Barriers to writing

A friend once asked me how I was able to become an editor without having a degree in English literature, linguistics, or the like. How could I know correct punctuation, grammar, and usage without formal training, she wondered. She is a teacher turned elementary school principal, so despite my years as a medical editor, I felt momentarily insecure. Then I considered her question seriously, which lead me to thinking about formal versus informal training in writing.

Oregon Zoo, Portland Oregon
Photo by Ralph S. Pfeifer

My public school experience is really the only formal education I ever got in writing, and I don’t recall it being inspiring in any way. But I’ve always loved reading and writing to express myself, and I think that is by no means rare. Just look at a local or chain bookstore: Most have shelves filled with blank lined journals to write in. That leads me to think that most people love to tell their stories as much as I do.

The bottom line is that I became an editor by writing. And in all the fulltime positions I’ve held as an editor, I never once met anyone who targeted editing as a career, particularly medical editing. Most were avid readers and writers who loved science and could understand the material. But they came to a medical writing or editorial position through a door that opened to them serendipitously, not through one they aimed to open.

If you’re feeling blocked by a lack of education in medical writing, editing, or in just plain grammar and punctuation, know this: It may feel beyond you, but you are not trapped; you've acquired far more difficult knowledge in nursing school. Grammar and usage can be learned as well, and you are smart enough to learn it. Click on some of the links to the right and try a few other sites, like the Purdue Online Writing Lab (or OWL), for additional tips and answers to your grammar and usage questions.

Don’t let your nervousness about a lack of formal training stop you from writing. Writing well is not contingent on formal training, it’s contingent on honing your story to make it understandable and useful in some way to the reader. 

Letting go

The grounds at FDR National Historic Site, Hyde Park, NY
Photo by Gail M. Pfeifer, RN, MA

It’s hard to let an article go. If you let your writing sit a bit (and I recommend that you do so), you’ll start to see errors that you didn’t notice while you were writing. This is normal and does not mean that you are a bad writer. Everyone makes mistakes during the process, and you will not be an exception. But correct those errors now, let the article sit a few days more, then read it again as if someone else had written it. Ask whether the point is clear, whether the topic grabs you, and tweak it further if you can improve on either of those domains. If not, let it go. It won’t be perfect, but if it’s the best you can do, let it go off to the editor of your targeted publication. If the topic is worthy, the editor will tell you what to do next.

Tips on pulling together your article

Once you’ve written a piece and think it’s ready to submit to an editor, set it aside for a day or two. Then go back to reading it and ask yourself a few questions:

• Does your headline set up your lead? The title of the article should grab the reader’s attention without being sensationalistic, guide the reader to the first paragraph (the lead).  
• Does your lead explain why the reader should care about this topic? That’s your angle to the story, and it’s essential for making the reader want to read on.
• Does each statement provoke a question on the part of the reader? This prompts your readers to want to know what happens next. (And of course you’ll answer that question every time.)
• Have you used subheads effectively? Editors will scan these for a sensible chronology and an organized story.
• Did you use sourced quotes for each section of the story? Quotes always strengthen the content. If the quote is from an interview, make sure you are comfortable that all the quotes are accurate. If you’re quoting a referenced document, make sure you have included a citation (according to the publications style manual) and that it is a primary reference (not a reference that your reference document cited; those are secondary references).
• Have you included examples and anecdotes? If so, your main points will have added clarity.
• Does your conclusion “play” on your lead? This helps to bring your topic full circle, and you’ll be able to see if you brought your reader smoothly from beginning to end.

If you're happy with the answers to these questions, your article is as finished as it can be (more on that in a future post).

Hooded falcon*
Photo by Gail M. Pfeifer
*The hood protects the bird from distractions during a falconer demonstration.

How to be a good freelancer

The main goal when you freelance is to make life easier for the editor who has hired you. Here are some Dos and Don’ts:

Do:

• Follow the guidelines the editor sends to you; if you don’t have them, ask for them. (See the related post on author guidelines here.)
• Read the publication you are writing for and glean the typical style; you won’t get everything right, but you will please the in-house copy editors who do the final style edit.
• Suggest a change in story angle if you uncover new information that warrants the change, but be ready to back that up with a solid rationale.

