Some brief thoughts on academic writing

Amongst the general array of things occupying this last working week has been some academic writing. On this occasion my hand has been forced somewhat by news of a previously submitted paper having been rejected by a journal editor, an event noted earlier on this blog here. So I’ve been putting in some early starts to pick up the threads with an eye on a submission elsewhere.

It interests me how people go about the business of crafting papers for publication. I enjoy playing with words, and am forever toying with sentences in the hope of producing an improvement. I also find it impossible to leave an error in spelling or grammar uncorrected. This means I do plenty of editing as I go along, which I know is not the way that everyone writes. But I really, honestly, cannot abide a page of text full of red underlines. Once I have a good draft I always seek the views of one or more valued colleagues, and listen carefully to what they have to say. To borrow a phrase Howard S. Becker uses in Writing for Social Scientists, I then like nothing more than to ‘get it out the door’. Papers have to be drafted, honed and tweaked but also published. That means letting them go, and submitting to the rigours of peer review.

There are plenty of places to read about people’s experiences of writing for publication, and spaces where ideas can be shared. #Acwri is the hashtag used by contributors to the Twitter academic writing discussion group hosted by Jeremy Segrott and Anna Tarrant. Pat Thompson has a good academic writing blog here. A book I particularly appreciated when I first started out is Philip Burnard’s Writing for Health Professionals.

Two out of three (revisited)

A brief note, further to yesterday’s post on the business of submitting papers for peer review and possible publication. Aled Jones (tweeting as @AledJonze) alerts me to this post on the LSE Impact of Social Sciences blog. In it Vincent Calcagno, an evolutionary biologist, writes that the ‘[p]re-publication history of articles tells us that rejection leads to higher citations’. Interesting.

Two out of three…

…ain’t bad. After a fairly intensive burst of writing over the last few months I received, on Saturday, an editor’s ‘no thanks’ email following completion of the peer review of a paper I offered for publication at the end of 2012.

Of three manuscripts under review at the turn of the year one is now available as early online and in green open access form. This is the article (written with Michael Coffey) on nurses as approved mental health professionals, which I blogged about here.

A second, which I mentioned here, has been revised and resubmitted. Fingers and toes remain crossed for a positive final outcome.

The last is now back with me for a rethink following receipt of this weekend’s editorial decision email. The anonymous reviewers and the editor, I have to say, gave this third manuscript a proper run-through. In turn I’ve thanked them for their efforts, disappointing though the outcome is. As it happens, one reviewer liked what s/he read, and a second definitely did not. The editor went with the second, and gave a reasoned account why the paper should not proceed. Thank goodness for that academic rhino hide I’ve developed. Emails rejecting papers sting, but it passes. So right now I’ll take what I’ve got and put some time into refashioning this paper for another outlet. More to follow in due course.

Learning from the study of trajectories

Trajectories paperHere’s a post about research, which draws on the paper Complex caring trajectories in community mental health: contingencies, divisions of labor and care coordination which I authored with Davina Allen.

One of the things I’m interested in is the study of ‘trajectories’. With colleagues, the US sociologist Anselm Strauss wrote about these in the book Social Organization of Medical Work. Most people will be familiar with the idea of illnesses ‘running their course’. To this everyday concept Strauss and his collaborators added a whole lot more, introducing the term ‘trajectory’ to refer:

…not only to the physiological unfolding of a patient’s disease but to the total organization of work done over that course, plus the impact on those involved with that work and its organization (Strauss et al. 1985: 8).

Trajectories are dynamic and often unpredictable, not least because they involve people. They are also vulnerable to being tilted by what Strauss et al term ‘contingencies’. Contingencies can have origins in the health and illness experience. So, a trajectory can (for example) veer off in a new direction because of an acute exacerbation of a chronic illness. But trajectories can additionally be shaped by contingencies which have organisational origins. These can relate to the biographies of workers, and to features of the system such as the availability of resources.

