Every year, hundreds of nurses provide presentations to thousands of their coworkers and colleagues at local, regional, national, and international meetings. Unfortunately for those of us not sitting in those audiences, most nurse speakers do not transform their presentations into published articles. This situation has always struck me as a real loss to nursing, only magnified in the past few years as fewer employers support nurses’ attendance at professional meetings.

I’d like to encourage critical care nurses who serve as speakers at their hospital, their school of nursing, their AACN chapter, the National Teaching Institute, or for nursing and health care organizations to consider transforming their oral presentations into journal articles so that nurses everywhere, and the patients they care for, might benefit from the information. In this editorial, I examine some of the reasons why nurses do or do not publish, identify what nurse speakers need to consider while contemplating this transition, and provide a step-by-step guide for completing this transformation from presentation to publication.

I hope that critical care nurses who serve as speakers will consider taking the time to convert their presentations into published journal articles so their colleagues might benefit from their knowledge and experience.

Preparing a formal presentation can demand considerable amounts of time and effort, often extending over days or weeks or months until the finished product is achieved and delivered. At that point, speakers might understandably be seeking some time-out before further engaging in their topic. Soon after that, however, other reasons emerge for why speakers don’t prepare their presentations for publication.

The most common reason is the enduring refrain across the health professions of not having sufficient time to do so.1,3 In addition, an interesting but not surprising array of issues was discerned by research librarians to explain why professionals who sought assistance with literature searches failed to follow through with publication.4 When these barriers to publication (Table 1) are examined more closely, they appear to fall into 2 major categories: fears that are lurking and factors that are lacking.

Fears Related to Publication: Criticism and Rejection

Among the reasons cited4 for not publishing were fears of public criticism and rejection. As an author of nursing journal articles for 32 years, an author of nursing books for 28 years, and a nursing journal editor for 25 years, I have neither experienced nor ever heard of any nurse author being subjected to public criticism related to papers submitted for journal or book publication. Except for overtly unethical or unlawful behaviors such as duplicate publication, falsification of data, or glaring plagiarism, which are publicly noted to readers, I am not aware of any nurse author who has any basis for this concern. Virtually all nursing journals use a double-blind review process to help ensure that authors are blinded to reviewers and reviewers are blinded to authors. This process guarantees anonymity in most cases (but not if authors identify their employer or include other identifying information).

Journal editors reject manuscripts for a wide variety of reasons, but I don’t know any editor who keeps track of rejected papers. Editors are busy and overcommitted just like you; we don’t give attention to papers we are no longer working with. Furthermore, if an author receives a rejection letter from a nursing journal editor, the only other person who may be aware of it is the journal staff member who works with the peer review process. Yes, the decision exists in the journal’s database, but no, editors do not share information of that nature with others, including the organization or association that may own the journal. Even if you receive a rejection letter, the worst outcome is that you submit your paper to your second preferred journal for review. That’s hardly the end of your career. In sum, many of the fears that prospective authors may harbor may be more myth than reality.

Perceived Deficits Related to Publication

Because there are only 24 hours per day, a prospective author needs to be willing to make time for converting his or her presentation into a paper and, for some, to learn the steps involved with that process. A second identified deficiency area, lack of motivation, is important to address early because it may determine whether the extended effort needed for publication is feasible. As shown in Table 2, nurses are motivated to pursue publication for many different reasons, ranging from the highly professional to the utterly pragmatic or deeply satisfying. One of the primary motivators is to reach a much larger audience. Virtually all other identified areas that may dissuade attempts at publication are amenable to resolution if speakers can be given some guidance and resources to support them in this effort.

For those of you who look at Table 2 and recognize your motivators for publishing, it’s time to move on to the next phase, when you more fully consider the merits of converting your speaking engagement into a journal article by finding answers to the following questions:

Is the presentation topic publishable?

