Nouns and Nominalization as Choices of Style

John Eric Bellquist, PhD

Guest Counselor

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Let meaning guide your choice of nouns and verbs.

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Nouns help us name people, things, actions, and ideas. In professional writing, however, turning actions into nouns or combining nouns into long phrases can make sentences harder to follow. Both choices can be useful. The question is whether they help readers understand what we mean.

Sentences, Subjects and Actions

Sentences can describe a state or relationship, as in “Coronary artery disease is the most common type of heart disease,” or express an action. An action can be transitive, with an object, as in the active sentence “Coronary artery disease causes heart attacks.” Its passive counterpart is “Heart attacks are caused by coronary artery disease.” An action can also be intransitive, without an object, as in “The prevalence of coronary heart disease is increasing.”

In an active clause expressing an action, the subject typically identifies the agent, “the doer or the source of what is done.”^{1(p. 148)} The predicate tells what the subject does. These actions “cover not only physical movement, but also mental processes, feelings, relationships, literal or figurative,”^{2(p. 29)} and the subjects can be people, things, or ideas.

In professional writing, we often turn an action into a noun and make that noun the subject of a sentence. In a review of published research, for example, the authors refer to “the data extraction process.”^3(p.1053) A writer might say that this process “was conducted,” rather than that “the data were extracted” (passive) or “we extracted the data” (active). The noun phrase directs attention to an abstract process; the verb tells readers what happened. It can also eliminate redundancy: extracting data is already a process. Unless the writer needs to distinguish a particular procedure, does adding “process” help the reader?

Nominalized Actions and Noun Strings

Nominalization and noun strings are related but distinct. Nominalization turns another part of speech into a noun: “extract” becomes “extraction,” for example, and “difficult” becomes “difficulty.”^2,4 A noun string places nouns together so that earlier nouns modify a later one. The APA Publication Manual discusses these constructions as “noun strings.”^5(p.112) In “the data extraction process,” “extraction” is a nominalization, while “data extraction process” is a noun string. A nominalization need not occur in a noun string, and a noun string need not contain a nominalization.

Both constructions are stylistic choices. They can provide concise names for familiar concepts, but they can also obscure actions or leave relationships unstated. Sometimes changing a word’s form or adding a possessive or preposition makes a phrase clearer. In Williams’ account of style,² a construction with more explicit grammatical relationships may be easier to understand even when it is syntactically more complex.

Consider “education programs” and “educational programs,” or “patient experiences” and “patients’ experiences.” The alternatives can emphasize different meanings: programs concerned with education are not necessarily the same as programs that educate, and experiences associated with patients may need to be distinguished from experiences belonging to them. Similarly, “study results” does not specify whether we mean “the study’s results” or “the studies’ results.” “Nursing professional identity,” a phrase used in a published article’s title and text,⁶ may refer to the profession’s identity, whereas “nurses’ professional identity” more clearly identifies the people whose identity is being discussed. These forms are not interchangeable in every context. The best choice expresses the intended relationship.

Ambiguities

Longer noun strings can become cumbersome or ambiguous. Breaking a four-word string into shorter units may help, although word count alone does not determine readability. Consider “a nursing patient classification system.”⁷ If the intended meaning is a system nurses use to classify patients, “a patient classification system for nurses” makes that relationship clearer. The original wording momentarily allows a different reading: a classification system for a patient who is nursing.

Likewise, “health care reform discussions” leaves readers to connect “discussions” with “health care reform.” “Discussions about health care reform” or “discussions of health care reform” states the connection. “Hospital health policy development”⁸ might mean “the development of health policies in hospitals.” That revision is appropriate only if “in hospitals” expresses the intended relationship; the original phrase does not make it explicit.

Noun strings save writers from choosing linking words, but those words often supply information readers need. A preposition such as “for,” “about,” or “in” tells readers how the concepts relate. Without it, a compact phrase may sound professional while requiring readers to reconstruct its meaning.

Some noun strings also add an unnecessary level of abstraction. “Health care reform discussions” and “hospital health policy development” can sound like labels for categories of discussions or developments. Such labels are useful when a classification matters. When it does not, a more direct phrase may serve the reader better. The same applies to “data extraction process”: “process” adds little unless the writer is describing or distinguishing the procedure itself.

Scientific writing often names processes, which may help explain the appeal of such phrases. But a scientific subject does not require every action to be labeled as a process. German can combine words into single compounds; English generally presents these combinations as separate words. Either way, readers still need to understand how the parts relate.

Pros and Cons of Noun Strings

Some combinations are familiar and useful. “Advance care planning,” for example, names an established concept and can be abbreviated as ACP after it is defined. Repeatedly substituting “planning about care in advance” would be cumbersome. Although “advance care planning discussions” adds another word, “ACP discussions” may be concise and clear for readers who know the abbreviation. “Discussions about advance care planning” remains an option when the relationship needs to be explicit. Familiarity and context matter more than a fixed limit on the number of words.

Other combinations are harder to interpret. Consider the published title “Nurse Manager Learning Agility and Observed Leadership Ability.”⁹ Does it name (a) “Nurse Manager Learning Agility” and (b) “Observed Leadership Ability,” or does “Nurse Manager” modify both (a) “Learning Agility” and (b) “Observed Leadership Ability”? The reader must decide how the words group together.

