Some of the most enjoyable aspects of being an editor are meeting with prospective authors to discuss ideas for articles, working with authors and reviewers to support manuscript development, and congratulating authors when their papers are accepted for publication. One of the most unpleasant aspects is notifying authors that Critical Care Nurse is not able to consider their paper for publication. When that message is communicated in response to a query letter, the discomfort is fairly minimal because the author’s and CCN’s resource investment is minimal. If that message needs to be conveyed after 1 round of peer review, it pinches considerably more, as the author’s time and effort in preparing the paper and staff time in processing the paper through peer review (preliminary check; identifying, assigning and confirming experts to review the paper; analyzing, summarizing, and forwarding decision and review comments to the author) often represent many hours extended over months. When that message is needed after multiple rounds of peer review, the level of disappointment escalates for the author and CCN as our cumulative time, effort, and expertise are seemingly expended for no return whatsoever. To minimize the chance of a rejection coming your way, I’ll use this editorial to share some time-tested truisms for getting your paper published in CCN. Virtually all of the principles contained in these tips apply to any professional journal, but I will tailor some points so you can tell how they specifically apply to CCN. My goal is to not only encourage you to submit papers for publication, but to persist through the revision stages until your paper is ready for publication. I will organize these tips along major stages in the manuscript development continuum, from selecting an idea for an article to receiving notice of manuscript acceptance.
Selecting an Idea for an Article
In order for a topic to be publishable, it needs to be relevant and timely for readers of that journal. Topic relevance relates to whether the content is consistent with the journal’s mission and purpose. CCN’s mission is to provide critical care, high-acuity care, and progressive care nurses with relevant and useful information related to direct care of critically ill patients. CCN’s purpose is to convey information that benefits the care that readers provide to critically ill patients and their families. When considering a clinical topic for CCN, ensure that it
Is within the scope of critical care, high-acuity care, or progressive care nursing.
Can include meaningful coverage of nursing implications.
A brief perusal of CCN’s masthead reveals that in addition to its primary focus on direct patient care, CCN also publishes papers related to academic education, advanced practice, ethical and legal issues, work environments, management, military, safety, and tele-ICU. Topics for these areas can be considered as long as they have overt application to some aspect of critical care nursing. For example, CCN is not a fitting venue for papers on graduate admissions, but is appropriate for faculty critical care practice partnerships that reduce readmission of heart failure patients.
For CCN, any topic without a patient care focus needs direct application to some aspect of critical care nursing.
Topic timeliness relates to whether the projected publication time horizon (often 9–12 months from acceptance) represents an opportune time to provide that information. In short, how “hot” will that topic be for readers? Whereas some topics (managing patients with Ebola virus) require expedited publication, they quickly descend the priority list after that. Other topics (care of patients with sepsis) become instantly unuseable if based on application of outdated guidelines.
Timing problems are less obvious when the topic is relevant, but has been around long enough to generate an ocean of research and review literature. For those topics to be publishable, its literature needs to be wanting in some aspect, that is, incomplete, obsolete, superficial, or silent on the aspect(s) your paper would cover. Otherwise, there is no justification to publish another paper that simply echoes existing literature (within or outside nursing).
Viable publication topics for CCN fill a need with content that is somehow new or different or unique or at odds with existing literature on that topic within or outside of nursing.
Preparing the Initial Draft
If critical care nursing is your passion and your topic is publishable, but writing is not your forte, consider one of the following 2 approaches: securing assistance from someone with expertise and experience as a published author who is willing to mentor you through the process or acquiring those skills on your own.
Either approach can generate 4 valuable outcomes: a publishable paper, a foundational set of skills that can be refined over your career, minimizing struggles that some authors experience with publication, and developing realistic expectations regarding your capabilities as an author, working with journals, and gaining from reviewers’ insights. For most CCN authors, the ideal mentor would be a prolifically published colleague, who understands your writing language, medical terminology, the critical care environment, and the critical care nursing perspective. A less optimal approach is assistance from someone skilled in writing. The major downside here is needing to explain terms and contexts to someone unfamiliar with the field. This type of assistance may be available at local colleges or university writing centers, where access to writing assistance exists for your support.
If you are a self-starter, then learning how to prepare a manuscript for publication represents a prime self-directed learning opportunity with a high likelihood of success. Excellent resources include the following:
Nurse Author & Editor, a publication providing informative articles on scholarly writing and publishing for nurses, with a website (naepub.com/for-authors) offering access to a compendium of free author resources.
An informative booklet, Writing for Publication (John Wiley & Sons, Inc, 2014), which lightly covers basic considerations such as identifying your purpose and messages to communicate, your audience, writing different types of articles and different types of information, and mention of ethical and copyright issues.
A directory of nursing journals
Writing Basics (naepub.com/category/writing-basics), with papers on Secrets of Successful Writers, Writing Guides, Rules of Writing, Publishing Secrets, Avoid Rejection, Revising a Manuscript, and more.
The free online course, Writing for Professional Journals, developed by Patricia Gonce Morton, phd, rn, faan (https://utah.instructure.com/courses/306223) to assist nurses in learning the steps of the publishing process. The course comprises 12 modules (including Getting Started, Focusing a Topic, Preparing Outlines & Choosing a Format, Writing the First Draft, Responding to Feedback) and additional resources.
