In the clinical setting, writing is a critical skill for providing excellent nursing care and effective management.1 Clinical written communication includes documentation, orders, and notes related to care provided. Because clinical writing is often condensed, nurses who move into managerial positions sometimes find the switch to business writing difficult. New nurse managers, while possessing excellent clinical skills, often have little or no formal experience in writing business communications.2 Business communication studies show that, on average, nurse managers spend 31% to 40% of their working day writing.2 The types of business communication nurse managers are called upon to write are varied and include e-mail messages, memorandums, business letters, meeting agendas and minutes, project proposals, legal documents, reports, questionnaires, policy documents, job descriptions, staff and patient education materials, staff evaluation reports, facsimile documents, tables, and visual presentations.2,3,4 New nurse managers should remember two basic things when preparing written business communication: Good writing is a process and following some simple steps can greatly enhance the quality of written materials and decrease the fear of writing.

The writing process

Gandolfo and Romano, in their classic book, The Nurses Writing Handbook, state that "the same basic problem-solving process informs both writing and nursing."1 In the writing process, as in the nursing process, the author must first assess by establishing the purpose of the communication, the intended audience, the subject, and the main ideas. The writer then plans the written statements and appropriate order. The intervention for a writer is to implement the plan by preparing (or writing) the actual communication message. Finally, the writer evaluates his or her writing and revises the material as necessary.1 Key to the writing process is careful planning. Time spent in planning can pay big dividends in ensuring high-quality written communication.3

Overcoming writer's block

It's not uncommon for managers, who have a report due in 2 weeks, to spend over a week and a half worrying about the report and then only a few days actually writing it. This inability to focus on a writing task is often referred to as writer's block. Writer's block can be caused by putting off the task (procrastination), growing tired of the long process of writing (impatience), or thinking that a draft must be perfect during the draft phase (perfectionism).3 Here are some strategies for new nurse managers to help overcome writer's block and the fear of writing.

* Schedule a reasonable amount of time to concentrate on the writing process.

* Schedule blocks of time to accomplish the task.

* Identify and review the purpose of your writing; write the purpose at the top of your first page.

* Avoid being a perfectionist; start by writing a draft, not the final work.

* Speak or think out loud to help you get started.

* Write the easiest part first.

* Don't revise until you have a complete working draft in front of you.

* Revise with your original purpose and audience in mind.3

Tricks of the trade

Let's now take a look at some basic tips for nurse managers to consider when writing five common forms of business communication. Following some simple rules will make written materials look professional and reflect positively on the manager who wrote them.

E-mail

An efficient and immediate communication form, e-mail has significantly changed the way people communicate. Unfortunately, some individuals have abused e-mail communication by sending degrading messages and personal attacks, junk mail, and very private messages that easily became public.5 Nurse managers should pay particular attention to the basic rules of e-mail communication. As Guffey and Murphy note in their book, The New York Times Guide to Business Communication, "One misdirected message, or an ill-tempered e-mail sent when emotions are heated, can threaten a career."6 Follow these basic tips when composing an e-mail:

* Don't make every e-mail message urgent; eventually, people will stop looking at your messages.5

* Attach a signature line to your messages so that the recipient can locate you through other communication channels.5

* Always include a clear purpose in your message; if follow-up is required, give a clear date and time when action is expected.

* Check your e-mail message for proper spelling, punctuation, and grammar; remember that the spell check feature won't pick up a word that's spelled correctly but used in the wrong context.

* Avoid abbreviations and difficult-to-understand concepts.5

* Never put anything in an e-mail message that would embarrass you if it were published on the front page of the newspaper.

* Avoid using your employer's e-mail system for communication other than professional business communication.

Memorandums

Memorandums (memos) are the traditional form of business communication to relay information to an individual or all or part of the staff of an organization.7 Office memos are written for use only within the organization itself. Some organizations have a standardized memo template; in addition, many word processing programs have predesigned templates for nurse managers to use. Today, memorandums are frequently disseminated via e-mail. The same rules apply for the creation of a memorandum as for hard copy or e-mail communications.

The format of a memo includes the following headings: TO, FROM, SUBJECT, and DATE. The TO and FROM lines take the place of any ending salutation or signature that might be used in a written communication such as a letter.7 No address is needed on a memo because the recipients are always internal to the organization itself. The message in a memo is often written like a letter except that it's often more direct and brief. Memos may have a CC (courtesy-copy) line directly following the TO line. If materials accompany the memo, an attachment line identifying the material that's attached should follow the message.7

Letters

Nurse managers need to write many letters. All business letters should be written with a purpose in mind. Letters should be clear, concise, and yet include all the information the reader needs. Heller and Hindle in the Essential Manager's Manual remind managers to "make your letters effective by thinking before you write, and always write what you think."8 The format of a letter is important. Attract the attention of the reader by indicating the reason why you're writing. Use short words and sentences and include the date, the reader's contact information, and an appropriate salutation and closing. It's better to err on the side of being formal rather than informal. Be sure to carefully proofread your letter and check for correct spelling and punctuation.8

Minutes

Minutes are written records of what was discussed at a meeting. The person responsible for the meeting is also responsible for making sure minutes are taken. The goal is to have clear and accurate information. There's a variety of formats for recording minutes. Generally, attendees and nonattendees are listed, as well as the date, place, and time of the meeting. Some managers choose to highlight action items so that individuals are reminded to followup. Here are some basics tips for the new nurse manager to follow.

* The order of the items in the minutes should be the same as the order of items on the agenda.

* Minutes should be brief and to the point; keep sentences short.

* The chairperson should always approve the minutes before they're distributed.

* Minutes should be understandable by those who were unable to attend the meeting.

* Minutes should be distributed promptly, usually a day or two after the meeting.8

Faxes

Nurse managers often use the fax machine to quickly send documents. A cover sheet should be sent with a fax transmission. The cover sheet should contain the name of the recipient, his or her department, and a personal phone number. It should also contain the sender's own name, fax number, phone number, and the number of pages (including the cover sheet).7 Many word processing programs have a fax cover sheet template. Always number the pages being sent. This enables the receiver to know that all of the pages were received. When receiving a fax, check to see that you received and can read all of the sent pages. If not, contact the sender right away. A key point to remember is that you should handle all faxes with the same urgency as you would a telephone call.7

Never fear, resources are here

There are many excellent resources for nurse managers to help improve their written business communication skills. The new nurse manager may want to purchase a reference book for the office to use as new writing projects arise. In some healthcare organizations, the human resources department may have classes or resource materials to help new managers acquire written business communication skills. Courses in business communication are available through universities and colleges. Private companies also offer seminars.

Learn and excel

New nurse managers quickly discover that their administrative responsibilities require them to write a variety of business documents. Professionally, good writing skills can dramatically add credibility to the upcoming nurse leader. Nurse managers need not fear writing tasks by utilizing the writing process, following simple rules for different forms of written communication, and learning writing techniques from experts. As with clinical nursing skills, proficiency in writing comes with practice.

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