Writing in Nursing: A Survey of Scholarship

The foundational role writing plays in nursing excellence has long been recognized. Florence Nightingale, one of the most prolific early writers in nursing, published an array of important projects, beginning with her 1851 The Institution of Kaiserwerth on the Rhine for the Practical Training of Deaconesses and extending to various editions of her more widely known Notes on Nursing. Other prominent writings in the Civil War era include Louisa May Alcott's 1863 Hospital Sketches and S. Emma Edmonds' 1865 Nurse and Spy in the Union Army. Lavinia Lloyd Dock penned one of the first nursing textbooks, Textbook of Materia Medica for Nurses, and published it in 1890. A prominent minority figure is Adah Belle Samuel Thoms, author of the compelling Pathfinders: A History of the Progress of Colored Graduate Nurses, first published in 1929.

Contemporary writing studies scholars have represented writing as a process, enabling richer understandings of writing in nursing. Patricia Bizzell and other compositionists have pointed out that scholars do not necessarily agree as to what steps or stages may be included in a model of the writing process, but the general point is clear: the notion of process represents the way people compose far better than thinking about specific products. Jennie Dautermann's Writing at Good Hope: A Study of Negotiated Composition in a Community of Nurses provides the best current critical discussion of writing in nursing, as her argument incorporates the process view and merges it in promising fashion with the concept of discourse communities. In Dautermann's conclusion to her book, she suggests the significance of Good Hope's research:

The story of the working writers at Good Hope complicates the ideas of audience, authorship, and text. It shows that an institutional context such as this operates on a number of levels related to regulatory and professional oversight, as well as local organizational structures. Beyond these material conditions, however, a number of intersecting value systems operate as constraints on written discourse. (117)

The "material conditions" to which Dautermann refers bring considerable complexity to any contemporary understanding of writing in nursing. It makes sense, for instance, that some writings, like recommendation letters for career advancement or other pay scale increases, have more economic capital than others.

In recent years, scholars in nursing and writing studies have begun to craft innovative pedagogical intersections of the two fields. Georgetown University's collaborative initiative between its School of Nursing and Writing Program proves to be one of the most progressive efforts. Building on a shared history of collaboration more than fifteen years old, the Georgetown program defines roles clearly for participants:

Faculty in the School of Nursing, in consultation with faculty from the Writing Program, are developing a systematic approach to affording students progressively more challenging writing assignments and facilitating the development of their writing skills across their course of study. The Writing Program provides consultation during the process of developing new courses, intensifying writing instruction in old courses, and creating standards that will measure the achievement of students' writing abilities at each level of the curriculum. (online)

Another program of note is at the University of Louisiana at Lafayette, where "writing-to-learn strategies" have been employed in introductory nursing courses. In "When Nursing Students Write: Changing Attitudes," Ann Dobie and Gail Poirrier describe "areas of impact" from the Lafayette program: "(1) improved student attitudes towards writing and learning, (2) strengthened student-teacher communication, and (3) increased student retention" (24). Beyond the specific programmatic innovations at Lafayette and at Georgetown, it's useful to suggest general findings associated with writing, nursing, and education. Our review of literature suggests the following of note:

Writing in nursing improves students' comprehension of course content (De Simone; Beeson; Ashworth and Vogler);

Writing in nursing enables students to have a more developed sense of empathy (Young; Fitzgerald and Weidner);

Writing in nursing enriches student's ability to read material critically (Turner);

Writing in nursing requires faculty to learn more about the workplace writing genres and contexts nurses encounter (Spears); and

Writing in nursing seems most useful when multiple types of writing assignments are given, instead of just one (Pinkava and Haviland).

These trends prove important, but it's our sense too that research concerned with writing in nursing specifically within educational spaces is just beginning.

Despite the pedagogical and theoretical advances made about writing in nursing, however, researchers have not yet examined the influence of popular culture, a compelling gap in scholarship that serves as the focus of this article. From the literary and cinematic terror of Misery, to the often-steamy plot lines of General Hospital, and to the sometimes-questionable medical "advice" available on the World Wide Web, images of nursing are clearly prevalent in the contemporary world. These images, we believe, necessarily shape the way teachers and students think about nursing, thus also shaping their related writing.