The attributes of a publishable topic are summarized in Table 3 and warrant some reflection because not all presentation topics are publishable. The good news is that nursing continuing education and association programs routinely prescreen proposed topics to ensure they are pertinent, requested, and timely for their constituents; so if your abstract was accepted, there is a better than even chance that your topic is publishable. The only way to confirm that, however, is by examining the existing literature on that topic; if coverage of your topic is already copious, current, and complete for all of the aspects you would address, then your topic is not likely to be publishable unless you can distinguish it in some relevant manner.

Is the purpose of the presentation and the paper the same?

As you look at the array of possible purposes that a nurse might have for either presenting or publishing (Table 4), try to recall your primary purpose for the presentation. If you were to transform the presentation into a paper, would or should its purpose change? Although most purposes could be readily transferred to a paper, others (eg, brainstorming or soliciting feedback) that rely on interactions between a speaker and members of the audience would require modification. In other instances, the primary purpose might be retained, but the emphasis might be sharpened; for example, a hands-on workshop to demonstrate how to use one manufacturer’s bariatric lifts for any adult patient could be narrowed to focus on illustrating how to adapt these devices for obese critically ill adults with spinal cord and orthopedic trauma.

Is the audience the same for both the presentation and the paper?

Some relevant attributes of your presentation audience include their number, position, clinical specialty, level of education, certification, geographic location, experience, category, and type of employer (eg, military vs civilian, proprietary vs not-for-profit). If you provided your presentation to a small, relatively homogenous audience and envision your publication being disseminated to a large, heterogeneous readership, you’ll need to keep the attributes of this new audience in mind when reworking that content.

What questions or comments did audience members bring up during or after the presentation?

Speakers can learn a lot by reflecting on the questions and comments that audience members pose to the speaker and to other participants during or after the session. Were these questions requests for clarification, elaboration, explanation, examples, or definition of terms? The nature and number of such inquiries are important because they may illuminate portions of the presentation not clearly or fully communicated or that require further content development, illustrations, or examples. Compiling these queries and replies can both enrich the speaker’s learning and afford valuable direction for improving the material for publication.

What feedback did you receive related to the content and quality of the presentation?

If this session was one of your personal best “great moments in teaching,” do take time to enjoy the accolades, but don’t neglect the due diligence of reviewing this list of questions to ensure that whatever features your original audience loved in your oral delivery will carry over to a much larger audience who will be reading rather than listening. In any case, carefully note both positive and negative participant feedback related to the content, discussion, and delivery so you can retain as many of the former, as appropriate, for the paper and improve or delete the latter.

After reviewing these questions, if you have determined that your presentation topic is publishable, clarified the purpose and audience for the paper, and identified sections of the presentation that need improvement, you should have all the information you need to decide whether your presentation lends itself to becoming a journal article. If it does, then 2 other sets of factors can assist you in finalizing this decision. The first set summarizes the similarities between oral presentations and articles to highlight how much of the conversion work has already been completed. The second set summarizes the differences between oral presentations and articles to highlight aspects of this transformation that remain to be completed.

The numerous similarities that exist between verbal presentations and published articles are summarized in Table 5. At first glance, these commonalities may suggest that once a presentation has been prepared and delivered, little further effort should be needed to produce an article. In reality, however, those similarities that lighten the work required for publication are counterbalanced by a longer and more detailed list of factors that distinguish these formats (Table 6—available online only, at www.ccnonline.org). And as it turns out, reworking those differing factors of the presentation so they accommodate the publication format is the secret to successfully converting presentations into articles. The next section details the steps you need to complete to transform your presentation into an article.

1. Whenever possible, set your sights on publication as you begin planning the presentation

  • As you specify the purpose for the presentation, consider whether your article would share the same or a different purpose.

  • As you prepare instructional objectives for the presentation, consider whether the article might share some or all of these outcomes or need an entirely different set.

  • After you develop a content outline for the presentation, develop a parallel outline for the article.

  • After you have decided on all the visual images that will be used in the presentation, carefully select the few that warrant inclusion in the article.

2. Decide on the purpose of the article

Clarifying the purpose for the article at this point will help the author establish decision points around which material will be selected, augmented, modified, or deleted from its coverage in the presentation. Keep a copy of your purpose prominently displayed so that it can serve as a guidepost for those making each of those decisions during the conversion process.

