Writing, Caring, Nursing Publications, and You

Jenny Chicca, PhD, RN, CNE, CNEcl

Writer’s Camp Counselor

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Inclusive language is more than just pronouns.

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The last five years have been particularly tough for me. I have had many personal and professional life changes, with some expected, some unexpected, some positive, and some negative. To name a few, I finished my doctorate, changed jobs, moved locations, and experienced the deaths of both my father and father-in-law. In case I needed some more life, I have also been experiencing health concerns. Since I am young and appear healthy, it took time to convince medical professionals to take me seriously. After many appointments, testing, and follow-ups, they finally believed me and I was diagnosed with several conditions that are associated with disabilities. Now they tell me that these conditions are systemic, progressive, and difficult to treat without a cure. My disabilities will continue to cause me issues like pain, fatigue, and mental health concerns. All fun stuff, am I right?

I face my new reality each and every day, and some days are better than others. Some days I feel hopeful, others I feel indifferent. I feel sad and sometimes angry. Or I can feel anxious about the fact that my conditions aren’t always visible. I wonder if people believe me. I think about what my future may look like and if I will be a burden to my family. Sometimes I tell myself it’ll be fine. All this to say, my relationship with my disabilities is dynamic and complicated. And I know it’s going to stay that way.

I bet you are thinking, I am sorry to learn about your health concerns, but what does your story have to do with writing? Good question. As a nurse, an author, and a person with disabilities, I would like to share strategies for writing with care in nursing publications. As members of a healthcare profession, you may need to write about individuals with chronic conditions or disabilities. You need to share with care to promote positive outcomes. Words matter and it is important that you use your nursing voice for good, but this is not always easy. You may lack the necessary knowledge, skills, and abilities to truly write with care. Thus, this article will cover caring writing approaches including person-first language, alternatives, and other considerations including language to avoid and language to use. These approaches will help you promote respect, acceptance, and inclusivity to improve healthcare outcomes.

What is Person-first Language? What is the Alternative?

My first suggestion for writing with care includes considering the use of person-first language. Like it sounds, person-first language is when the person is listed before their chronic condition or disability. For example, you would write “a person with diabetes” or “a person with cancer.” Person-first language can reinforce and emphasize the individual’s humanity while making it clear that their condition does not define them. Person-first language can also place the emphasis on someone’s abilities instead of their disabilities. However, person-first language can be seen as problematic as it may limit an individual’s ability to fully embrace their condition as an inseparable part of them. Individuals may feel that listing their condition second indicates that the condition can be removed. From a writing standpoint, it can also be cumbersome to read person-first language, especially when it is used repeatedly.

The alternative to person-first language is known as identity-first language where an individual’s chronic condition or disability is listed first. Revisiting our earlier example, you would write “diabetic” (let’s revisit the term diabetic shortly) or “cancer patient” (let’s revisit the term patient shortly). Identity-first language can acknowledge a person’s condition as a fundamental part of their identity and reminds others that the condition is not negative. The individual can claim and choose their identity versus allowing others to do so for them. Additionally, positive identification with a disability or chronic condition can positively impact their adjustment and coping.¹ However, identity-first language can reduce the person to their condition, disregarding their other abilities and promoting negative stereotypes.

When Should You Use Person-first Versus Identity-first Language?

Just like my relationship with my disabilities, deciding whether to use person-first or identity-first language can be a complex, dynamic process. The reality is that, even with the same condition or disability, preferences will vary. And, if one individual prefers person-first language and another prefers identity-first language, both are correct. So, what do you do? My first piece of advice is to ask directly or ask the experts. For example, if you are writing a case study about a particular person or community, directly ask them or key community leaders what they prefer. If you are unable to ask directly, look to outside experts to try to identify the preferences of a particular community. You could research information available from professional organizations such as the American Association of People with Disabilities (AAPD), National Disability Rights Network (NDRN), Autistic Self Advocacy Network (ASAN), and the National Association of the Deaf (NAD). If you are writing about a particular condition or disability, chances are you’ve been reviewing the literature. As you analyze materials, notice how experts refer to individuals in these communities. Asking is a great way to identify preferences to write with care.

Of course, you may never know the exact preference of each individual and preferences may also change over time. If you do not feel confident about the language to use, you may want to switch it up. According to the American Psychological Association (APA), it is acceptable to shift between person-first and identity-first language. Switching it up can help readability but is also a great way to balance your discussions when you do not know the preference of each individual, or how they feel at that particular time. You could even include a disclaimer which outlines why you have chosen to use both person-first and identity-first language. For example, the article by Arbour and colleagues² on inclusivity explicitly draws attention to the person-first versus identity-first debate and discusses why they chose to use both. They state, “The authors acknowledge the debate regarding person-first vs identity-first language. Many disability advocates prefer identity-first language because their disability is often a defining feature and cannot be separated from them. However, person-first language is often preferred, including in written work. For this reason, both person-first and identity-first language will be used without strength or power given to either.”^{2 (p. 183)} Personally, some days it does feel like my disabilities consume me and come first. Other days I feel like I come first. So I appreciate these suggestions. A balanced discussion with a disclaimer can help respect and accept individuals with care.

