Trail Pack: Publication Is Not the Finish Line

Judy E. Davidson, DNP, RN, MCCM, FAAN

Writer’s Camp Guest Counselor

Welcome to our monthly Trail Pack! This month, Judy Davidson takes us behind the scenes of a scholarly idea that moved from research and commentary to wider professional dissemination. This Trail Pack brings together two previously published articles and Judy’s essay about the winding trail that connected them. Begin with the essay, then follow the links to the published pieces to see how the same core idea was shaped for different audiences. — Leslie H. Nicoll, Camp Director

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Previously Published Articles

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Ideas on the Trail

For this Trail Pack issue, I’ve been asked to write 1,000 words about a 1,000-word editorial. The editorial was about a commentary, which was itself written in response to a full-scale research article by Omid Razmpour. That’s three levels of abstraction. I’m just about out of words about this, so you’re going to get a little extra around the edges. Let’s ramble down the trail together, and I promise I’ll get to the point eventually.

First off, I am a hiker, and I love the trails. I jog the trails, hike the trails, and belong to several hiking groups. I even belong to a book club offshoot of a hiking club that selects books about trails and journeys. When email first came along, my husband and I started a joint account that begins with “gchiker.” Guess what that stands for? Right, the mighty Grand Canyon. We used to hike to the bottom and stay at Phantom Ranch about every 18 months. Last year, when I pseudo-retired, we hiked it three times in three months. Given our newly wide-open schedule, we took the opportunity to snatch other people’s last-minute cancellations instead of waiting to hit the lottery. The Grand Canyon is one of our favorite spots on Earth.

In my publication classes, I encourage prospective authors to make writing fun. When I was writing my doctoral capstone project, a midrange theory called Facilitated Sensemaking, I booked a special suite at El Tovar, the glorious lodge on the South Rim, to write the first two chapters. I typed every morning and hiked every afternoon. Nothing could have been more inspiring. Well, unless you count the time I wrote the balance of the capstone in Kauai after testing the theoretical model, writing from 8 to 12 each morning and hiking Waimea Canyon in the afternoon. Martinis and editing at 5 p.m.

When you are on the trail, your mind starts to clear from everyday life, opening up space for new ideas. I can just about guarantee that the idea to study nurse suicide developed while I was on a trail, and every iterative study thereafter was conceived, refined, or polished while hiking or jogging on one.

At one point in my career, I had a very bad position in a glorious location. My office was across the street from Torrey Pines State Park on the Pacific Ocean. I didn’t take meetings in my office, though the view out the window was superb. Instead, I asked those meeting with me to wear walking shoes, and we would “walk and talk” on the trail. They loved it. I also kept a bathing suit in my file cabinet so I could body surf after work. Now, with my new hiking groups, I troubleshoot obstacles and develop research ideas with colleagues as we hike together, some retired and others still in the trenches.

A Question I Couldn’t Let Go

Over a decade ago, I learned that three nurses who worked in one building in my organization had died by suicide. They worked in different departments, and I only drew the facts together because, as the nurse scientist, I served nurses throughout the organization. As a performance improvement specialist, I also knew that three nurses in one location was an “astronomical value,” a quality-improvement signal that something unusual may be occurring.¹ Meaning: Pay attention. Something is odd here.

I went to the literature to find the incidence of nurse suicide, only to learn that no one had studied it in over 20 years. I knew I had to do something, even though behavioral health was not my specialty. I wrote the names of the three nurses on a note and posted it on the corkboard above my desk, concealed so that only I knew the names were there. I vowed not to stop until we had some answers about nurse suicide and could give their loss some meaning. Then I got to work, partnering with physicians and pharmacists to conduct research, fill the gap in the literature, raise awareness, and develop and test the first nurse suicide prevention program in the country.

There was a problem, though. Programs cost money, and I didn’t know what nurse suicide was costing—not just to the organization, but society. The nurse turnover literature focused on institutional costs—the expense to the organization when a nurse leaves and must be replaced. But what about when a nurse leaves the profession entirely? What about the investment in education, the cost of postvention after a suicide, funeral expenses, and the wages that nurse would have earned over a lifetime?

I reached out to several experts in nursing workforce economics and asked whether anyone had calculated the societal cost of losing a nurse to the profession. While they agreed that it was an important question, none had the time to take it on. So, for years, I kept talking about the missing piece in lectures and presentations, hoping someone would pick it up.

It took time, and I despaired of ever finding a colleague to help me with this, but eventually I connected with Robert Longyear at Emory University. Robert enthusiastically agreed that the question needed attention. His attitude was essentially, “Let’s just do it.”