3. Confirm the audience for the article

Once the purpose for the article is determined, specify the most appropriate audience; some relevant audience attributes will include the following:

  • Clinical area—could be as broad as all nurses, more narrow to just a single clinical specialty such as critical care, or even more focused to a subspecialty area such as neonatal critical care or patient transport

  • Functional area—such as clinical practice, academic education, staff development, administration, management, research, patient/family education, or ethical/legal subjects

  • Position—such as staff nurses, clinical nurse specialists, nurse practitioners, managers, researchers, administrators, infection control coordinators, faculty members

  • Patient population—distinguished by age group (eg, neonatal, pediatric, adult, geriatric) or a particular disorder (eg, heart failure, end-stage renal disease, or trauma)

Many papers have both a primary audience as well as several secondary audiences who would find the content relevant to their work. The most important reasons for identifying the readers who would be interested in the paper are to use that information for decisions related to selection of content and selection of a few journals appropriate for publishing the paper.

4. Identify changes related to the presentation suggested by audience feedback and questions that are applicable to the article

Following the presentation and keeping your purpose and audience in mind, compile the input from attendees and program sponsors regarding your session and use that information to tailor improvements in the article:

  • Delete content areas that were not relevant

  • Expand coverage that needs more detail

  • Rebalance coverage to include perspectives suggested by participants

  • Condense material that only a small segment of the audience found useful

  • Raise or lower the level of discussion to better coincide with the needs of the audience

  • Discern the reasons for any program elements rated poorly to determine how those issues can best be resolved

5. Redraft the content outline so it aligns with the article’s purpose and audience as well as any relevant feedback

Do this as soon as possible following the presentation, while you are still enthusiastic about the topic and have sufficient feedback from the audience (questions, discussion points, formal evaluation ratings and comments) to identify its strengths, weaknesses, omissions, excesses, and degree to which the needs of the audience were met. Try to redraft the outline within 2 weeks of the presentation, immediately after any necessary recovery time you need after being away from work and before you become distracted or deeply involved in other projects and priorities. If you begin the redrafting as soon as possible, you will also be more likely to maintain your commitment to pursue the conversion process. If you put this off for weeks or months, it will likely never regain its priority to you.

6. Identify 3 or 4 journals that would be appropriate for the paper

Fit between paper and journal depends primarily on the topic, purpose, and audience intended for the paper. The free newsletter titled Nurse Author and Editor at www.nurseauthorandeditor.com provides an extensive directory of nursing journals published throughout the world and includes the name, mailing and e-mail address of the editor, as well as a direct link to the author guidelines available at the journal’s Web site. Once you have identified a few journals that would be appropriate for your paper, rank these in your preferred order for publishing the paper.

7. Update the literature search for the paper

When speakers need a few weeks to prepare for a presentation, a single thorough search of the literature may suffice to identify all sources relevant for the topic. Once you decide to use that presentation as the basis for a paper, however, it is often necessary to repeat the literature search to capture any sources added since your last search. Rerunning the search to identify only citations posted to the database subsequent to your previous search can avoid retrieval of all the citations previously located and ensure that your reference list is again current and complete.

8. Review the author guidelines to determine how all components of the paper should be structured, formatted, and prepared for submission

When you know which journal you will be submitting your paper to, obtain a copy of their author guidelines, a document that will provide you with virtually all the information you will need to prepare and submit the paper. Pay attention to both general requirements for the paper such as manuscript inclusions and reference style format as well as more specific requirements such as manuscript length, margins, spacing, and line numbering. Adhering to these guidelines can save an author many hours of revision later on.