Finalizing the Manuscript
Once the content, format, and presentation are developed, a number of final checks need to be made to ensure consistency with the journal’s requirements and to avoid unnecessary revisions. Every professional journal has its own author guidelines, which specify how papers need to be prepared, structured, referenced, and submitted. All authors need to follow these instructions at the outset of writing. CCN’s Author Guidelines (ccn.aacnjournals.org/site/misc/ifora.xhtml) include specifications that facilitate processing of incoming manuscripts; not adhering to them precipitates delays and extra work for staff and authors. Using CCN’s checklist will help ensure all requirements are met.
As mundane as final proofing may sound, there is nothing more off-putting to editors and reviewers than struggling to read a paper riddled with spelling gaffes, uncorrected typos, subject-verb disagreements, punctuation errors, incomplete or incoherent sentences, and other glaring writing flaws. These reflect poorly on authors and color reviewers’ impressions of your work.
Another suggestion is to obtain preliminary feedback on the paper by asking several colleagues to critique one primary aspect. For example, for a manuscript on medications for managing heart failure, ask a pharmacologist to review for currency and accuracy of pharmaceutical information, ask colleagues in different geographic locations to verify whether patient management practices differ from yours, and ask another to examine for clarity and organization. Your goal is to resolve weaknesses before the journal’s peer review process so the latter can refine the paper, rather than salvage it from rejection.
Complete a final check before submission to correct problems with spelling, grammar, punctuation, sentence structure, reference accuracy, and formatting
Use CCN’s checklist for authors to prepare for submission
Secure preliminary reviews to resolve problems with accuracy, currency, clarity, and organization before submission.
When an author’s native language is not English, a language editing service may help prepare the paper—see CCN’s Author Guidelines.
Submitting the Manuscript
Authors who have followed the preceding guidance typically find the manuscript submission process easy to complete. CCN’s Author Guidelines provide links to a tutorial that illustrates the submission procedure and to the online manuscript management portal at Editorial Manager (www.editorialmanager.com/ccn) and describe how to obtain any additional help needed.
Submit the manuscript according to directions at the journal’s website and/or manuscript management system.
Responding to Reviewer Critiques in Revising the Manuscript
The peer review process exists to afford some level of quality assurance before material being published. With the exception of personal opinion pieces such as editorials, every column or feature that appears in CCN is subject to peer review. Peer review distributes the author’s work to a panel of health care professionals with expertise in the topic area and requests their appraisal of its merits, weaknesses, and suitability for publication. The best reviewers are constructive, specific, and instructive in their comments; others may be critical, caustic, sweeping, and dismissive. Authors who have published extensively have learned to expect, deal with, and learn from the full range of possible reviewer remarks. A few tips for responding to reviewer comments may be helpful:
It is exceedingly rare for a manuscript to be accepted as is on initial submission. In more than 30 years as editor, perhaps 5 papers sailed through peer review without needing substantive improvements. Your paper could be the sixth, but odds are heavily against it, so best adjust expectations accordingly.
Reviewer comments are a gift to authors. Reviewers are busy professionals just like you, who volunteer time to offer suggestions for improving your paper. They get nothing except satisfaction from helping a colleague they do not know. Some are the same experts cited in your paper, so appreciating their investment in your work is a useful viewpoint.
When you receive a request for revision, authors should feel encouraged that their paper is still considered promising, rather than discouraged for revisions still needed.
Copious reviewer comments may represent the need for substantial revisions, but may also reflect a reviewer suggesting rephrasings, a more verbose communication style, or a point especially important to them. In any case, the volume of comments received may, but does not always, reflect the amount of revision necessary, so perusing them all and responding to each in turn remain the mainstays for manuscript revision.
Authors do not need to agree with every reviewer comment, but when they disagree, they need to explain their perspective and supply references, as appropriate, for support. Addressing comments in a clear, respectful tone enables rapid consideration of author replies. Quasi-snarky replies, expressions of disagreement without rationale or evidence, or not addressing comments are neither appropriate nor facilitative.
Respect reviewers’ time and expedite revisions by making it easy for reviewers to locate changes made to improve the paper. When revised papers are resubmitted, authors must provide a direct reply to each reviewer comment and identify where changes were made.
If you are only submitting a paper to meet an academic requirement or to see if a school paper might get published as is with no intention of ever revising it for publication, then do not submit it to CCN. Our staff and reviewers should not be obligated to waste their time on optimizing a paper when its author is not making that mutual investment with us.
Repeating Rounds of Peer Review and Revision
Less seasoned authors are more likely to experience the need for multiple rounds of peer review and revision because the number and nature of necessary improvements may be greater. As a result, each revision may bring incremental improvement over the prior submission, yet the need for substantive changes persists. CCN attempts to support less experienced authors by offering multiple opportunities at refinement, but even this has limits, so attending to the changes requested is necessary for the paper to remain under consideration. A more frequent reason for revision merry-go-round is an author neglecting to make changes requested in a prior review. An additional opportunity may be offered, but is not guaranteed.
Issuing acceptance letters to authors is the best part of my job, so I hope that the information provided here offers you the foundation and inspiration to publish in CCN. We are here to help support you on your journey as a CCN author and look forward to receiving your best work very soon.