Writing Letters to the Editor, Editorials, and Op-Ed Essays (Part I)

Nurses have indispensable observations and views about health care, but their voices are often under-represented in the mainstream media. One reason for this is that nurses are busy people with many competing commitments. Taking the time to craft a written response to a current issue in a timely fashion may seem a daunting task. This guide is intended to provide a simple and clear template that nurses can use to respond promptly to important issues. You can use this formula for any topic.

First, keep in mind that your response must be timely. Newspapers and other media may impose a time limit on responses, so make sure that you understand what that deadline might be.

Second, even if your letter, editorial, or op-ed essay is not published, it serves an important function: it educates the editorial page editor.

Third, if you are responding to the work of a reporter or journalist, send a copy of your response to that person as well; the journalist needs to be educated about nursing.

Finally, follow the instructions provided by the news outlet (e.g., length [usually limits on the number of words], how to submit).

Template for a Letter to the Editor

Template for an Op-Ed Essay

–Thomas Lawrence Long

Writing Letters to the Editor, Editorials, and Op-Ed Essays (Part II)

Template for a Letter to the Editor

Establish the context for your letter (the issue, article, report, editorial, op-ed essay that you are responding to).

    • Example: Your April 30 article by Jane Smith (“Physician Shortage Ahead”) ignored a vital healthcare profession that is already filling primary care gaps.

Establish your credibility (credentials or experience).

    • Example: As a clinical nurse for 25 years and a nurse educator for the past 15 years, I have seen how advanced practice registered nurses (APRNs) have for years provided primary care to children and adults, diagnosing illness, and prescribing treatments.

Make your argument in one or two points by making an assertion and supporting it with facts.

    • Example: APRNs are educated and clinically experienced to provide comprehensive health care in the frontlines, helping families stay healthy with preventive care and being aggressive in treating illness. In 16 states they provide independent care at less cost than that of physicians, and they specialize in disease prevention and health promotion. According to a RAND estimate Massachusetts could save four to eight billion dollars over ten years with expanded roles for APRNs.

Conclude your letter with a call to action or a summary of your main idea.

    • Example: Your readers are not well served by ignoring the essential role that nurses will play in the Affordable Care Act’s expansion of health care, and future articles on the impending crisis must take APRNs into account.

Template for an Op-Ed Essay

–Thomas Lawrence Long

Writing Letters to the Editor, Editorials, and Op-Ed Essays (Part III)

Template for an Editorial or Op-Ed Essay

The op-ed essay is longer than a letter to the editor, so you can devote more space to the introductory paragraph and develop your points in greater detail. It may be less time sensitive, though it still focuses on issues in the news.

Establish the context for your op-ed essay with an attention grabbing first paragraph by using: a) a striking statistic, unusual fact, or vivid example or anecdote, b) a paradoxical statement, c) a quotation, d) a question, e) an analogy.

  • Example: According to John W. Rowe, MD, a physician and professor of health policy at Columbia University, the Affordable Care Act (sometimes called “Obamacare”) will create an enormous need for an additional 30,000 physicians by 2015 and 65,000 by 2025, a gap that could be filled by advanced practice registered nurses (APRNs), “well-trained registered nurses with specialized qualifications who can make diagnoses, order tests and referrals, and write prescriptions. APRNs could provide a variety of services that primary care physicians now provide.”

Establish your credibility (credentials or authority)

  • Example: The next generation of APRNs that my colleagues at the University of Connecticut School of Nursing and I are educating today will help meet that need.

Make your argument in two or three points by making assertions supported by facts.

  • Example: Two obstacles stand in our way of meeting the needs that Dr. Rowe has highlighted. First, we need to recruit and prepare additional nursing faculty. We cannot simply increase our enrollments in APRN programs; our accrediting agencies stipulate the student-to-faculty ratio in order to ensure quality preparation. Second, we need to legislate in each state an expansion of scope of practice permitted to APRNs. As Dr. Rowe has observed, “despite an urgent need and clear evidence that APRNs can complement and extend primary care providers’ roles — without sacrificing quality of care — nurses are only permitted to practice independently to the full extent of their training and competence in 16 states and the District of Columbia. The remaining states impose regulatory barriers that limit their scope of practice.” It’s time for the remaining 34 states to expand APRNs’ scope of practice.

Conclude your essay with a call to action or a summary of your main idea, but keep in mind that people are persuaded by stories more often than by facts.

