From the Bedside to the Glossy Pages: Coaching Direct Care Nurses in an Authoring Experience

Abstract

When direct care nurses write for publication, benefits abound. Expert clinical nurses contribute valuable real-world perspectives to manuscripts, especially ones that address practice issues. In turn, direct care nurse authors build new professional skills and may experience enhanced confidence and job satisfaction, which have a positive impact on patient and organizational outcomes. However, direct care nurses rarely pursue authoring opportunities, due in part to a perceived lack of ability, knowledge, and supportive networks. A team approach with an authoring coach-leader can position nurses for a positive authoring experience. When direct care nurses generate potentially publishable topics, or when direct care nurses are invited to join an authoring endeavor, a wise first step is to share the idea or opportunity with their manager. The manager can encourage the would-be authors to clearly articulate their ideas, offer enthusiasm, and suggest enlisting an authoring coach. The authoring coach ideally has publishing experience and some familiarity with the focus of the manuscript. Authoring coaches may be advance practice nurses, doctorally prepared nurses from academic or clinical settings, or senior nurse leaders. Occasionally a direct care nurse with authoring experience can serve effectively as a coach. If the authoring coach is recruited externally, the manager can negotiate resources for the coach, such as money, work space, and library access. In collaboration with the novice authors, the coach clarifies the aim and scope of the manuscript and recommends a target journal. Novice authors can rely on the authoring coach to thoroughly understand submission guidelines, communicate with editors as needed, and integrate key ideas into a rough abstract of the manuscript, as a place to begin. While a single direct care nurse can work successfully with an authoring coach, gathering a small team around a potentially publishable idea holds three distinct advantages for would-be authors, as well as organizations. If a team of 3 or 4 nurses steps through an authoring experience with a coach, then the coach's influence is extended and more than one direct care nurse gains the professional development opportunity of authoring. The content of manuscripts can be enriched when direct care nurses with varying types of expertise synthesize perspectives. Lastly, authoring teams learn leadership skills and forge relationships that contribute to healthy work environments in organizations. Members of a writing team ideally have expertise in the manuscript topic, enthusiasm for the endeavor, willingness to be coached, and support from supervisors. The coach may recommend adding interprofessional partners who could strengthen the manuscript with a diverse viewpoint. More than four new authors on a team, though, may extend the time and energy of the coach and make it difficult for each author to have a unique contribution to a manuscript. The coach invites the team to a face-to-face meeting, either at a common site or through video technology. The initial meeting may require 2 to 4 hours and features team-building, conveyance of key information to new authors, and verification of commitment to the project. During the meeting, the coach fosters the development of collegial relationships among members and creates confidence that each new nurse author can contribute meaningfully to the manuscript. Warm, respectful synergy among team members boosts risk-taking, innovation, and the overall pleasure of the authoring experience. At the initial meeting, the coach helps the group negotiate the order in which nurses' names will be listed as authors, an important issue to address at the first meeting. The authoring coach may be listed as a co-author with the writing team if the coach meets the guidelines for authors from the International Committee of Medical Journal Editors. The team will become familiar with these guidelines during the writing process. To enhance team functioning and leadership development, team members can volunteer to fill various roles. For example, one team member may become the communications director, managing group email reminders and arranging for meetings. Another team member might be the grammatical expert. Ideally, one team member will become the lead apprentice, or assistant coach, the one who will work most closely with the authoring coach and prepare to be an authoring coach in the future. A key element of the initial meeting is a brainstorming segment to develop an outline of the manuscript from the initial abstract. Arranging for an external recorder for this part of the meeting can ensure that all ideas are captured while team members are fully engaged in the discussion. The coach may opt to prepare ahead of time a draft of an outline to jump start the discussion. Projecting the outline visually in the room and modifying it in real time allows the group to track the evolving details. The coach is responsible to keep the work focused on the overall objective of the publication. Ideally, by the end of this meeting segment, the group will agree on an outline for the manuscript, and each new author will self-select the portion of the manuscript they would like to write. The coach can distribute sample articles from the target journal and assist new authors in analyzing the journal's expected reading level, typical sentence structure, organization of content, use of headings, and formal or informal style of writing. The coach can offer additional writing resources for skill-building. It is important to let team members know everyone's writing will be checked for plagiarism, and, furthermore, their exact wording may not make the final version of the manuscript, which will be crafted to read like one voice. As team members begin to write, the coach can be available to offer direction. The team may want to set a “writing day,” when the team meets in a designated place, scatters and writes, and comes back together, while the coach circulates and advises. In general, new authors report that it is valuable to have frequent contact with the authoring coach for reassurance and direction when writing. The coach and apprentice review the first drafts for content, grammar, plagiarism, reference citations, missing content, and overlapping or contradictory content. The coach requests revisions and provides specific feedback to each author while supporting their confidence, aware that this feedback may be the first critique of their writing skills in recent personal histories. The coach can request that team members complete revisions within two weeks. Allowing a longer time can result in a lessening of momentum, a potential loss of confidence, and withdrawal from the process. When the team submits revisions for each section, the coach and apprentice re-write as needed to gain the one voice presentation. The coach checks reference citations carefully. The coach, apprentice, and any interested team members, master the steps of the submission process that the journal requires to ensure that all stipulations are met, including preferred formatting for the narrative, tables, figures, and references. The coach distributes the final version to all team members for last comments. The final version includes the official title of the manuscript and all authors' names, listed in order. As a fun moment, some teams gather together around a computer and click on “submit” as a unified way of sending their work off to the editor. The coach can schedule an in-person or video meeting to celebrate the submission and educate the team on the journal's review process. Specific content may include the process and timing of the review; the possible outcomes, from acceptance to rejection; how the team will be notified; and next steps if the manuscript is rejected or requires revisions. A wise coach encourages new authors to recognize the great value of submitting a manuscript, even if it is not accepted on the first review. The coach can ensure authors' supervisors receive a report on the submission and recognize the authoring team publically. Lastly, the coach leads the group in a reflective exercise, pondering what it was like to be a first-time author and how the process could be improved. The coach can solicit ideas for future manuscripts and plan for continued skill development, if new authors are interested. New authors may be inspired at this point to discuss possible next steps in their career development. We have used the team approach with an authoring coach at our Midwestern teaching hospital over ten times in the past five years, resulting in the publication of 11 manuscripts in refereed health care journals. Thirty nurses were first time authors on the manuscripts, 14 of whom were direct care nurses. In addition, authoring teams presented over 40 times at professional conferences. Four apprentice leaders have become authoring coaches and led nurse teams to publish five additional manuscripts. Nurse retention, perceived teamwork, and nurse satisfaction with professional development in our system remain high, as direct care nurses acknowledge the significance of their everyday work and celebrate the expertise they have shared with the professional world. Renee Twibell, PhD, RN, CNE, is Associate Professor, School of Nursing, Ball State University, and Nurse Researcher, Indiana University Health Ball Memorial Hospital, Muncie, Indiana, USA. Her email is RTWIBELL@bsu.edu.