9. Prepare your first draft of the paper

Develop the content of your paper in an organized manner from beginning to end. The following reference points will help you stay on track:

  • Purpose of the paper to serve as your guidepost; everything in the paper should contribute to achieving that purpose for your targeted audience

  • Outline for the publication to develop content for the paper in an organized manner

As you work through each section in the content outline, you will also be making one of 3 decisions related to material from the oral presentation:

  • Retain: if that content is included in the outline

  • Delete: if that content is not included in the outline

  • Modify: if that content is in the outline, but needs to be revised for the paper

Owing to the differences between oral presentations and printed articles indicated in Table 6 (available online only), some of the material that is frequently used in and perfectly acceptable for oral presentations will need to be changed for use in the paper, including the following:

  • Remove or reword comments that pertain only to local or regional conditions

  • Convert most first- and second-person writing into third-person narrative

  • Delete asides, personal stories, and rhetorical questions

  • Replace any outdated references

  • Replace secondary sources if primary references are warranted

  • Use the journal’s requested reference style format throughout the paper

10. Ask a few colleagues to critique the first draft, then improve it based on their input

After you have completed the first draft, take a break from writing and solicit some feedback on your work.

  • Ask colleagues who did not attend your presentation and are not familiar with the project described in your presentation

  • If possible, ask colleagues who have experience and skills in writing for publication and who will give you a candid appraisal of the paper’s strengths and weaknesses

  • Identify colleagues who represent readers of the journal you intend to submit to

  • Ask 2 or 3 to get diversity of opinions

  • Make revisions to the first draft in response to this colleague feedback

11. Make your paper a pleasure to read

Repair structural defects via editing

As Table 6 (available online only) mentions, in order for readers to comprehend published material, they rely on information being presented to them according to established rules and conventions, including how words are used and spelled and how sentences are constructed and punctuated. When an author does not follow these structural rules, disruptions to the smooth flow of reading can quickly become annoying work. To prevent readers from reacting that way to your paper, take some time after finalizing the content to fix any of those structural weaknesses. Making these changes will improve the readability of your paper.

Improve writing efficiency via lists and tables

Readers are just like you—busy professionals whose time is precious and in short supply. As a result, readers appreciate an author who makes good use of their limited time by condensing long sections of text into smaller and easier to locate units such as lists or tables and by presenting data in visually appealing and eye-catching forms. Both lists and tables are efficient vehicles for summarizing and highlighting large volumes of important information in a highly economical format. Rather than using complete sentences to fully elaborate thoughts, these structured formats offer a synopsis of points gleaned from that information.

Lists typically consist of a single enumeration in a vertical format, whereas a table consists of multiple columns of information comprising text, numerical data, or some combination of both. Lists may be bulleted when many entries are included or they may be numbered when the inclusions represent steps or stages, or some progressive increments. Tables may incorporate lists within one or more columns.

Enhance visual appeal via illustrations

In addition to lists and tables, a variety of other illustrations can be included in papers to present information. When planning how to complement the content, consider including some of the following types of illustrations to add information value and visual appeal: forms, flowsheets, or templates designed for a particular purpose; algorithms; line drawings; photographs; and graphs (eg, line graphs, pie charts, bar graphs).

12. Obtain permission to publish previously copyrighted materials

Any material taken directly from a previously copyrighted source as well as tables, forms, graphic art, and other types of illustrations that were either directly borrowed or adapted from previously copyrighted materials require written permission before they can be published. In most instances, the publisher of that material owns the copyright. Exceptions to this rule exist when the material appears with identification of a different copyright owner as well as a notation that relates that permission of that copyright owner has been granted to publish the material.

Speakers need to be especially careful to prevent copyright issues that may arise between material used for the presentation or proceedings and material to be submitted for publication. Speakers need to read speaker contract terms very closely before returning materials to program sponsors so they understand any effects that handing over their work will have on copyright ownership.

13. Finalize and submit the manuscript as directed in the journal’s author guidelines

Finalizing a manuscript includes completing content revisions and structural corrections and verifying that all required components related to the paper are ready and complete. Keep in mind that even for nurses with long lists of published papers to their credit, the process of writing-revising-rewriting-revising cycles multiple times before they consider their paper as ready for submission to a journal. Unlike academic papers that may have been drafted 2 nights before their due date, revised the day before, and submitted the next morning, papers being developed for publication are expected to undergo numerous (perhaps 5 or 6 major and many more minor) rewrites before they are ready for finalization and submission. Published papers will be read by thousands of readers rather than only one, so considerably greater writing and revising efforts are expected of authors.

