your fondest wish for your writing project?  What’s your greatest fear? Lack of self-confidence? Lack of know-how? Lack of support? A combination of these? Naming your greatest fear(s) can help you anticipate writing challenges. Now that you’ve identified your writing challenge, let’s find out how these three nurses trounce their challenges. Strategies for breaking the writing barrierDuring the last 20 years, I’ve developed strategies that help nurses meet writing challenges by allowing their wishes to overcome their fears. Applying these strategies move Kelley, Rhett and Jennifer’s writing projects from stall to start.  To bolster her self-confidence, Kelley rereads notes and letters from grateful patients and families in search of words or phrases that describe her “something special” (Heinrich, 2008). The phrase “caring for the whole family” pops up everywhere and resonates with Kelley’s sense of what’s special about the care she gives. With this knowledge, she’s prepared to write a clinical narrative that showcases the special kind of care she provides. Rhett compensates for his lack of know-how by identifying the four essentials common to all writing projects—idea, reader, vehicle and slant. Focusing on a single idea, he writes for a particular group of readers who read a specific vehicle, and he communicates his idea using a slant or angle that his audience can’t resist (Heinrich, 2008). For the article he has been asked to write, Rhett identifies the following: Single idea: Finding a new career in tough economic times Particular group of readers: Those who read our local newspaper Specific vehicle: Our local newspaper Slant: Retooling tips for the resilient in a rough economy Identifying these four essentials upfront helps keep Rhett’s writing project on topic. Jennifer is an extrovert who does her best thinking out loud. Unfortunately, her usual circle of colleagues and friends is not providing the sounding board she needs. To compensate for that lack of support and make writing the abstract a social activity, she seeks out a good listener who asks insightful questions and tape-records their conversation.  From the recording of that verbal give-and-take, Jennifer crafts an abstract that describes her poster. She refines her draft by soliciting feedback from a colleague known for writing winning conference abstracts. Jennifer enjoys these interactions so much that she decides to turn her poster presentation into an article for her organization’s newsletter—with the help, that is, of a few good listeners and peer editors. Two important questionsThe next time you want to move a writing project from stall to start, ask yourself two questions: What is my fondest wish for this project? What is my greatest fear? Your responses will tell you whether you’re lacking self-confidence, know-how or support. This lack is your writing challenge. Refer back to your wish, and you’ll find the clue for compensating for this deficiency. Make up for what’s lacking, and you are well on the way to overcoming your writing challenge. As you do, you’ll catch a glimpse of how writing can open up new career opportunities, touch lives far beyond your workplace and influence the profession in ways that nothing else can. Don’t let your nursing stories go untold! Allow your wishes to overcome your fears, so you can write about the amazing things you do every day. RNL   Kathleen Heinrich  Educator, author and speaker Kathleen T. Heinrich, RN, PhD, is principal of K T H Consulting in Guilford, Connecticut, and author of the book A Nurses’ Guide to Presenting and Publishing: Dare to Share.

Want to write for publication but intimidated by the process?

Want to write for publication but intimidated by the process?

“Nurses are involved in every aspect of patient care, so their insights could vastly improve health care. That’s why knowing how to write about their experiences is key to change,” says Cynthia L. (Cindy) Saver, RN, MS, veteran nursing author and editor of a new book, Anatomy of Writing for Publication for Nurses, published by the Honor Society of Nursing, Sigma Theta Tau International (STTI). Saver brings together 15 of nursing’s top writing experts to answer the most common questions asked by nurses who are interested in writing but intimidated by the publishing process. The 256-page book, which covers topics ranging from peer review and online submission to mind-mapping and social media, includes a foreword by Diana Mason, PhD, RN, FAAN, editor-in-chief emeritus, American Journal of Nursing. “Communication is defined as a process by which we assign and convey meaning in an attempt to create shared understanding,” Saver says. “By learning how to write clearly and effectively, nurses can share their knowledge with policymakers, journalists, hospital administrators, nursing educators and the general public, which will benefit everyone.” “If you are looking for a comprehensive text on writing for publication, from A to Z, look no further,” says Tim Porter-O’Grady, DM, EdD, ScD(h), senior partner of Tim Porter-O’Grady Associates Inc. “Anatomy of Writing for Publication is a great contribution to all nurses, from novices to scholars,” observes Pam Cipriano, PhD, RN, NEA-BC, FAAN, editor-in-chief, American Nurse Today. Cindy Saver Saver, former book acquisitions editor for STTI, is president of CLS Development Inc., an editorial consulting firm. A nurse for more than 30 years, she has spent the last 20 as a writer, editor, speaker and nursing publications executive. Saver has written for Nursing Management, Nursing Spectrum, American Nurse Today, AORN Journal, OR Manager and the American Journal of Nursing, to name a few. Her writing experience includes a 10-part series for the AORN Journal, research reports, case studies, interviews, clinical articles and continuing education modules. STTI has also just published Take Charge of Your Nursing Career by Lois S. Marshall, PhD, RN, which includes advice on pursuing potential career options. Both books are available at www.nursingknowledge.org/ STTIbooks.