An apostrophe can clarify the relationship: “Nurse Managers’ Learning Agility and Observed Leadership Ability.” A preposition can make it clearer still: “Learning Agility and Observed Leadership Ability in Nurse Managers.” Both revisions retain “observed,” which may distinguish the assessment of leadership ability from that of learning agility. Whether that word can be removed depends on the study’s methods and intended meaning; we should not assume that both qualities were assessed in the same way.

If “observed” adds no necessary distinction, the shorter alternatives “Nurse Managers’ Learning Agility and Leadership Ability” and “Learning Agility and Leadership Ability in Nurse Managers” may work. In the latter, “in nurse managers” states the relationship that the original string leaves implicit. In Williams’ terms,² the added preposition creates a more explicit grammatical structure that may be cognitively simpler. The remaining combinations—“learning agility,” “leadership ability,” and “nurse managers”—are each only two words long. “Nurse manager” is a compound noun, not an example of nominalization simply because it combines two nouns.

Outliers

Nominalization can also appear in unexpected editorial advice. A referee for a journal that may remain unnamed once told an author to replace supposedly “passive” expressions such as “it is difficult to …” with “difficulty exists for ….” This change turns the adjective “difficult” into the abstract noun “difficulty.”

The recommendation rested on a grammatical error. Expressions such as “there is,” “there are,” and “it is” are not, by themselves, examples of passive voice. In the constructions at issue, “there” and “it” function as expletive, or dummy, subjects. Passive voice is a different construction, illustrated earlier by “Heart attacks are caused by coronary artery disease.” “It is difficult to do something” is also more direct than “difficulty exists for doing it.” The author had little to gain from following the referee’s advice.

Conclusion

Naming actions as categories can be useful, but it can also distance readers from the people performing them. Consider this instructive sentence:

Although many nurses are unaware of the term relativism, they are applying its philosophical assumptions during problem-solving, ethical decision-making, conflict resolution, and dealing with legal issues in practice settings.^{10(pp.141-142)}

The sentence makes its point: nurses can apply philosophical assumptions without naming them. They may be more concerned with solving problems, making moral decisions, resolving conflicts, and dealing with legal issues than with the philosophical categories used to describe those activities. The list, however, mixes nominalized activities—“problem-solving,” “ethical decision-making,” and “conflict resolution”—with the verbal phrase “dealing with legal issues.” We can make the list parallel and show the nurses acting:

Although many nurses are unaware of the term relativism, they apply its philosophical assumptions when they solve problems, make ethical decisions, resolve conflicts, and deal with legal issues in their practices.

The revision presents the activities as verbs and gives each one the same subject: the nurses. Either approach can be stylistically acceptable. Nominalizations help us name concepts; verbs help us show actions; noun strings can condense familiar terms. We should choose among them according to the meaning we need to convey and the work we ask readers to do. That judgment may help us avoid what a critic of English usage emphatically called a “noun-plague.”¹¹ Like health conditions, verbal conditions too can benefit from self-management.

References

1. Fahnestock J. Rhetorical Style: The Uses of Language in Persuasion. Oxford University Press; 2011.
2. Williams JM. Style: Toward Clarity and Grace. University of Chicago Press; 1990.
3. Simpson V, Pedigo L. Health risk appraisals with aging adults: an integrative review. Western Journal of Nursing Research. 2018;40(7):1049–1068. doi:10.1177/0193945917740705
4. Kolln M, Gray L. Rhetorical Grammar: Grammatical Choices, Rhetorical Effects. 8th ed. Pearson; 2017.
5. Publication Manual of the American Psychological Association. 7th ed. APA; 2020.
6. Payne A, Lalonde M, Vanderspank-Wright B, Perron A. Nursing professional identity: a critical review of the concept amidst COVID-19. Advances in Nursing Science. 2026;49(1):E17–E26. doi:10.1097/ANS.0000000000000529
7. Artuso I, Da Rin Della Mora R, Dasso N, et al. Do nursing patient classification systems to classify inpatients impact outcomes? A scoping review. Western Journal of Nursing Research. 2025;47(12):1214–1224. doi:10.1177/01939459251367529
8. Banisalman IM, Lanzillotta-Rangeley J, Warner L, Smith CR. Nurses involvement in hospital health policy development: benefits and barriers: an integrative review. Western Journal of Nursing Research. 2026;48(2):194–205. doi:10.1177/01939459251387801
9. Glassman KS, Withall J. Nurse manager learning agility and observed leadership ability: a case study. Nursing Economic$. 2018;36(2):74–82.
10. Hirani SAA, Richter S, Salami BO. Realism and relativism in the development of nursing as a discipline. Advances in Nursing Science. 2018;41(2):137–144. doi:10.1097/ANS.0000000000000207
11. Follett W. Modern American Usage. Hill & Wang; 1966.

Author: John Eric Bellquist

Guest Counselor Bio: John Eric Bellquist, PhD, serves as editor and as lecturer in writing for nursing research at the University of Texas at Austin School of Nursing. Formerly the managing editor for the journals of the Psychonomic Society, he has authored books as well. You can contact John at jbellquist@mail.nur.utexas.edu. ORCID: 0000-0003-0216-6541

Reviewed and Edited by: Leslie H. Nicoll

Copyright © 2026 Writer’s Camp and John Eric Bellquist. CC-BY-ND 4.0

Citation: Bellquist JE. Nouns and nominalization as choices of style. The Writer’s Camp Journal, 2026; 2(4):3. doi: 10.5281/zenodo.23317723