Around the same time, we learned that Omid Razmpour, a PhD student at Emory, was updating earlier work on institutional turnover costs. Rather than duplicate or compete with his work, we decided to wait until it was published and then extend it to include societal costs. We contacted Omid, and he was completely supportive of the idea.

Putting a Price on What We Lose

Omid had two papers published in late 2025 and early 2026.^2,3 Around the same time, Alex Pretti, RN, was killed, abruptly ending a nursing career decades earlier than expected. Robert and I saw that his case could help us illustrate the societal costs that existing turnover calculations did not capture. We contacted Sean Clarke, Editor-in-Chief of Nursing Outlook, about writing a letter responding to Omid’s article. Sean suggested a commentary instead, which gave us more room to develop the idea.

Robert and I began digging into the costs associated with losing a nurse to the profession: education, lost lifetime wages, postvention, funeral expenses, and other societal costs. It got complicated quickly. Costs vary enormously by region, employer, education, and individual circumstances—complexity that may help explain why others had not attempted this calculation. We knew our estimates would be imperfect and open to criticism, but the underlying point was important: There is more to the cost of losing a nurse than institutional recruitment and onboarding.

We used a case simulation to address some of the wide variation in estimates. Ultimately, our goal is to develop an open-source calculator so the profession does not have to rely on a single figure published in 2026. Users will be able to select variables specific to their situations and regions and perform their own calculations. That work is in progress.

Publication Is Not the Finish Line

Once the commentary was accepted, we used the time before publication to write for secondary markets. I wasn’t sure a commentary would get much traction, but I was willing to try. In my publication classes, I encourage nurses to think differently about the life cycle of their projects and research. I used to teach that the work wasn’t finished until it was published. Over the past two years, I’ve expanded that philosophy: Publication is no longer the finish line. You’re not done until you advocate for the wider dissemination of the new knowledge you worked so hard to create.

Taking the Work Further

I started with LinkedIn. Using the abstract and highlights, I drafted a post and then used AI to help refine it without increasing the word count. I also used AI to suggest high-volume hashtags. I changed the article title to something pithier—a lure—and made sure the article link appeared in the body of the post rather than in a comment. That extra click matters; make it as easy as possible for readers to get to your work.

Next, I drafted an Associated Press-style media release. I used AI to provide the standard framework and populate a first draft from the abstract and the LinkedIn material I had already developed. Then I checked it for accuracy, filled in the missing details, and finalized it. I also asked AI to create a 75-character summary for those situations when you have only one sentence to get the message across. Finally, I developed a list of healthcare journalists who might be interested in the story. I tucked everything away, ready for publication day.

Then I turned to MedPage Today. I had written for them before and knew they were interested in timely and potentially controversial healthcare topics. I contacted the editor who handles opinion pieces, described our forthcoming commentary and its expected publication date, and asked whether they would be interested in a companion editorial. They were.

I wrote and refined the piece and had it ready to go. On the day our Nursing Outlook commentary was published, I submitted the companion editorial to MedPage Today. They published it a week later.

Conclusion

Oh, I see we’ve gotten to the end of this winding trail. If there’s one thing I hope you take with you, it’s this: publication is not the end of the journey. Think about where else your work needs to travel and how you can help it get there. Thanks for joining me.

Happy trails to you, until we meet again.

Reference

1. Ogrinc GS, Headrick LA, Barton AJ, Dolansky MA, Madigosky WS, Miltner RS. Fundamentals of Health Care Improvement: A Guide to Improving Your Patients’ Care. 3rd ed. Joint Commission Resources; 2018.
2. Razmpour O, Pappas S, Lee DKK, Mian S, Bouvier M, Cimiotti JP. Advancing the calculation of nurse turnover costs: A methodological approach using the RETAIN Framework. Nursing Outlook. 2025;73(6):102517. doi:10.1016/j.outlook.2025.102517
3. Razmpour O, Pappas S, Bouvier M, Mian S, Lee DKK, Cimiotti JP. Operationalizing the RETAIN Framework: Calculating the cost of nurse turnover in practice. Nursing Outlook. 2026;74(2):102694. doi:10.1016/j.outlook.2026.102694

Author: Judy E. Davidson

Reviewed and Edited by: Leslie H. Nicoll

Copyright © 2026 Writer’s Camp and Judy E. Davidson. CC-BY-ND 4.0

Citation: Davidson JE. Trail Pack: Publication is not the finish line. The Writer’s Camp Journal. 2026;2(3):16. doi:10.5281/zenodo.22163340

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