Ready, set, write: 5 tips for becoming a better writer

Ready, set, write: 5 tips for becoming a better writer For this writer, the first step was to start running

By Tiffany M. Montgomery

Getting a PhD is unlike anything I’ve ever done. Once my coursework was complete, and it was up to me to continue progressing through the program, I was at a standstill. I was surprised, because writing has never been difficult for me. As a child, I loved to write. I wrote songs, short stories, and poems. I’d even doodle my name for hours on end. But it didn’t take long for me to realize that writing the chapters of my dissertation would be much different than the type of writing I was used to. Because I had never really taken on a task that I deemed too large to complete, I was unsure of how to move forward. I tried talking to a dissertation coach. She helped me break down the overwhelmingly large chapters I had planned into more doable sections. Meeting with her was helpful, but it didn’t do the trick. I still found myself stuck. I tried writing at different times of the day, a technique that had previously been helpful. This time, it didn’t work. I began to feel that the only way to conquer this formidable task was to take lessons I had learned from overcoming other obstacles and apply them to my writing. The problem was, I didn’t have a plethora of previously conquered obstacles to choose from. Until then, I had led a pretty safe life, taking on only those things I knew I could achieve. So, as a way to train for writing, I started to think of a new, self-inflicted obstacle I could overcome. It didn’t take long before I decided that running would be that obstacle. I have never enjoyed running. Never ever. I used to get in trouble during physical education class for refusing to run. I didn’t mind participating in other forms of physical activity, but running was always tough for me. Several asthma attacks had been triggered by running in cold weather, and those experiences made me hate running even more. I used to say, “If you see me running, you had better start running, too, because there’s probably something chasing me.” As I said, I hated running. I don't remember the day I decided to run, but I remember exactly how I felt. I thought I was going to die! Upon reaching the end of that first section of bike trail, I was proud of myself. I didn’t die. I didn’t even pass out! And I had achieved a goal I once thought unattainable. As I walked the next section of the trail, my breathing slowed, my heart didn’t beat so fast, and I was ready to run again. I continued to alternate between running and walking each new section of trail, and, by the time I made it back home, I was beaming with pride. I did it! Now that I knew the truth of what could be, there was no stopping me. Every time I went for a jog—more accurately, a jog-walk—I had to mentally prepare myself. “You can do this. You won’t die. Just keep moving. Whatever you do, don’t stop.” And every time I arrived back home, I was proud of myself. Once again, I had accomplished something I was truly scared to do. I used the lessons I learned while jogging to help me become a better writer. There is an endless list of tips I could give to help any new jogger or writer, but I’ve chosen five to share with you: 1. Go at your own pace. You don’t have to do what everyone else does. Quite honestly, you shouldn’t want to. This is your race. You aren’t competing with anyone but yourself. Almost every runner on the trail moves at a faster pace than I do. I don’t care. I’m not running in a competition. My only goal is to do better this week than I did last week. That’s it! When I started walking regularly, my pace was 22.5 minutes per mile. Today, I jog at a pace of 15 minutes per mile. My goal is to get below 12 minutes per mile, and it will happen. I just have to keep going. I’m committed to staying in my own lane, no matter how fast others around me are running. The same is true with writing. Not everyone will write at the same pace. Even if we did, the dissertation chapters, journal articles, and class papers wouldn’t be the same length or word count. Some people have more references than others. Some people’s methods are more complicated than others. Nothing