Clinical Nurses Encouraged to Write for Publication

Several types of manuscripts are published in CCN, including structured review articles, quality improvement reports, evidence-based practice articles, and case reports.

• A structured review article requires a systematic literature search to locate the best available evidence on a particular topic and to minimize bias. Structured review articles include integrative and scoping reviews.

• Quality improvement reports should follow the SQUIRE 2.0 reporting guidelines, which provide a standard framework to ensure that important information is considered for inclusion in the report.⁸ 

• Evidence-based practice projects are performed to answer a specific clinical question. Many nurses are familiar with the PICO (patient/population/problem, intervention, comparison, outcome) format, which is used to guide a literature review to locate evidence.⁹  Resources for authors who want to write evidence-based practice manuscripts include the Evidence-Based Practice Process Quality Assessment¹⁰  and the Johns Hopkins structured publication guide.¹¹ 

• Case reports submitted to CCN should follow the CARE guidelines, which provide resources to describe the timeline of events and ethical consideration to protect patient identity.¹² 

Manuscripts related to acute and critical care patients across the life span are appropriate for CCN. However, authors should keep in mind that the majority of American Association of Critical-Care Nurses members care for adult patients, and articles are selected and published in an attempt to meet the needs of CCN’s readers.

Selecting a topic and reviewing author guidelines are the first steps in writing for publication.¹³  Additionally, reviewing the mission of the journal is important to ensure that your topic is a good fit.

Nurses involved with caring for a patient whose case was rare or unexpected or involved with implementing a new patient care strategy should consider sharing this experience more broadly.

Nurses who recently presented a project by poster or podium may already have completed much of the background work needed to write a journal article.^14,15  For example, Ring and Pfrimmer¹⁶  presented a poster on propofol as a drug of diversion at the American Association of Critical-Care Nurses National Teaching Institute in 2019 in Orlando, Florida, and they published an article on this topic in CCN in 2021.¹⁷ 

If articles have already been published on your selected topic, consider how you might contribute a different perspective on that topic. For example, several articles on caring for patients receiving extracorporeal membrane oxygenation (ECMO) have been published in CCN. The focus of ECMO articles has ranged from a review of caring for obstetric patients,¹⁸  pharmacological considerations,¹⁹  a case report of a patient with COVID-19 receiving ECMO,²⁰  mobilization of patients receiving ECMO,²¹  ECMO as a bridge to lung transplant,²²  nursing care recommendations from a professional advisory committee,²³  and a general overview of caring for patients with percutaneous mechanical assist devices.²⁴ 

As CCN’s editor, I welcome queries about potential manuscripts and their fit for the journal. Query letters should contain details about the proposed project, including the purpose, scope, and type of article you are interested in writing. I try to avoid overlap in content, and I submit screened articles for peer review on a first-come, first-served basis.

I recommend writing with a team to include input from several stakeholders. Novice authors can benefit from working with an experienced author. Student authors or recent graduates should discuss authorship with faculty who were involved in the writing or development of manuscripts or projects.²⁵  Turning a school paper into a manuscript requires mindful revisions to address journal readers as your audience.^26,27 

All coauthors must be involved in the writing process, although there are several models for writing in teams. Some teams divide the workload and each coauthor writes a section of the manuscript. In other teams, the first author writes the first draft of the manuscript followed by several rounds of constructive feedback and suggestions from the coauthors. All authors should contribute to their manuscript in a meaningful way.²⁸  When I am the first author for a manuscript, I ask my coauthors to challenge my thinking, improve the sentence structure and grammar, improve overall clarity and flow, and critique the content throughout all phases of the writing process. I prefer that my coauthors provide feedback and help to improve the manuscript on the front end versus risking a harsh review following submission to a journal.

While writing a manuscript, it can be tempting to include every piece of available evidence related to the topic of interest. I recommend developing a concise purpose statement for the intended article and referring to it regularly during the writing process. Consider what your manuscript is and is not. When writing with coauthors, the purpose statement will help to ensure a focused approach. Many writing resources are available to guide novice authors through the writing process.^2-7 

Create an outline for the manuscript, listing subheadings and key points that should be covered. The first author should be prepared to edit the manuscript thoroughly after each round of major writing or revisions.²⁹  Using a feature like Track Changes in Microsoft Word can help authors follow the revision process more easily. A few tips about writing include the following:

• For review articles, prepare an evidence synthesis table before writing the body of the manuscript. Write the first draft of the manuscript using evidence from the synthesis table.

• For case reports, create a figure or table of the timeline, including medical history and interventions.

• Try to avoid interrupting the writing process. While writing the first draft, write what comes to mind; this approach will help the flow of the manuscript. Revisions, such as selecting more professional terminology, replacing clinical jargon, verifying facts, and adding citations, can be done later.

• Highlighting and comment boxes can be used to identify words that you may want to change at a later time and make notes about things to review and questions for coauthors.

• If you have writer’s block, just start writing. Sometimes, I start a writing session by assuring myself that I will write for only 20 minutes. I try not to agonize over the perfect sentence but instead concentrate on writing a consistent message. This way I will have something to revise, and revisions are often much easier to do compared with writing the first draft.

• Keep a file for any deleted content. By keeping deleted sentences in a file, the material is still available if it is ever needed.

• If you write with a team, revise the manuscript as needed to make it read as though it were written by one person.

Manuscripts submitted to CCN should reflect an understanding of the nursing role and include recommendations for clinical practice, as appropriate. Authors are often experts in their specialty and may forget to fill in the details and context that less experienced readers require to understand the article. One section that is often underdeveloped in manuscripts submitted to CCN is the Discussion section. In this section, compare and contrast findings in your manuscript with what is known in the literature. If your findings are different from the published evidence, provide a plausible explanation to help readers understand why your project had different findings. As appropriate, describe any recommended steps for practice, policy, and/or research.

Submission of a manuscript and supporting files to CCN is done online, using links from the CCN website. After submission, the manuscript is examined to ensure that the author guidelines were followed, the submission file is complete, there is no suspected plagiarism, it fits with the journal’s mission, it does not overlap with other manuscripts in the system, and its general quality and readability are good. It is possible that the manuscript could be rejected at this point.

Manuscripts moved forward will undergo peer review. The CCN review process was described in detail in the December 2022 issue (Critical Care Nurse. 2022;42[6]:8-10).³⁰  Peer reviewers are volunteers with clinical and/or methodological expertise who objectively review a manuscript and provide constructive feedback to help improve the end product. If revisions are requested following peer review and the manuscript is not rejected, the editor and peer reviewers consider the manuscript to be a good fit for the journal and they are interested in helping the author to advance the manuscript toward publication, pending successful completion of the requested revisions. Expect all manuscripts to require revisions as part of the review process. Manuscripts accepted for publication will be copyedited before publication.

Like many of my colleagues, I have had manuscripts rejected by a journal. Although rejections are disappointing, it is important not to take them personally. The manuscript may be well written and address an important topic, but the timing and/or selected journal may not be a good fit. If your manuscript is rejected, ask a colleague to review the manuscript and provide suggestions for improvements. Revise and submit the manuscript to another journal before the supporting evidence becomes outdated.

Several of the articles mentioned in this editorial were authored by staff nurses and/or first-time authors. Writing resources and potential writing mentors are widely available. I hope that reading about writing for publication will inspire some of you to start brainstorming with your colleagues about possible topics and begin your own writing journey.