Trajectories can be studied. In my PhD I borrowed the design and methods used by Davina Allen, Lesley Griffiths and Patricia Lyne in their study of stroke care, and used these to understand the trajectories of people using community mental health services. In each of two contrasting parts of Wales I recruited three people currently using secondary mental health services. Each became the starting point for a detailed, small-scale, trajectory case study. Over a period of months I followed each person’s unfolding experiences, and the organisation of work surrounding. Using snowball sampling I mapped the network of (paid and unpaid) people providing care to each, and interviewed those identified in this way about their work. I observed care planning meetings, home visits, and read each service user participant’s National Health Service (NHS) records.

Community Mental Health JournalIn the publication for Community Mental Health Journal to which this post relates, Davina and I drew on these data to show how trajectories unfolding in the mental health field are shaped. We offered instances of trajectories being tilted by mental health crises, but also by key professionals leaving their posts and by a lack of resources within the larger system.

We then used data to reveal actual divisions of labour, in a way which has not (to the best of my knowledge) been done before  in the mental health context. By mapping the networks of care surrounding each user participant we were able to learn about work being done by all sorts of people, including many who (I suspect) are rarely thought of as making significant contributions at all. We wrote about the work of community pharmacists, support workers, lay carers and indeed the work of service users themselves.

Having laid all this out we closed by pointing to the importance of what Strauss et al called ‘articulation work’. This is the work associated with the management of trajectories, through mechanisms such as care coordination. Mental health workers in the UK know all about this through things like the care programme approach (CPA).

The detail of this paper you can read for yourself, with the link at the top of this post taking you to our author’s copy of the manuscript as stored on Cardiff University’s ORCA repository. This, word-for-word, is the same as the version of the article which is currently in press here.

For those interested in the paper’s back story, just to note that when it came to selecting a journal I was keen not to submit to a nursing publication. I have no problem with nursing journals per se, but this ‘trajectories’ paper was (and is) aimed at a wider readership. Community Mental Health Journal is based in the US, and publishes papers on, well, community mental health. And that fitted well with the intended audience. This said, one of the anonymous reviewers of the submitted manuscript had things to say about the language used, reminding us that the journal to which we had submitted is read by mental health practitioners and academics and not, primarily, by sociologists. Attending to the review meant some rewriting to improve accessibility. I’ll leave future readers to judge for themselves whether we succeeded.

19th International Network for Psychiatric Nursing Research Conference

Here is just-published information on this autumn’s NPNR conference, which I’ve grabbed from the RCN website:

The Personal and Political of Mental Health Nursing Research

  • 05 September 2013 – 06 September 2013
  • Warwick Arts Centre, The University of Warwick, Coventry, CV4 7AL

Event home

Calling for papers NOW

This international conference aims to examine the personal everyday experiences of living with mental health problems and delivering mental health nursing care and some of the political responses and implications of the events and forces that provide the context within which we live and work.

Mental health nurses regardless of setting are engaged in highly personal alliances with individuals with mental distress. In that light, we wish to hear about research that examines the therapeutic alliances, mental health nursing interventions and creative partnerships that form the focus of much mental health care.

But these personal and professional alliances can also be influenced by wider events that can shape and determine the culture of mental health nursing practice. National responses to global financial crises in the form of austerity measures, cutbacks in services and changes to roles within the workforce can dovetail with existing patterns of inequality, stigma and discrimination to the detriment of mental health service users and staff alike.

The personal and political can be seen to be played out too in the relationships between nurses and the people they seek to support and help through issues of involvement, partnership and collaboration – whether in practice, education or research.

This conference provides an opportunity for an informed and critical look at the therapeutic alliance and the therapeutic environment from the personal and political perspectives of service users, carers, mental health nurses and colleagues. Papers examining interactions and interventions in mental health settings and the wider community are welcomed and could include nurse/patient interactions dealing with resistance, challenge, compliance, containment, risk, sexuality and gender, employment and inequalities.

Oral and poster papers are invited that seek to measure mental health outcomes and critically examine the ways in which these findings work to advance the development of interventions better suited to the needs of individuals and society.

