Some years ago, when I was still teaching in a high school setting, the driver education teacher quipped, "Bad grammar will never kill me, but bad driving will." While I will never decry the importance of quality driver education programs and skilled drivers, neither will I negate nor qualify the importance of grammar and its more essential sibling, attenion to detail.
Since I have joined the staff of the Journal of the Dermatology Nurses' Association (JDNA), I have been impressed, educated, and touched by the content of the various articles and departments. The professionalism and dedication are obvious as the authors prepare their manuscripts. However, sometimes, authors are so caught up, and rightly so, with the content of their articles that the grammar and mechanics may fall by the wayside. Obviously, no one is perfect, and I have an anxiety attack nearly every time I press "send" to okay a final proof. From that moment, I bear sole responsibility for any errors in the manuscripts. I have read my own writings numerous times and still miss errors. Let's see how well I did with this editorial.
Professionals lead very demanding and busy lives; I am inspired that so many have time to research, write, edit, and submit articles to JDNA. How, then, does one find time to hone these articles to the fine grammatical edge that journal writing demands? One of the most useful resources on the Web for American Psychological Association (APA) format and general mechanical and writing conventions help is the Online Writing Lab (OWL) Web site sponsored by Purdue University, Indiana (see Resources). The site includes sections such as APA Guide, Research and Citation, Subject-Specific Writing, and OWL Exercises to practice grammar. In their section specifically for nursing students, the OWL editors comment that writing should be "concise, evidence-based, supported by credible and appropriate research,[horizontal ellipsis]professional, and[horizontal ellipsis]follow APA style" (Tompkins, Tompkins, & Angeli, 2010). The contributors further note that the correct use of grammar and mechanics adds to one's ethos/credibility and makes writing appear more professional. In any writing setting, Axelrod and Cooper (2010) in their college text maintain that writing conventions (punctuation, spelling, capitalization, paragraphing, grammar, and usage) serve several purposes, including providing predictability to enable effective communication, giving writers the ability to evolve and allow for innovation and variation and actually allowing writers to be more creative.
Not only is the written word vital to a journal article, but also are illustrations, graphs, and other visuals. Hutto (2008) of Juniata University, Pennsylvania, described a study that compared tables and figures in the research journal The Journal of Cell Biology to tables and figures from an applied medical journal, The New England Journal of Medicine. The study addressed the question of how scientific visuals contribute to the persuasiveness of a writer, looking at how the graphics within an article affect the credibility or ethos of the writer. The complete package, as it were, reflects on the author and the journal as a whole. Hutto contended that, when one considers ethos, the author must recognize that scientific writing presents information visually, such as figures and tables as well as in the written text. Biologists from the Center for Disease Control related to Hutto that many of them only looked at these visuals instead of reading entire articles. Both in pure research and applied medicine, as represented by the two compared journals, graphics and visuals pervade the texts, claimed Hutto, to reinforce credibility. Also important with such visuals is correct documentation and permission from patients and those who may be pictured in photographs, as required by JDNA.
Documentation is the bane and yet the quintessence of quality writing. APA format works well, in that this system allows the date to be displayed in the citation, a vital element in determining the credibility of a source. Timely material in the science and medical areas not only is the hallmark of vigorous research but also is the bulwark of life-saving and life-changing best practices. Obviously, the authoritative resource is the Publication Manual of the American Psychological Association (6th ed., 2nd printing; American Psychological Association, 2010) as well as the APA sponsored Web site (http://www.apastyle.org/elecref.html), which provides an introductory tutorial. An easy reference text is Diana Hacker's (2010) A Pocket Style Manual (5th ed.) from Bedford/St. Martin's Press. This text also has a companion Web site at http://www.dianahacker.com/pocket.
An article that contains correct grammar, usage, spelling, and the generally accepted conventions of writing and APA formatting does, indeed, lend itself to have readers take its content more seriously and add credibility to the text. I believe, however, that, beyond the scope of accepted language conventions, the effective use of correct mechanics, grammar, and formatting shows a much more important, if not critical, skill-attention to detail. Years of teaching college freshmen have given me some comical errors to report: "condom" instead of "condone" and the ubiquitous "form" instead of "from." I have been entertained by "thong" instead of "thing" and "ate" instead of "are." Although these errors are innocuous, even if a little embarrassing, such errors and transpositions could be lethal in a medical setting. I know of a friend who was diagnosed with "BPD" during an emergency room visit and then was admitted to an inpatient mental health facility. What was meant as "borderline personality disorder" was interpreted as "bipolar disorder" and thus began years of incorrect prescription intervention. Obviously, attention to detail matters in following scripts and in writing flowcharts, care plans, and narratives.
Whether one works in a private office or public setting, patients trust professionals to be just that-professional. Synonyms for "professional" include "expert," "skilled," and "proficient." Yes, we are human, but we must also perform as best as we are humanly and humanely able. Attention to detail, pride in one's work, conscientiousness, and completing each mundane and tedious task as if another's life depended on our work ethic become a reality in the nursing profession. "IV" (intravenous solution) may be misread as "IU" (medicine dose in international units), and the antiseizure drug Lamictal could be easily confused with the antifungal medicine Lamisil. The antianxiety agent Xanax sounds a lot like the acid suppressor Zantac (Institute for Safe Medication Practices, 2011). The possibility of such errors for practitioners and nurses is one of the major reasons medical professionals use tall man lettering, writing part of a drug's name in uppercase letters to prevent misinterpretation or confusion (Grissinger, 2012). Improper APA format or a split infinitive will not kill another, but confusing the wrong dose or medication may.
I am honored to serve in an editor capacity and have utmost respect for the authors and pride in JDNA. Let us keep striving to maintain the standards of excellence of the Journal; to pay attention to grammar, mechanics, and documentation; and to attend to the many details required in professional writing. Good writing, like most worthy endeavors, is not an accident but the result of hard work. Those in the dermatology nursing profession know how to live with that work ethic and, by doing so, to enable others to live longer, fuller lives!
Resources
http://www.apastyle.org/elecref.html
http://www.dianahacker.com/pocket/
https://owl.english.purdue.edu/owl/
Patti Paull
Editorial Assistant
References