Sunset Over Great Sound No.2, Stone Harbor, NJ
Photo by Gail M. Pfeifer

Don’t:

• Miss a deadline; you won’t be hired again, no matter how good a writer you are.
• Give frequent updates on the roadblocks you have encountered while writing; your editor wants your article, not your excuses.
• Share the obstacles you have overcome (I did the interview on the lunch hour during my day job; I skipped my planned vacation this weekend to get you this article, etc).

Using outlines

Train tracks en route to Banff from Lake Louise, Alberta, Canada
Photo by Gail M. Pfeifer

I tend to avoid outlines when I write (I like to plunge right in and fix it later; see my October 22, 2010 post on that approach), but some people love them. Here are a few tips that I’ve gleaned over the years, mostly from my notes listening to Alan Richman and Robert Santelli (see my post of February 13, 2011), both of whom are writers who taught community education courses I attended at Brookdale Community College, Lincroft, NJ, in the 1990s.

Tips: To begin an outline, start with the title or purpose, move to the lead, provide examples that amplify the lead, answer the question “What happens next?” then wrap it up with a conclusion that reconnects with your lead.

As you proceed through each step, remember to begin each subsequent paragraph with a “mini-lead.” And don’t forget to include transitions that help your reader move smoothly from one idea to the next; you may know a topic inside and out, but your reader needs to be lead by the hand to end up understanding the topic the way you do, from experience.

Call it a Train of Thought outline if you will: The snowplow, or lead, hits you first; the locomotive pulls you on track through each idea; the train cars, or mini-leads, support your theme; and the caboose wraps it up!

Jumpstart your creativity

Watercolor vase
Watercolor sketch & photo by Gail Molnar Pfeifer

Along the lines of my previous post on July 19th, Taking a break, you can use other art forms to boost your creative juices during a writing hiatus: 

• Go outside and sketch; you don’t have to be an artist to enjoy it
• Play with watercolors; remember how much fun you had with those as a kid
• Take photographs of people, places, and things you love; sketch from the photos if you can’t get outside

 You might be surprised at what trying another art form can do for your writing!

Taking a break

Sunset over Great Sound, Stone Harbor, NJ
Photo by Gail M. Pfeifer

Some writers call it a "block" when their writing lies fallow; I call it “taking a break.” It’s summer in the Eastern US, and I live near the coast, so life, and work, slow down a bit. Instead of berating myself for not writing more, like I used to do, I consider this a time to read, spend time with friends and family, and mull ideas. And I am always writing something in my head. I hope you are too. Happy Summer!

Don't be afraid of criticism

Chicken on the road, St. George, Bermuda
Photograph by Gail M. Pfeifer

Feedback on your writing will help you sharpen your skills; don't be a chicken. One way to get started is to begin with colleagues who are interested in writing for publication, too. Seek them out through your unit, HR department, or area bulletin board. Meet before or after your shift or plan a breakfast or lunch meeting where everyone brings a short piece of work to share. Or do some timed writing exercises (see Natalie Goldberg’s ideas in Writing Down the Bones and read my April 9 post for other ideas).

Distractions

Tobacco Bay, Bermuda
Photograph by Gail M. Pfeifer

It’s pretty easy to think of something else to do besides writing, even when you are a writer. Making the ideas you have in your head clear enough on the paper so that a reader can understand your point of view is the big challenge. One of the things that helps me jumpstart my writing is to collect great essays and poems. I keep them in a file and, when I read them—for distraction, of course—they inspire me to start writing again. 

Try it for yourself. Here is one suggestion: Billy Collins, our former US poet laureate (2001-2003) reads his poem “The Lanyard.” It’s terrific in print, but his inflection puts the sense of wistful humor in the work.

Mindfulness and writing

Sanderling on beach, Stone Harbor, NJ
Photo by Gail M. Pfeifer

I recently relearned the importance of mindfulness after carelessly slamming the car door—
on my thumb. While I wait for that injury to heal, I keep thinking about how important paying attention is to just about everything, including writing. I’ve even read a few good books on the topic. Here they are:

Zen in the Art of Writing, by Ray Bradbury (Available free online)

Wild Mind, by Natalie Goldberg

If You Want to Write, by Brenda Ueland

Enjoy reading them—and pay attention!

