SCCM Pod-535: Professional Development for Early-Career Healthcare Workers
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Hello and welcome to the Society of Critical Care Medicine podcast.

I'm your host, Diane McLaughlin. Today, I'm joined by Heather Meissen, DNP FCCM, in our series focused on addressing the unique professional development concerns of healthcare workers at the beginning of their career. Society of Critical Care Medicine is a multidisciplinary organization that helps all members with professional development opportunities. Nursing has special concerns when it comes to professional development. This podcast aims to address some of those concerns.

Heather Meissen is a nurse practitioner at Emory Healthcare and associate clinical professor with Emory School of Nursing in Atlanta, Georgia. Welcome, Heather. And before we start, do you have any disclosures to report? I have no disclosures. I'm very excited to be here. Thank you for inviting me, Diane. All right, awesome. So we're talking about nursing and publishing and academia today. So can we start by just briefly talking about why it's important for nurses to publish and

Yes, I think that this is a very interesting topic, one that is very dear to my heart. It's hard sometimes, I think, for new nurses to get out there and publish, but it's incredibly important because nurses are at the bedside with the patient. They can see trends that

other health care providers might not be able to see. They work so closely with patients and their families and can identify issues more readily, I feel like, than some of our other colleagues. And so with that, it's easier for nursing to see where different issues and quality improvement can occur and different types of improvement with patient care.

And when they can identify those trends and see problems and possibly run a research study to figure out how we can improve some issues, it really lends to better care for patients. And I think it's just incredibly important that our nursing colleagues, you know, sort of get over that initial feeling of imposter syndrome and do get their thoughts out there for the rest of the world to see.

Yeah, I feel like nurses are kind of the like, keep it real group because they are there at the bedside and can say, yeah, that was a great theory and concept. It doesn't work when you bring it to the bedside.

Right. So now that everybody's like, well, this is great. I have a million ideas that I want to publish. I think the question is, where do you start? Well, you know, I think that it's important to find a good mentor or a sponsor to really help with building your question out and making sure that what you're trying to investigate is realistic and is timely. And I guess that's another place to start is what is your question? Really developing that question. But a good mentor can help you through that.

I know a lot of times when you're starting out, you want to conquer the world and you have these big ideas and these big questions, but really honing down into something that is manageable, that is specific. You know, think about your SMART goals, specific and realistic and timely. It's important to hone down those questions to something that is a realistic target. And starting there is

then having your mentor really help you through that process and then getting up and going again, having a mentor just really can help with setting your project up and implementing it and helping you figure out what may be some, you know, challenges that you probably don't see yet along the road and helping you prepare for those challenges. But having a good mentor is a really great place to start. So how do you find a good mentor? Well,

Well, you know, I'm here if you want to reach out to me. Both of us are here, you know, reach out to your colleagues in the society, reach out to your colleagues across the national networks. You know, if you're interested in a particular research area,

I suggest, you know, pulling some papers in that research area and seeing which nurses are authors on those papers and reaching out to them, finding an expert in that area. You know, they don't even have to be close to you. They can be available through Zoom. So anywhere across the country, finding somebody who's an expert in that area. Or if you want somebody who's local that's just an expert in setting up research projects, doesn't have to be their area of expertise. They may not

be interested in, say, end-of-life care, but they can help you set up your project and help you through all the components of that project.

And it seems like sometimes it happens really organically that you find somebody and they can help guide you without even knowing that they're doing it. And then other times it really is that you have to like reach out to somebody and say, hey, I don't really know what I'm doing, but I'm really interested in this. Like, where's a good place to start? Right. And, you know, just your contacts come to Congress and make some friends, come to the nursing section business meeting and, you know, make some contacts and then ask

folks. Do you know anybody who's interested in mentoring me for, say, burnout or catheter care, et cetera? There's so many different opportunities. And we have such a large number of experts within the society that can be of help and want to help mentor. Yeah.

And it's kind of a great place to find people because if they're there, you know that they're pretty active. Right. That's one of the things that maybe sometimes as somebody that both has been menteed and a mentor is if you're going to put energy into something, you want to get equal energy. Right.

So make sure when you're reaching out and developing this, if it's not something that you can actively do right now, maybe make the contact and say in the future, I'm interested in this. But make sure you're putting in the same energy you're expecting from someone else. Right. And, you know, if you do approach somebody and they say, you know, I don't really have the time right now, ask them if they have a name of somebody else who they may recognize.

I've done that a few times where I've been overloaded with work and I've had students or some of my colleagues in the unit reach out and I've said, you know, I'm very interested in this topic. I can help peripherally, but you need somebody who's going to be there with you, you know, week by week. And this is who I recommend for that. But again, I'm here for questions and comments. So ask, you know, if there's an additional person that may be available.

