The WRite Attitude: Nursing Students Write Their Way to Improved Patient Care
By Mike Jackman

Often, nurses provide our most prevalent human contact during some of our most difficult experiences. Yet for many years, nursing training emphasized the technological, rather than the human, side of patient care. The nursing school realized it was turning out good nurses who nevertheless couldn't interact well with patients. As a result, the U of L Nursing School began taking another look at its training program. Says Nursing Associate Professor Ruth Voigner, "Perhaps creativity was removed in the scientific community." One way creativity has been put back into nursing is through the use of innovative writing assignments.

Why are writing assignments important in nursing studies? As Voigner explains, the nursing program is concerned with developing students' cognitive critical thinking skills and their "affective disposition" towards critical thinking, a broad term that refers to the ability to see issues from other perspectives as well as the ability to use emotion in the service of patient care.
 Writing assignments provide a window into students' cognition. "You can see the students' thought processes," says Voigner, including whether students have "synthesized" their learning. By comparing assignments over time, teachers can try to assess whether students' critical thinking has improved.

That the affective disposition of students can be dramatically changed by writing is shown in the "Exploring the Human Response" assignment. Used in Nursing 322, "Nursing Care of the Adult," the assignment's goal is to develop care and compassion. Explains researcher Sandy Young (who is writing her dissertation on the use of writing assignments in nursing), the "depictions of the human responses [in art, poetry, drama, and fiction] are often a more realistic representation than those provided in traditional textbooks."

In the assignment, students watch the movie Philadelphia, in which Tom Hanks plays a lawyer dying of AIDS, then write about the character they most identified with. Young found that nurses were "jolted into the world at large" from the narrow scientific frame of their studies. One nurse, for example, realized she will have to deal with AIDS patients and not walk away from confrontation. Young reports that intense emotional involvement and the adoption of new perspectives by nursing students was the rule.

From a WR perspective, the assignment is effective because it directly relates disciplinary concerns to student writing–in this case, focusing on a film representation of an AIDS patient and the reactions of students  to that representation. "In order to understand a patient," explains Young, "you need to understand their hopes and fears; literature brings this out." The result: "By writing . . . they have become more humanitarian."

Voigner reports "a definite commitment"  to using writing in nursing classes and that instructors show "a lot of enthusiasm for it." Through the encouragement of former WR Coordinator Dr. Brian Huot, Voigner herself has presented two papers on ways of using writing to foster critical thinking–this past February at the 2nd International Writing across the Curriculum Conference, and last year at the Conference on College Composition and Communication.

While Voigner is happy that opportunities exist to present her work to the composition community, she wishes there were more possibilities for presenting interesting and successful curriculum practices "in our discipline." One hopes that in the future more disciplines will become open, in conferences and in publications, to examining the roles writing plays in critical thinking and emotional development.