Read in order to write

I am in the middle of my second read of The Lacuna, by Barbara Kingsolver. Despite the mixed reviews of this book, from "literary masterpiece" to "disappointing," it is one of my favorites, and it seems to me that no one can dispute this writer’s skill at turning out beautiful phrases. One of my favorite lines, which is repeated throughout the book is this: “The most important part of the story is the part you don’t know.”

Wheel-thrown pot by Gail M. Pfeifer
Photo by Gail M. Pfeifer

Why bring up reading in a blog on writing for nurses? Because writing well grows out of reading great writers. Think about the books you’ve read that have held your interest. What were their characteristics? Were they page-turners, were they written about a topic you are passionate about, or were they simply new information you really needed to know about? Try to remember, and perhaps reread those books, because that’s the kind of writing you can emulate as you begin to tell your nursing stories. And the most important part of your story is the part we don’t know. So tell us.

Stories are everywhere

We visited our son, Patrick, in New York City recently, and strolled around the Village on our way back to his apartment. I happened to notice a Bowery building that was gated and covered with graffiti, but with striking architecture. “How sad that someone doesn’t do something with that building,” I said. With that, Pat’s girlfriend turned and said, “Someone lives there, they won’t sell it, and the inside is amazing.” I thought she might be pulling my leg until she sent me an article from New York Magazine, with slides of the interior. An artist and his family live inside the 72-room former Germania Bank, built in 1898—and it’s true—they won’t sell. The inside story is worth a read.

The smoke room at Monticello
Photo by Gail M. Pfeifer

So what’s the point for nurses? There is a story inside everything, particularly inside your work: What presents as an obvious diagnosis in one person can be something else entirely in another—and you have ferreted that out at times. What the physician prescribes today might not be best for your patient in the long run, based on your clinical observations and your knowledge of how much—or how little—family support the patient gets. What your colleagues view as a family that is “a pain in the neck” to the nursing staff, you see as close-knit kin under extreme stress—a treatable diagnosis. There is more, as you know. These inside stories are worth a read, and you should write them.  

Networking with other writers

Conch shell, Stone Harbor, NJ
Photo by Gail M. Pfeifer

Writing is a solitary activity; it helps to network with other writers, whether RNs or or local community members. Check out local writing groups at your local bookstore, community college, or vocational technical venue. Online sites, such as Linkedin, Writer’s Digest, etc, also have a selection of groups to peruse. And, of course, you can start one of your own. The tips and ideas you garner will be invaluable.

How to weather rejection

Sketch & photo by Gail Molnar Pfeifer

As you begin to submit your work for publication, you will receive acceptance and rejection letters from editors. 


If your proposal for an article is accepted, that’s great, but be prepared for rejection as well. And guard against taking any rejection letter personally—sometimes your idea just doesn’t match what the editors are looking for.

If you’re lucky, an editor might be kind enough—and have the time—to explain why your idea is not being accepted right now. If so, pay attention to the suggestions the editor gives you, and try again if you’ve been encouraged to do so.

Always have a second publication venue in mind for your ideas. If the rejection is in a form letter style, with no hint of interest from the first editor, immediately mail out the same query to your next targeted journal, newspaper, or other periodical. Keep this process going until you’ve hit the right publication and landed an acceptance. (Of course don’t forget to do your homework; read my October blog entries on the basics of querying an editor.)

Keep generating ideas and developing query letters over a period of a few months.

Once you have an idea accepted, be sure to read the author guidelines, and follow them carefully.

Listen to a writer

UVA dome room, Charlottesville, VA
Photo by Gail Molnar Pfeifer

When I first became serious about wanting to get published, I signed up for a local community college lecture on writing. Lucky for me, the instructor was Robert Santelli, and his advice was simple: start writing and don’t stop. He brought no notes, no handouts, and just spoke about his experience. Already a published author, he told us how his love of music and local history led him to become a freelance music journalist, and, eventually, to write The Big Book of Blues in 1993 (updated since then). He’s also written books on Bob Dylan, baseball, and travel topics. He went on to become an executive at The Rock and Roll Hall of Fame and Museum in Cleveland, the Experience Music Project in Seattle, and he is now the executive director of the GRAMMY Museum.

So I’m glad I took his advice, and suggest the same to you: start writing and don’t stop. No handouts needed.  