What Are Some Other Considerations?

Although there is some debate regarding using person-first versus identity-first language, there are definite missteps or language that you should not use in your writing. Experienced and inexperienced authors may need to review their writing within this context. For example, after I wrote this article, I re-reviewed it for missteps and made several adjustments. Avoiding these missteps will help promote caring in your publications. Table 1 covers language to avoid with examples.

Table 1. Language to Avoid to Promote Caring
Misstep	Examples
Always labeling severity	Mild, moderate, severe
Always using the term patients	The patient with diabetes walks 30 minutes daily
Indicating negative connotation or pity	Afflicted, confined, suffers, victim, stricken, damaged
Offering accolades which may devalue	Brave, courageous
Referring to the disability as a noun	Spastic, epileptic, amputee, paraplegic, disabled, handicapped, retarded, crippled
Referring to limitations	Wheelchair-bound
Self-projecting	I wouldn’t want to deal with that disability
Sensationalizing	They do well for a disabled person
Sharing only extreme cases	Severe disability to get tear jerk reaction
Using gender-specific personal pronouns	His or her

Those are a lot of missteps! I will say that some of these are more easily avoided, but some may be harder to confront. For example, negative connotations or accolades which devalue can be omitted, or you can share mild or moderate cases of a disability. However, what about concerns like references to limitations? Or gendered language? Those may be harder to address, especially if you are used to writing in a certain way. So, let’s cover alternative language to promote caring. Table 2 covers harder to address original missteps and then provide “sure steps” or language to promote caring with examples.

Table 2. Language to Promote Caring
Misstep	Sure Step	Examples
Always labeling severity	Only label severity when needed for the piece of writing	Person with chronic kidney disease (severity not needed)
Always using the term patients	Only use client or patient when applicable	The patient with diabetes is having surgery today
Indicating negative connotation or pity	Use a neutral verb	Encounter, experience, have, with
Referring to the disability as a noun	Use person-first and/or identity-first language, depending on preferences	Person with fibromyalgia, Autistic person
Referring to limitations	Emphasize assistive-devices as enabling	Uses a wheelchair, uses assistive technology to communicate
Using gender-specific personal pronouns	Use gender-neutral personal pronouns and generic greetings	They or their (singular or plural) and good morning/ afternoon/ evening/ night

What If You Write the Wrong Thing?

Whew, those are a lot of considerations and you may be worried about writing the wrong thing. So, what if you write the wrong thing? Before I respond to that, let’s get this out of the way: at some point during your writing career, you will write the wrong thing. Or you may write the correct thing at the time, but then language changes. As social norms, perceptions, and new opportunities for inclusion arise, so will the language we use. And language will influence society.³ All that being said, when you write the wrong thing, own up to it! Be okay with being corrected. Apologize. And stay curious to strive to learn and improve. This will help you continue to write with care in your publications.

Conclusion

Writing with care in publications is a difficult yet important task and nursing authors may be ill-prepared in this area. Carefully consider approaches to writing with care, including person-first language, alternatives, and other factors like language to avoid and language to use. Use writing with care is an opportunity to learn and realize that changes may occur over time—what you write today may not be correct tomorrow. Writing with care respects individuals and promotes acceptance and inclusivity to improve healthcare outcomes.

References

1. Grech LB, Koller D, Olley A. Furthering the person-first versus identity-first debate. Australian Psychology. 2023; 58(4): 223-232. doi:10.1080/00050067.2023.2192863

2. Arbour M, Hansen K, Milazzo M, Houston J, Walker K. Inclusivity in nursing education: Mixed methods inquiry into knowledge and attitudes of faculty about neurodiverse students. Nurse Educator. 2025; 50(4): 183-188. doi:10.1097/NNE.0000000000001838

3. Kuang J, Bicchieri C. How language framing shapes the perception of social norms. Current Opinion in Psychology. 2024; 60(December 2024): 101886. doi:10.1016/j.copsyc.2024.10188

Author: Jennifer (Jenny) Chicca

Reviewed and Edited by: Leslie H. Nicoll

Copyright © 2025 Writer’s Camp and Jennifer Chicca

Citation: Chicca J. Writing, Caring, Nursing Publications, and You. The Writer’s Camp Journal, 2025; 1(3):5. doi:10.5281/zenodo.17391311