about a PhD program screams “competition.” I completed my dissertation proposal and advanced to candidacy a full year after some of my classmates. It doesn’t matter. In the grand scheme of things, my job was to write and defend my proposal—and I did. As hard as it is, try not to compare yourself to others. It doesn’t help you progress any faster, and, ultimately, it takes your focus away from the task at hand. In most cases, wearing blinders isn’t a good way to approach a situation. In this case, it’s OK. 2. Use the proper tools. As I have become a more experienced runner—(I use the term “experienced” lightly—I’ve learned to use proper tools, which keep me from having sore ankles or becoming so irritated while running that I stop midstride. Not too long after beginning to run, I bought my first pair of running shoes. I thought it was the only tool I’d need. I was wrong. When I began running, my keys were in my hand, and the sun beat into my eyes. When it was cold, I wore a very thin warm-up jacket that did nothing to keep cold air from getting to my lungs. After running more than enough days feeling like my chest was on fire, I purchased a light, but very warm, running jacket, and I made sure it had zippers so I could safely secure my keys, phone, and ID. When it rains, I put the hood on. On warmer days, when I don’t wear my jacket, I put all my belongings in my running pouch. If running after sunrise, I wear a baseball cap or sun visor. Finally, I use the Run Keeper app. It tracks the length of my runs and allows me to comment on my friends’ workouts, as well. These and other tools are staples for “real” runners. As I’ve become somewhat of an experienced writer, I have also found several writing tools I can’t live without. One of these is EndNote, a reference manager. Once I began using EndNote, I was mad at myself for not discovering it earlier. It’s a true writing assistant! I no longer have to manually enter in-text citations or entries to my reference list, and I am able to group my 750-plus references for easy identification. I can attach article PDFs directly to the references, and EndNote saves the highlights and notes I make on the electronic copies of the articles. It’s an amazing tool, indeed! I’m not suggesting that everyone go out and buy EndNote. It’s the reference management software I like to use, but there are plenty of other software programs that can help organize your references. Another tool I use, though not as regularly as I did when writing my proposal, is my Pomodoro app. The Pomodoro method of writing says that, for every 25 minutes of writing, you should take a five-minute break. Then, for every two hours of writing, including those brief breaks, you should take a longer break of about 15 to 30 minutes. This technique has been shown to increase productivity for many, including me. There’s an entire science behind this method, which I won’t go into now, but it’s worth checking out. 3. Find a group to encourage you. Running was OK when I was alone, but it became really fun when I started running with a group. Earlier this year, I began to power walk and run with a local Black Girls Run (BGR) group. BGR has running groups all over the country. Members meet at various times and locations to work out together. One of the things I love about this group is their motto “No woman left behind.” Whether you are a walker, jogger, or runner, you will not have to go it alone. I experienced this the first day my running partner couldn’t make it to our morning running group. I can’t run as fast as some of the ladies, but they promised not to leave me, and they didn’t. They’d run laps around me, run to a tree, then back to me, or just run alongside me at my pace. There’s something special about doing things with a group. Running is no different. Just as running groups help you run, writing groups help you write and develop healthy habits. During my third year at UCLA, I joined a writing group on campus. We didn’t actually write together, but we met weekly to report our writing experiences during the previous week, give advice to each other, and thus help increase our writing efforts. We set what we thought to be attainable goals each week. Sometimes we met our goals, sometimes