A great month to start writing

Nelson House, Yorktown, VA
Photo by Gail Molnar Pfeifer

I used to think that we should find a way to wedge the month of February between November and December, to give us some leeway between that string of end-of-year holidays. But now I’m not so sure I want to give up the respite that February offers before the hurry of spring—it gives us a breather and an opportunity to fill our space (particularly that space away from work) with fresh activities. Here are some ideas:

• Catch up on the Oscar-nominated films
• Read a both-feet-on-the-floor-kind of book (The Lacuna, The Immortal Life of Henrietta Lacks, The Age of Wonder: How the Romantic Generation Discovered the Wonder and Terror of Science, etc.)
• Plan your garden
• Research an astronomy app for your computer or smart phone. (These apps identify constellations and outline them for you when you hold your device up to the night sky—and February is a great time to star gaze!)
• Write for publication!

An example of writing from ideas in the last post: “I remember…”

November flowers, Key West, FL
Photo by Gail Molnar Pfeifer

Our yard in Middletown, New Jersey, was so shady that impatiens were pretty much the only summer flower I could grow. By autumn, when the impatiens finished blooming, they started to leave behind small pods. At times the pods looked so much like early buds it would be hard to tell the difference save for the season. As the weeks passed, though, the pods grew distinct; shiny green wormlike shells filled with the seeds of next year’s flowers.  

Autumn, Middletown, NJ
Photo by Gail Molnar Pfeifer

As a young child, my daughter noticed and picked these pods, although she never picked the flowers. Sometimes the pods were sturdy and endured the harvest, and sometimes they were so ripe that just your breath alonge would burst them. We called them “poppers,” because the shells would unfurl like a wet, used straw wrapper, spewing seeds all over and startling us both into laughter every time. This autumn ritual went on for years.

I don’t recall the exact moment when my daughter stopped noticing our poppers. And I don’t recall the exact moment she turned from sheltering and planting the seeds of her future self and flowered into the woman she has become. But every autumn, when I pass my neighbor’s impatiens, bolted in the summer sun of our new neighborhood, I look for poppers. I find them and hold them in my hand, and, smiling, wait to see what happens. 

Reducing anxiety by writing

Here is another perk of writing: A study published in Science magazine on January 14, 2011 (read the abstract here), showed that when students wrote down their thoughts before taking an important text, their exam scores improved. So if you’re anxious about writing for publication, well, write about it.

Historic trail, Yorktown, VA,
Photo by Gail Molnar Pfeifer

One of my favorite books, which you may find helpful in this regard, is Writing Down the Bones: Freeing the Writer Within, by Natalie Goldberg. (Read an excerpt here.) Goldberg gives a good overview on beginning to write, and devotes a whole chapter to topics for writing practice. Here are a few examples of her suggestions from that chapter, to help you start writing:

What is your first memory?

Begin with “I remember…”

Write about leaving (the house, a job, a marriage)

In the book, Goldberg also shares her own experiences with writing, how it felt for her to be a beginner, and the insecurity writing can evoke.

Your first publication might not be your last

Writing a short essay or letter to the editor can open doors to regular writing. When I first began my writing and editing career, it was in line with my hobby, wheel-thrown pottery. I started reading letters to the editor of Ceramics Monthly in detail. When I found that what readers were asking for dovetailed with my own interest in a community pottery studio where I worked in clay, I pitched a story on our studio renovation to the editor. They liked the idea, and told me to go ahead. I wrote the piece, accompanied by my own photos.

Assateague Beach, Chincoteague Island, VA
Photo by Gail Molnar Pfeifer

I also had an interest in hand-built Native American pottery. When I learned that an expert potter was exhibiting in New Jersey, I queried Clay Times about an article on his work, and the editor gave the assignment to me. It turned out to be the July/August 1997 cover story, “The Spiritual Pottery of Al Qoyawayma.” I was offered more work.

Although pottery and nursing may not seem all that connected, writing about what you know and what you love are connected. As a nurse, do not dismiss how much you know, and what you would like to see in the literature. Then begin. 

Nursing jobs in editing and writing

In my last post, I mentioned that medical editors and writers often are not schooled in the discipline; this plays out as an advantage for the registered nurse who wants to write. You already know basic anatomy, physiology, and most medical terms that describe an array of diseases. This is a huge advantage when starting a career in medical publishing. Your ability to read and understand scientific and medical articles can translate into a new career if you choose to do so. Starting small, with an essay or letter to the editor can open the door to work. I'll describe how in my next post.