Increasingly, nurses are called upon to not only care for the physical needs of patients, but also to further and create legal, medical, and academic knowledge in the form of workplace documents such as charts, lab reports, and nursing research.  On the job, the health of a patient may depend on the nurse's ability to speak and write.

The Importance of Writing Skills Development in the Nursing Profession

Journals such as Pediatric Nursing (2001), Nurse Educator (1990), and Journal of Nursing Education (1992) emphasize writing skills associated with  advancing nursing research, improving nurses’ communication, teaching others, and being current in the field.

In the keynote speech at a meeting of the American Association of Colleges of Nursing, the President of Carnegie Foundation for the Advancement of Teaching emphasizes the role that writing across the curriculum should play in educating and professionalizing future nurses: “[T]he top priority of those in undergraduate education, including those who are preparing for the health profession, must be to help all students become proficient in the written and spoken word” (Boyer, p. 102).  Indeed, nursing educators should develop teaching strategies to ensure that workplace demands for accountability can be measured and are accurate, reliable, and reasonable. Jennie Dautermann mentions in Writing at Good Hope: A Study of Negotiated Composition in a Community of Nurses that the dominant preference for oral information exchange in actual practice sometimes leads to a devaluation of the expected role that written communication and the development of writing skills play in the nursing profession (p. 50).  Similar work with language and writing in the field of nursing recognizes the need for analytical, organizational, and mechanical writing skills.  The Lab Newsletter for the School of Nursing graduate program at University of Wisconsin-Madison notes, “Nurses write a great deal every day, but mostly in single words, phrases, and symbols.  Therefore they must learn or relearn how to construct grammatical sentences and well-developed paragraphs and to organize masses of data" (p. 3).

In her research study, Lynda W. Slimmer, Ph.D. and RN, notes, “writing is used not only to improve students’ communication skills but to promote learning and to provoke critical thinking” (p. 75). Her study also found that when students were confronted with assignments that provided inadequate support for student research, negative attitudes about writing were reinforced.  From this research, two actions ensure more successful programs: providing a writing laboratory and designing evaluation strategies to support ongoing research (p. 76).  Such changes increased positive affective attitudes by students about research in nursing: “These results add empirical data to the work of others who assert the use of writing across the curriculum techniques to promote affective learning, to provoke critical thinking, and to integrate a liberal arts focus throughout undergraduate education is worthy of consideration by other nursing programs” (Slimmer, p. 78).

The Importance of Writing in the U of L School of Nursing

In Teaching Writing as Reflective Practice, George Hillocks, English Education professor at the University of Chicago, emphasizes the role that inquiry (a term he uses to refer to critical thinking) can play in teaching writing.  Specifically, allowing our students to use writing as a means of solving problems as well as developing the skills needed to convey ideas to others are essential to what Hillocks found to be the most successful mode of writing instruction — the “environmental” mode of instruction.  The environmental mode, “places student, teacher, activities, and learning task in balance” and encourages the use of “student-led small-group discussions [and writing tasks] focused on solving problems” and addressing shared issues (Hillocks, p. 221).  Through its course content and required projects in its WR courses, the curriculum in the School of Nursing at the University of Louisville emphasizes the development of such inquiry skills through writing.  As the syllabus for NURS 350, a course entitled “Lifeskills for Nursing II,” demonstrates, course objectives include: obtaining varieties of information needed to make sound nursing and health care decisions; effectively communicating in writing with peers and clients; using theoretical frameworks to work effectively with clients and other professionals; demonstrating critical thinking in working with clients; evaluating the effectiveness of the processes and outcomes of interventions; and disseminating appropriate evaluation findings to peers and clients.  Because NURS 350 addresses a number of these current professional needs and at the same time stresses the significance of writing in developing critical thinking skills, we wish to highlight four of the many writing-intensive assignments of the course to  illustrate how writing can be utilized successfully to help students “write their way” into the disciplines.

Communication Assignment

This group assignment, which incorporates both an oral and a written component, is designed to allow students the “opportunity to identify and address communication needs” for chronic health care clients. The assignment forces student writers to sift through their research and make informed choices about which models work and the reasons for making their choices, as well as finding support for their decisions in the current disciplinary research. Additionally, formulating their hypotheses allows them to apply general critical thinking skills to a more specific disciplinary situation.

Health History

This assignment asks each student to compile a health history of an individual.  By requiring students to utilize interviews and review health records, the assignment hopes to “promote the student’s identification of, and the implications of, cultural, psychosocial, environmental, and wellness practices that influence the health status of an individual.”  By participating in this project, the students develop skills that can be applied to a “real-life” health care situation in the nursing profession.

Research Utilization: Improving the Quality of Patient Care

The goal of the research utilization assignment is to help students understand the importance of research in the nursing profession.  The claim that research informs practice underwrites this assignment. Working in groups, students read, review, and present on one study from a professional nursing journal, concentrating on study design, methodology, theoretical assumptions, and implications for practical application in a specific clinical setting.

The Patient’s Voice

This assignment provides students the opportunity to explore a client’s reaction to an experience of illness, to explore and describe their own reactions to the client, and to consider how they might apply their insights and nursing interventions in similar situations.

NURS 350 provides numerous opportunities for prospective nursing professionals to “write their way” into the discipline.  Allowing them to utilize modern “writing-to-learn” strategies — writing tasks that ask students to think through, organize and develop specific skills through writing — helps nursing students at U of L to become capable and successful writers and professionals. As the discipline of rhetoric and composition discovers more effective ways to teach and improve written communication, we hope that Nursing will continue to avail itself of this knowledge and improve the vital communication skills of a crucial profession.

References:

Boyer, E. L. (1989) Connectedness through liberal education. Journal of Professional Nursing. 5.2 102-107.

Dautermann, J. Writing at good hope: a study of negotiated composition in a community of nurses. Greenwich: Ablex, 1997.

Feeg, V.D. (2001) Another view on professionalism. Pediatric Nursing. 27.3. 220-221.

Hillocks, G. (1995) Teaching writing as a reflective practice.  New York: Teacher’s College Press.

Slimmer, L.W. (1992) Effect of writing across the curriculum techniques on students’ affective and cognitive learning about nursing research. Journal of Nursing Education. 31.2. 75-78.

Parker, R.P., and Goodkin, V. (1987) The consequences of writing: enhancing learning in the disciplines. Upper Montclair, NJ: Boynton/Cook.  85-112.

Sobralske, M. C.  (1990) Writing in the disciplines. Nurse Educator  15.6. 11-14.

Writing Lab Newsletter. (1989) 13.5 University of Wisconsin-Madison. 5-8.