  • Example: You already know how hard it can be today to get an appointment with a physician and how little time the physician can spend with you. Think about how worse that will get in a few years when 30 million additional currently uninsured Americans become regular patients. However, a cadre of advance practice nurses stands ready to provide you and your family with a full range of health care. Provide the faculty needed to grow their ranks and give them the authority to practice what they have been prepared to do.

Nurses’ voices—your expertise and observations—are indispensable. Following this formula will make it easier for you to speak out on behalf of your profession.

Template for Letter to the Editor

–Thomas Lawrence Long

Times Articles–Your Response?

Two articles in today’s New York Times cry out for a response from nurses.

“Doctor Shortage Likely to Worsen with Health Law” mentions the word “nurse” once but fails to discuss the role of the APRN http://www.nytimes.com/2012/07/29/health/policy/too-few-doctors-in-many-us-communities.html

“What Can Mississippi Learn from Iran” begins with an extended anecdote of a visiting nurse in Mississippi’s HealthConnect (modeled after the primary care system developed by Iran in the 1980s) http://www.nytimes.com/2012/07/29/magazine/what-can-mississippis-health-care-system-learn-from-iran.html

Keep in mind that, if you decide to respond, your response must be timely; the on-line comment board closes after a few days, and letters must be submitted within a week.

Comments can be submitted on each article’s page.

Submit a letter here: http://www.nytimes.com/content/help/site/editorial/letters/letters.html

Submit a longer op-ed here: http://www.nytimes.com/content/help/site/editorial/op-ed/op-ed.html

CFS: JAMA

Journal of the American Medical Association seeks essays and creative writing, as well as original research. Categories include:

  • Commentary. These papers may address virtually any important topic in medicine, public health, research, ethics, health policy, or health law and generally are not linked to a specific article. Commentaries should be well focused, scholarly, and clearly presented and must have no more than 2 authors. Maximum length: up to 1200 words of text—or 1000 words of text with 1 small table or figure—and no more than 10 references. Commentaries not meeting these guidelines will not be considered.
  • A Piece of My Mind. Most essays published in A Piece of My Mind are personal vignettes (eg, exploring the dynamics of the patient-physician relationship) taken from wide-ranging experiences in medicine; occasional pieces express views and opinions on the myriad issues that affect the profession. If the patient(s) described in these manuscripts is identifiable, a Patient Permission form must be completed and signed by the patient(s) and submitted with the manuscript. Omitting data or making data less specific to deidentify patients is acceptable, but changing any such data is not acceptable. Manuscripts are not published anonymously or pseudonymously. Length limit: 1800 words.
  • Letter to the Editor. Letters discussing a recent JAMA article will have the best chance of acceptance if they are received within 4 weeks of the article’s publication. Letters may have no more than 3 authors. They should not exceed 400 words of text and 5 references; letters not meeting these specifications are generally not considered. They should be double-spaced and a word count should be provided. The text of letters should include the names, academic degrees, and primary institutional affiliations for all authors, and the e-mail address for the corresponding author. Letters must not duplicate other material published or submitted for publication and should not include unpublished data. Letters will be published at the discretion of the editors and are subject to abridgement and editing for style and content.
  • Poetry and Medicine. Poems related to the medical experience, whether from the point of view of a health care worker or patient, or simply an observer, will be considered. Poems should be original, not previously published or under consideration elsewhere, and no longer than 50 lines. Authors may submit multiple poems to JAMA simultaneously.

Questions about submitting poems may be sent to: jamapoems@jama-archives.org

Author information at: http://manuscripts.jama.com/cgi-bin/main.plex?form_type=display_auth_instructions

Nurse in the House?

Writing in today’s New York Times op-ed pages, Theresa Brown calls for federal action to increase hiring of nurses:

Doctors can indeed be heroes. But when a patient takes a sudden turn for the worse, it’s the nurses who are usually the first to respond. Each patient has a specific nurse assigned to watch over him, and it is that nurse’s responsibility to react immediately in the event of an emergency.

That’s getting harder to do, though. Cost-cutting at hospitals often means fewer nurses, so the number of patients each nurse must care for increases, leading to countless unnecessary deaths. Unless Congress mandates a federal standard for nurse-patient ratios, those deaths will continue.

The essay, “Is There a Nurse in the House?” is available on line.

Brown, an oncology nurse, is a contributor to The Times’s “Well” blog and the author of Critical Care: A New Nurse Faces Death, Life and Everything In Between.