Many journals have a checklist for authors to assist in ensuring that all manuscript elements are included with the submission. Use this checklist before you submit your paper to the journal.

After you submit the paper to a journal, you will receive acknowledgment of receipt of your paper from the journal. If the editor decides that the paper is not suitable or appropriate for the journal, the editor will notify you. If the editor decides to consider the paper for publication in that journal, he or she will assign a panel of reviewers and the paper will be sent out for peer review. After all reviews are received, the editor will review these critiques and communicate one of 3 decisions to you: accept, revise, or reject. It is exceedingly rare, perhaps 1 of 100 or 1% (exact % would be different for every journal), for the initial submission of a paper to be accepted for publication “as-is.” A number of papers will be rejected at the end of this first round of peer review—the percentage would again vary for each journal. The greatest likelihood is that you will receive a request for revision of the manuscript together with copies of the reviewer’s comments and suggested changes. With many online manuscript processing systems, you will also be given a due date for return of your revised paper.

14. Expect one or more requests for revision of the paper and follow through each time by making the changes requested.

Don’t be annoyed or frustrated or discouraged when a request for revision arrives. Revision is the norm rather than the exception in publication. Good reviewers examine your paper closely to see where improvements could or need to be made. They make a huge investment in you for no compensation of their time or effort, so try to weigh their critique with as open-minded a perspective as possible. The only one who will benefit from their investment in you is you.

If a revised paper is improved, but still not yet ready for prime time due to other changes still needing to be made or changes previously requested not being implemented, you should anticipate receiving another request for revision. This is your second opportunity to improve the paper before thousands of readers see it, so take advantage of this opportunity.

Be patient with reviewers as well as yourself in making necessary revisions. Good writing requires attention to details you may not usually notice; those details may not be important to you, but they are important to your paper, so try to appreciate reviewers’ attempts to assist you. Attend to all reviewer recommendations or explain why not in a separate letter. Otherwise, you will likely be asked once more to make the changes previously suggested. After a few cycles of peer review, your paper should be approaching acceptance for publication. After that milestone, the paper will be scheduled for a particular issue and professionally copyedited to correct any structural, grammatical, or compositional flaws before being returned to you for final approval.

15. Return all necessary corrections for your finalized paper to the journal’s production department in an expeditious manner

Once work commences on a particular issue of a nursing journal, production often runs on tight schedule and staff have little time to complete all changes in time for transmitting the entire issue to the printer. Authors participate in this hectic pace when copies of their copy-edited paper are sent to them as “proofs” for final approval. Only essential changes can be made at that time and the timeframe for returning those pages to the production staff is often very brief, perhaps a day or two. Examining your paper closely for absolutely necessary changes and returning those changes within the time specified are required for the issue to come out on schedule. Once those proofs are approved, you can sit back, await the arrival of your issue, and enjoy your reserved location in the professional nursing literature.

I hope that the hundreds of critical care nurses who provide professional presentations every day will consider taking the time to convert those presentations into published journal articles so their colleagues around the globe might benefit from their knowledge, insights, and experience. Although the process of transforming a presentation into an article has no guarantees for being easy or fast, it is entirely doable with the right admixture of know-how, commitment, and persistence. I sincerely hope that this summary of issues that speakers need to consider while contemplating that conversion and the step-by-step guide for completing that transformation inspire and enable more nurses to commit to this challenge.

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New Contributing Editor

I am delighted to present a newly appointed contributing editor. Please join me in congratulating her and in communicating with her about articles you would like to read (or write) for her column.

Patient Transport

Jill Johnson, msn, aprn, fnp-bc, ccrn, cen, cfrn, lead nurse practitioner for TCHS and Transport Education Consultant with N. N. Inc in Louisville, Kentucky.