Papers are invited which fall into the following themes:

  • Researching alliances, interventions, partnerships

Therapeutic alliances, mental health nursing interventions, creative partnerships in mental health care: this thread will include papers that focus on the personal and professional aspects of mental health nursing care.

  • Politics, populations, equality and diversity in mental health nursing research

We welcome contributions to this new thread that focuses on research that addresses political issues, including equality and diversity, in mental health nursing or that considers mental health needs in particular populations.

  • Austerity, costs and service delivery

We are keen to focus on service developments, evaluations and research that address the realities of financial restrictions and cuts in service delivery and some of the innovations and creative solutions that are emerging as a result.

  • New roles, new ideas, new researchers

We welcome papers reporting research that explore new or developing roles emerging in mental health care alongside papers that have something new and stimulating to say – give us something to think about! This thread is also open to new researchers perhaps presenting for the first time or presenting work in progress.

  • Innovation in teaching and learning

Developing new ways of delivering teaching and learning in mental health, for both staff and service users, has never been more urgent as roles and demands change, costs are considered and new technologies invite fresh ideas. We are keen to include papers that report research and evaluation of educational initiatives in mental health.

Concurrent sessions

These are presented orally. Each presenter is allocated a total of 20 minutes per session to include time for discussion (5 minutes).

Workshops

Workshops are interactive sessions of 50 or 70 minutes where the leader works with the participants to develop their knowledge and understanding within a specific field. A workshop is presented by an expert within the field and may be pitched at a novice, intermediate or advanced level. Please indicate the level in your submission. To be considered for a workshop you must submit an abstract (1000 words limit), detailing the focus of the workshop and the nature of participation.

PhD Symposium

This will be an interactive session of 90 minutes where PhD students are invited to present one aspect of their research, which may be related to their theoretical framework, methodology, preliminary findings etc. Each presenter is allocated a total of 20 minutes per session to include time for discussion (5 minutes). PhD students are invited to submit an abstract is the usual way, but mark the theme ‘PhD Symposium’.

Posters

Poster presentations form a significant part of the conference proceedings and presenters will have an excellent opportunity to interact with delegates. Posters should present key themes or findings in a clear and stimulating way.

Ready to submit your paper?

Please prepare your abstract submission in a word document, (using Arial, regular, font size 10), including all points within these guidelines and save a copy to your device. Please forward a copy of your paper via email to Laura Benfield at npnr@rcn.org.uk. Please note only submissions received via email can be accepted. You will receive an abstract reference number for use in all future correspondence regarding the abstract.

The process for accepting abstracts is carried out through a scientific committee and the critieria can be dowloaded here.  

Key dates for your diary

– 5 April Call for papers open
– 12 April Registration opens
– 17 May Deadline for submissions
– 12 June The Skellern Lecture (Prof Alan Simpson) Sign up
– 17 June Abstract outcomes communicated
– 1 July Final programme announced
– 31 July Special rate for presenters (£220) ends
– 5-6 September Conference

Start networking now!

www.twitter.com

Use #NPNR2013 to tweet with the network as well as keeping up to date with programme developments and other conference news!

uk.linkedin.com/pub/network-psychiatric-nursing-research/50/1b8/a92/

Join over 700 contacts engaged with NPNR, find us using the above link.

More details about NPNR can be found at www.rcn.org.uk/NPNR

Two day delegate fee
Presenter rate – £220
member rate – £260
Non member rate – £330
Student/carer/service user – £100
Conference banquet – £40

Event contact

Laura Benfield
Conference and Events Organiser
Royal College of Nursing
20 Cavendish Sq
London
W1G 0RN

Tel: 020 7647 3591
Email: NPNR@rcn.org.uk

NHS changes, and the state of research in nursing

Since publishing my last post the Health and Social Care Act has come into force in England. For a frontline NHS worker’s views on what this means, check out this commentary by East London GP Dr Youssef El-Gingihy. Personally I’m glad to be living and working in Wales. I am pleased to say that here there is still government support for an NHS which is funded, planned and provided with the public good in mind.

