1. Winslow, Elizabeth H. PhD, RN, FAAN

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Diana Mason's Editorial, "Consider the Source" (April), should be required reading for all writers. Students frequently tell me that a teacher has required that any reference they use be no more than five years old. But it's the quality of the reference, not the year it was published, that should guide us in our selection.


Using secondary sources leads to the perpetuation of errors. When I reviewed the literature for a research study on bedpan versus bedside commode use,1 I found that the energy cost of toileting (how much effort or energy it requires), as reported in the original 1950 research, had been misunderstood and misquoted in a subsequent publication. This error remained in the literature for decades because other authors had used that secondary source.


In addition, the primary source is often written with an elegance not found in other sources. Asher, for example, in a 1947 article vividly describes the dangers inherent in going to bed: "Look at a patient lying long in bed. What a pathetic picture he makes!! The blood clotting in his veins, the lime draining from his bones, the scybala stacking up in his colon, the flesh rotting from his seat, the urine leaking from his distended bladder, and the spirit evaporating from his soul."2


But AJN's "Primary and Secondary Sources: Guidelines for Authors," in the same issue, is unnecessarily complicated. For research studies, if the person who did the research wrote the paper, it's a primary source. If the paper is what someone else says the researcher found or said, it's a secondary source.


Editor's note: For more letters on this topic, go to


Elizabeth H. Winslow, PhD, RN, FAAN






1. Winslow EH, et al. Oxygen uptake and cardiovascular response in patients and normal adults during in-bed and out-of-bed toileting. Journal of Cardiac Rehabilitation 1984;4:348-54. [Context Link]


2. Asher RA. The dangers of going to bed. Br Med J 1947;2(4536):967. [Context Link]