The book I'm reading was recommended by Oprah: A Million Little Pieces by James Frey (2003, published by Nan A. Talese, an imprint of Doubleday). A Million Little Pieces is a memoir about Frey's journey through his addictions to recovery. His writing style is unusual, written in a kind of "stream of consciousness" style, with no quotation marks or paragraphs. According to Bret Easton Ellis, quoted on the book jacket, "A Million Little Pieces is this generation's most comprehensive book about addiction: a heartbreaking memoir defines by its youthful tone and poetic honesty[horizontal ellipsis]." This memoir spent 15 weeks at the top of the New York Times Bestseller list for nonfiction and has sold 1.77 million copies in 2005. Due to the hype about the book, some reporters did background research on Frey to add to their own articles about the book. What they found is that some of his stories (about his arrests, other people mentioned in the book, etc.) didn't add up. According to The Smoking Gun (an investigative Web site at http://www.thesmokinggun.com/archive/0104061jamesfrey1.html), Frey tried to sell his story to 17 publishers as fiction, and it finally sold as a memoir "with all that was not factual excised." However, Frey admitted that some of the details had been embellished.
This controversy has resulted in a lot of interesting articles, letters, and editorials in the newspapers about honesty in memoirs and truthfulness in journalism. Is it important if we know what is fact or fiction? The public should be able to trust that what is held up as factual is indeed factual and that fiction is clearly fiction. We expect that news stories are factual, and newspapers are very conscientious about maintaining their reputations for accuracy. When I went to journalism school, checking and re-checking facts was taught with the same emphasis as giving the correct dosage in nursing school. Maintaining accuracy in reporting is as important a value as doing no harm to our patients.
This is the perfect opportunity to look at Plastic Surgical Nursing and describe the process we take to keep our content at a no-need-to-doubt, high quality level.
First, there are a number of sections in this journal. The editorial is purely opinion. Letters to the Editor are opinion pieces as well. We welcome Letters to the Editor. This year we have received and printed one. The writer may add a few references to back up a "point." We would love to see more letters, so send them to me at [email protected].
Generally, we include three or four feature articles in each journal issue. These are scholarly papers that generally include many references. These are factual papers that have been through a double-blind peer review process to ensure they are current, valid, and significant. The review process, in brief, is as follows: When the editor receives a manuscript, it is sent out to the Associate Editor who manages the peer review process. From a list of manuscript reviewers, she chooses three reviewers who have expertise in the clinical area related to the topic of the paper. The reviewers do not know who the author is and the author does not know who the reviewers are. The reviewers read each manuscript carefully, make comments, complete a review checklist, and return them to the Associate Editor who forwards it to the Editor. The Editor makes the final decision. The reason we go through this multistepped process is so that reviewers who have specific expertise in the field examine each paper and ascertain that the content is current, is complete and accurate, and is of interest to our readers. The American Psychological Association's Publication Manual provides the styling format and, more importantly, the editorial and authorship guidance for our journal. In their manual, they state that "there are basic ethical principles that underlie all scholarly writing. These principles are designed to achieve two goals: (1) to ensure the accuracy of scientific and scholarly knowledge and (2) to protect intellectual property rights." Consequently, we believe that an author of published scholarly works already has the ethical acumen to produce writing that does not contain inaccuracies, errors of omissions, or plagiarism. And as editors and reviewers, we, through our review process, are doing are best to ensure that the articles we publish are valid, accurate, significant, and timely.
When our authors sign a statement giving us permission to publish their papers, they also sign a statement that clarifies if they have any conflict of interest. For example, if an author writes a paper about particular vitamin supplements recommended before surgery and is a part-owner in a company that manufactures those vitamins, he or she would have to declare that prior to publication. We, in turn, would make a note of that to accompany the article.
One of the best things about our society having a professional journal is the opportunity for readers to share their experience with other nurses. In this issue, Nancy Strzyzewski shares her experience as a clinician/educator in an Anesthesia Department and shares some of her experiences in the article "Common Errors in Resuscitation." There may not be as many references in this article as in others because this is her experience. These events are true, she learned something from them, and she is sharing them with us so we can give better care to our patients.
We frequently publish case reports that describe a patient case and the nursing care that ensued. These articles are a combination of the nurse's experience and nursing standards, for example. Authors of this type of article would likely reference several sources.
Other key sections of the journal are the departments, a set of "columns" that appear several times a year. You may have noticed a new department in the last issue: Media Reviews. This will be a section that included reviewers' opinions on books and other media pertinent to plastic surgery nursing. Other departments are Patient Education, Taking the OR to the Office, Management, Pharmacy, Legal, and Wound Care. These departments clearly indicate, through the writing style, if it is fact or opinion. For example, in the Journal Club over the last year, Dawn Sagrillo and Sue Kunz gave reviews of a large number of Web sites. These reviews assist the readers in choosing Web sites worthy of their time to check for information about procedures or worthy of recommending to their patients. The legal column, graciously written by Theresa Wisk, RN, JD, is legal opinion based on the facts of the law.
Some people who have read Frey's book have said that the embellishments make it a "good read" and really drive home the point about the dangers of addictions. Many people say "What's the big deal?" whether he told the truth or not. I took a writing class at University of Iowa one summer called "Turning Life In to Fiction." Even the title of the class was clea[horizontal ellipsis]start with a good life story, turn it into fiction. In the end, we know what the product is-fiction. There have been some notorious cases in the past where journalists wrote feature articles deemed as true, good enough to win Pulitzer Prizes, only later to be revealed as untrue. The trend in feature writing now is creative nonfiction. The factual story should be as interesting and read as smoothly as fiction. A creative newspaper article can leave the reader wondering, "Is this really true?"
Part of the Editor's job is to make sure that the lines between fact and opinion are clear, even when they coincide in the same piece of writing. Our readers should never have to worry about the blurrying of truth lines. We, and our authors, will always strive to keep the ethical writing standards of the medical profession at its highest level.
Now, only if I could get Oprah to recommend folks read PSN journa[horizontal ellipsis].