Elsewhere, within my corner of nursing (the academic bit) an editorial by David Thompson and Philip Darbyshire which appeared in the January issue of the Journal of Advanced Nursing has provoked a series of robust, just-published, responses. These have variously been penned by Bryar et al, Gallagher, Ralph, Rolley, White and Cross and Williams. JAN also carries Thompson and Darbyshire’s rejoinder, through which the responses are responded to.

The debate has a number of elements. In their editorial Thompson and Darbyshire argued that the quality of academic nursing has declined, and that some nurses working in some universities occupy positions of seniority which their experiences and qualifications have not prepared them for. They also accused those they termed the ‘killer elite’ of running departments as managerial fiefdoms, without tolerance for critical enquiry or dissent. This month’s responses include pieces both for, and against, the Thompson and Darbyshire position. Interested readers can follow all this up for themselves through the links I’ve given above, and I won’t attempt to summarise the full range of views offered.

What I will say is that, for all sorts of historical and contextual reasons, it remains remarkably difficult to sustain a career as a nurse doing research. Funding streams for nursing and midwifery departments in UK universities are largely earmarked for teaching, and relatively few university-based nurses have had opportunities to study for research degrees. Amongst those who have completed doctorates many have found it hard to progress to become independent researchers. Large numbers appear to have returned to roles which do not include significant research components. Only a handful of departments have a critical mass of research-active nurses and midwives, leaving the majority vulnerable when key people leave or retire.

But we have to keep at it. What nurses do touches the lives of millions, every day of the year. Research has an important part to play in improving the nursing contribution: from finding out ‘what works’, to learning about the experience of people on the receiving end of nurses’ services, and onwards to establishing how care might best be organised. Taking a research idea and turning it into a proposal which stands a chance of securing funding through open competition is tough (ask a scientist or a historian: it’s just the same for them), but if we truly want a sound base for nursing practice then this is work which has to be done. And as I am currently learning all over again, actually doing research once funding has been obtained is never as straightforward as the textbooks would have us believe.

A brief correcting post on the education of nurses

Yesterday the Health Secretary, Jeremy Hunt, declared that would-be nurses should spend a year doing hands-on care, working directly with health care assistants, in order to be eligible for funded nursing degrees. Today it occurs to me that large sections of the population may be labouring under the misapprehension that student nurses currently spend their whole three years sitting in classrooms. So let me join the queue of people who have already pointed out that, absolutely, they do not. In order to register, students are required to spend half of their time working directly in practice. This point, plus others, was very well-made by the University of Southampton student (whose name I cannot remember, unfortunately) who was interviewed on this matter on yesterday’s BBC News. Bearing in mind that nursing degrees are lengthy affairs (the terms are much longer than those followed by students of most other disciplines), the amount of time learners spend doing care work is already significant.

Writing for publication

Some promising news today from the assistant editor of a journal a colleague and I sent a jointly authored paper to last year. It’s taken a while for them to be sent, but we’ve now received peer review comments. They’re detailed and considered, and we’ve got work to do, but I’m optimistic the reviewers like our paper enough for it to make the cut (at some futue point) and get into print.

It would be tempting fate to say more at this juncture (like giving the identity of my esteemed collaborator, the name of the journal or what the paper is about), so I’ll resist. Suffice to say that the receipt of an editor’s email with an update on a submitted manuscript is always a moment of excitement and anxiety, in equal measure. It’s a big deal getting something into press in this job, and invitations to revise and resubmit (or even better, correspondence indicating that a journal will accept something ‘as is’) are always welcome.

Of course, editors also say ‘no thanks’, and I can confirm that I’ve had my share of being on the receiving end of emails of this type. At this point thick-skinned tenacity is key. I’ll perhaps sulk a little and protest to loved ones, friends and colleagues, but then I have to get on with it and do what’s necessary before offering my article to a new journal. I once had to submit versions of a paper to something like five journals, one after another, before one was willing to accept it. It was either ‘too social science-y’, or not ‘social science-y’ enough, depending on where I sent it.