we didn’t, but I loved the community that was built among our group, and I remained in the group for the duration of my third year. In addition to in-person writing groups, there are tons of group-writing websites, such as AcademicLadder.com and the Text and Academic Authors Association. Social media sites, such as Twitter, also encourage group writing through hashtags that include #AcWri (academic writing), #amwriting (early morning writing), and #shutupandwrite. Anytime you can write in the presence—or virtual presence—of another person, you will be encouraged to do your best. If you have become distracted from writing, I urge you to join a writing group. If nothing else, the group members will hold you accountable. You’ll either get with the program, or you’ll leave the group. 4. Do it even when you don’t feel like it. If I had a dollar for every time I said, “I don’t feel like running today,” I’d be able to buy myself a nice pair of Jimmy Choo pumps. Whether or not I feel like running when I begin, I always feel great after my run is complete. And never have I regretted getting out of bed at 4:30 a.m. to go for a run. That’s right, my running group takes off at 5:15 a.m. I have plenty of excuses to stay in bed, but getting my run in early has yet to negatively affect my plans for the day. So I run, no matter how I feel. Like running, writing is not something that comes easy for most people. Even among those for whom writing does come fairly easy, we aren’t always in the mood to write. While completing my proposal, I discovered something about writing: You don’t have to be in the mood to write to be a productive writer. The best way to become a great writer is to write as often as possible. Every day you don’t write is a 24-hour period closer to never writing again. That said, write when you want to write and especially when you don’t. I promise, once you get started, it’s not so bad. The first five or 10 minutes of writing are always the most difficult. After that, your ideas become more organized, and the words just begin to flow. 5. Quiet the mind-chatter. Running is the most physical thing I have ever done. However, I have learned my mind will give up long before my body does. One of my friends who runs gave me the best advice ever. She told me, “Just keep moving your arms.” She was right. As long as I kept moving my arms back and forth, no matter how badly I wanted to quit, I kept running. At this point in my running journey, I don’t even listen to the negative thoughts anymore: “You’re not going to make it.” “You’re going to pass out.” “Your legs can’t take this.” My mind says these things, but my body hasn’t failed me yet. Just like running, writing is more mental than physical. Your mind will keep you from writing long before you ever sit down to type. You can’t allow yourself to listen to those negative thoughts. You have to sit down at your desk, at the kitchen table, or wherever else you write and think like the Nike slogan: “Just do it!” While it’s important to take mental health breaks, don’t let negative mind-chatter talk you out of writing altogether. Even if it’s for only 15 minutes, write something! If you manage to write for 15 minutes, you can probably write for 15 more. Once you look up, two or three hours will have gone by, and you’ll be done with your writing for the day! These tips are but a few that may help you become a better writer. I am no expert, by far, but each of the aforementioned tips has been of great help to me. If you are struggling to write—and even if you aren’t—I encourage you to take on a new and challenging activity, and use the lessons you learn to help you become a better writer. For me, it was running. For you, it may be swimming, knitting, dancing, or hiking. It may also be something like jigsaw puzzles, computer games, or a musical instrument. Whatever you decide to take on, if you stick with it, you won’t be disappointed. Your writing will be much improved, and you’ll find a new hobby along the way. RNL Tiffany M. Montgomery, MSN, RNC-OB, C-EFM, a women’s health nurse since 2005, initially worked as a labor and delivery nurse before broadening her focus to obstetrics and gynecology. She is now pursuing a PhD in nursing at UCLA.