Selecting students of nursing

During my recent visit to the Netherlands I learned that universities there are obliged to offer places to applicants provided that the formal entry requirements are met. So, for applicants to nursing courses, there are no selection events: no interviews, no assessments of aptitude or attitude, no tests in numeracy or literacy. Here in the UK, the NMC (our regulatory body) requires that offers of places on nursing degrees are only extended after face-to-face selections have taken place. The NMC asks that interviews include assessments of motivation, and of reasons for choice of intended field of practice (adult, mental health, children or learning disability). Would-be students are also invited to demonstrate their understanding of the work of nurses. An interesting difference in approaches, I thought.

Visiting the Netherlands

HAN 4
Bisschop Hamerhuis in Nijmegen, home to Dr Bauke Koekkoek and the Social Psychiatry and Mental Health Nursing research group

Michael Coffey and I have just returned from a four day trip to the Netherlands, an event supported with funding from the Mental Health Research Network Cymru. We were there to share and develop research ideas with the impressive Dr Bauke Koekkoek and colleagues, and to learn about the Dutch mental health system. Bauke, a mental health nurse, is Associate Professor of Social Psychiatry and Mental Health in the Hogeschool van Arnhem en Nijmegen (HAN) University of Applied Sciences, and is interested (amongst other things) in matching the needs of people with mental health difficulties with services. You can read more about Bauke’s work in his inaugural lecture.

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Bauke, in mid-flow

Bauke did a great job organising a full schedule of activities for our three working days away. Well done, Dutch train and bus companies, for delivering Michael and me to our various destinations in timely fashion. We were, though, reminded during our trip that it is the bicycle which remains the vehicle of choice for many Netherlanders.

We had the chance to meet with academics, practitioners and service users during our travels across Utrecht, Arnhem and Nijmegen. Our thanks to everyone who gave their time and who shared their expertise so generously: Dr Arjan Braam; Mark van Veen; the Kompas team at Pro Persona‘s Wolfheze site; Dr Ad Kaasenbrood and his colleagues in the Arnhem Functional Assertive Outreach Team (and particularly Vincent and Riska, who Michael and I spent Tuesday morning with); the Arnhem FACT Team service users who welcomed us into their homes; the HAN Social Psychiatry and Mental Health Nursing research group; and Hein, Rob and Leon who teach at HAN and have interests in developing international links.

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Michael, holding forth

The Social Psychiatry and Mental Health Nursing research group, who we met on Tuesday afternoon, are a capable and accomplished team. Their MATCH Project is supported by a significant grant, and Bauke and his collaborators have done exceptionally well in using this as a springboard for further, associated, studies. Examples include PhDs investigating the effectiveness of therapies, and a planned ethnographic examination focusing on discharge (and non-discharge) of people from community care.

It was good to hear people present and discuss their ideas, and in a spirit of collegiality Michael and I had the chance to share our interests and plans. I took the chance to talk about my research in a general sense, using as a prop this set of slides embedded below:

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Attentive listeners!

Interesting to learn during our time away was the system of preparing mental health nurses in the Netherlands. Yesterday, for example, we met Rob Keukens who runs HAN’s part-time, 18 month, post-qualification social psychiatric nursing programme. This is the nearest thing to what here, in the UK, we would describe as a post-registration course for community mental health nurses (CMHNs). For those interested, Bauke has described and analysed the Dutch CMHN profession in this paper.

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Me enjoying a joke. Or something like that.

The principal purpose of our trip was to further our research connections, and for Bauke, Michael and me to spend time putting our heads together to develop new research ideas. We know we’ll need to involve others, and target funding streams sympathetic to international research proposals which set out to create new knowledge to improve mental health and well-being and the organisation of mental health services.

More on all this to follow in due course, I am sure.