Telling our stories brings healing to our woundedness.​

Telling our stories Telling our stories brings healing to our woundedness.​

By Patrice Rancour

​“The stories people tell have a way of taking care of them. If stories come to you, care for them. And learn to give them away where they are needed.” — Barry Lopez, Crow and Weasel Is it any wonder that the PBS Masterpiece Theater program “Call the Midwife” has piqued the interest of the public? In these stories, written more than a half-century ago, viewers see their own stories—birth, death, suffering, joy, tragedy, humor, mystery—the gritty pathos of day-to-day life, so often lived in quiet desperation. And they see us—nurses and midwives—right in there with them, living with them, birthing their babies, ministering to their sick and wounded, and helping them, at the end of their lives, to cross the threshold into the unknown. The series demonstrates in a very real way that the bulk of health care still takes place in homes and communities where people live, work, and play—not merely in doctors’ offices. This is why, except for the tragedy of 9/11, when firefighters rightly took front stage, the public continues to identify, year after year, nurses as the most trusted professionals. And yet, our work typically remains invisible to most people, until they need us. Which brings me to my point. The healing power of story When we share our stories—with each other and the public—we accomplish a number of things. The power of writing and telling stories about our work lies in the compelling power of healing they evoke. There is an old proverb: “In the hearing is the learning, but in the telling is the healing.” In the telling of our stories, woundedness—ours and theirs—is distilled, allowed to bubble up from regions of unconsciousness, where, as we shed light upon it, it can be transformed, released, and healed. I have written extensively elsewhere about my work with patients, asking them to write narratives about their illness experiences—to write letters to parts of their bodies they struggle with, to people with whom they are in conflict, even to people who have died. This ability to write one’s story is powerful in that it seeks after meaning and coherence and gives people who often feel mute and powerless a voice. James Pennebaker’s work on journaling demonstrates that patients who journal about their health issues require far less treatment—even as much as six months less—than people who don’t write about them. Such people become the heroes of their own stories and define themselves as such, rather than letting someone else define them as victims. This is true not only of patients, but of ourselves as well. It is an error in judgment to believe that coming into contact with so much suffering does not affect us. We can bear suffering inasmuch as we find meaning in it. Giving voice to our stories helps us preserve our individual and group energies and defends us from the rigors of compassion fatigue and burnout. The act of writing about these experiences elevates our response to illness experiences, moving such descriptions from the merely banal to tales of heroic journeying. When I listen to nurses share such stories, I often hear them say that they feel privileged or humbled in being allowed entrée into peoples’ sacred spaces. This self-reflection inoculates nurses against the very real occupational hazard of contact trauma. Such stuff leads to peak—rather than bleak—experiences, not only for our patients but also for our selves. And it allows us to come back and work yet again, another day. Story as teaching tool Telling our stories to one another and to the lay public becomes a teaching tool. If you are old enough, you probably remember those odious process recordings of yore: assignments demanded by an earlier cohort of fastidious nursing instructors that required us to write down, painfully, entire verbatim conversations between ourselves—as students—and our patients. Columns identifying feelings generated, assessments made, and how these translated into action followed. Voilà, the nursing process (also known as critical thinking). In these days of bulleting and texting, I fear that such critical thinking is getting lost in the translation. Reliance on technology and pharmacology is eliminating the use of self as therapeutic tool. Writing and telling our stories takes us back to a time of self-empowerment that comes with knowing there is virtually no room I can enter in which suffering cannot be reduced just by virtue of my being intentionally and therapeutically present. Telling stories about how this is accomplished is crucial to mentoring succeeding generations. All the computer programs in the world cannot help a medical or nursing student who is asked to have an end-of-life discussion with a patient when all that the student wants to know is, “But when she asks if she’s dying, what do I say?” Telling stories about how these interactions occur is a means for providing such students with not only information but also the self-reflective practice tools that help us all become more self-aware, learn to center, use language as a healing modality, use words to help one another derive meaning—and, therefore, transcendence—especially in the face of fear, uncertainty, or death. So when I write about my work, I am not necessarily seeking merely after facts, but rather after the truth of the experience. Story telling is what gets to this. As sociologist William Bruce Cameron observed, “Not everything that counts can be counted, and not everything that can be counted counts.” In a world of measurement mania and outcomes obsession, story-telling can get to the truth. Story as cultural mediator Lastly, when we share our stories with one another, we create a pool of shared experience in which we develop a culture of values that is passed on from one generation of nurses to the next. When we tell each other our stories, we are pooling and preserving a group culture and collective wisdom that strengthen us and help us resist powerlessness. Sharing our stories creates continuity and ensures that the essence of what we do is captured in self-reflective practice. The stories we tell one another about ourselves lift us up. The stories we share with the public about the work we do give them a voice in telling their own health and illness stories. And, in that respect, such stories evoke healing, not fear, for all of us. So, tell us and one another your stories. Use words for the purpose of healing, to evoke hope, to help one another and your patients move through grief, make sense of the inexplicable, and make the world whole again. RNL Patrice Rancour, MS, RN, PMHCNS-BC, clinical assistant professor in the College of Nursing at The Ohio State University (OSU), is a behavioral health and Reiki therapist at The OSU Center for Integrative Medicine. She is the author of Tales from the Pager Chronicles, published by Sigma Theta Tau International.