So now in our like fake scenario, we got very excited about a topic. And then we listened to this podcast and we said, Oh, okay. I emailed Heather Myson and she said she would help me. I'll help you. And then what comes next? Well,

You really do need to be familiar with the evidence that surrounds your current topic. You may see a problem in your unit and you may think that you have a great way of testing a solution, but that also may have already been investigated. So go out there to PubMed if you have access to it. If not, Google Scholar and type in whatever the question is. So burnout in bedside critical care nurses and see what pops up. And then if there is already...

strong evidence out there, go ahead and implement that into your unit. You could create a quality improvement project based off of that evidence and then

potentially present a poster sometime at Congress. So really, once you've identified what you're interested in, go and search that literature and dive into what's already out there and see if you can find any gaps in what the current evidence suggests. I love that you mentioned the poster, because I feel like a lot of us, that's your first thing that you do is you do a poster, you develop an abstract.

And I remember how daunting that was at the time. I remember being nervous, like with presenting it, oh, is anybody going to ask me questions? But that is a great first step.

It is a great first step. And I guarantee you, everybody there who's presenting a poster feels like the same way you do. They think that they have imposter syndrome and they're nervous about getting asked questions. But you have to remember, once you've gotten to the point of creating a poster, you're currently the expert on what you've done. And so you should be able to ask any questions. And I have a tip. If you don't know the answer to that question, you can always say, oh, that's a great question. I'm going to have to research that and get back to you.

So that's a great way of answering questions that you might not know the answer to. That's like a pro tip right there. Yes. Because I think everybody thinks that they're going to sit down and write the great American novel and they're going to submit their, you know, nurse burnout to the New England Journal of Medicine and be

be identified as the expert. And even though that's a great goal, I don't know that I'd recommend that everybody start with the New England Journal of Medicine or critical care medicine. Right. What are some good ways to identify what the right target journal is or what the right home for your work is?

That's a great question. And it really boils down to who do you think your audience is going to be? If your audience is only critical care nurses, you may want to target the critical care nursing journals. If your target is multi-professional, you may want to target critical care medicine or critical care explorations, which is our open access online journal. I'm currently writing a paper

on moral injury in advanced practice providers that is not specific to critical care. So when I'm thinking about who my audience is going to be, because it's not specific to critical care, I'm thinking more outside of the box. And so there's a journal of healthcare administrators that readership may be interested in my content. So you really have to think about who's interested in the content and then because they're going to be more likely to accept your paper if it targets their readership.

And though it would be nice to think that every time you submit, it's just going to come back. This is amazing. We will take it exactly as is. I've never seen that happen ever. That never happens. And I'm glad you brought that up because I wanted to mention when you submit or even if you have your mentor read your paper first, expect there to be feedback. Expect there to be comments. I remember I submitted a paper in my DNP program and my chair said,

emailed me before she sent me the paper. And she's like, I just want to let you know, there's a lot of red marks. And I opened it and the entire thing was red lines, the entire thing. There was not a single sentence that she kept. And I was like, you know, this is okay because this is helping me to grow as a writer. And this is helping me to grow as, you know, someone who wants to publish in the future. And so take the feedback that your mentor gives you, take the feedback that the peer reviewers give you,

Don't be offended. They are only trying to help you have a better paper. And what you don't want is for it to get published and then to get the feedback from the population. So these peer reviewers, your mentor, they will help make the paper better. So view it as this is how I'm going to get better and this is how I'm going to have a better manuscript, not as a personal attack, if that makes sense.

That is another pro tip and something that I think when you're new into putting your work out there can be problematic. It sounds like you entered that with a very open attitude. I can't say that I was like, I think the first one I got back, I was like, but

that, no, that's, I want to say it like this. This is how I like it. Right. But now years later and having the experience from the opposite side as a reviewer, I mean, some of it is opinion and style things, but a lot of it, you put a lot of time into trying to help make that better, make the paper better, make it more straightforward, make it more appropriate for a certain journal.

Yeah. And, you know, there's always the option of disagreeing. So if peer reviewer number two, because it's always peer reviewer number two that has something out of left field and you're like, where did that come from? Say they have something that completely contradicts what the entire integrity of your paper is saying. You can politely thank them and say, you know, thank you so much for your feedback. I understand what you're saying, but this would contradict my entire paper. You're allowed to say that and to keep your paper the way it is and that

sense if it's like one or two comments. The goal of the peer review process is to improve the paper, but if it impacts the integrity of your paper, you're allowed to decline that suggestion. I just suggest not making it a habit because, again, the peer reviewer process is to help make it better. And if you do decline too much, they may reject the paper. But again, if it impacts your paper too much to where the paper no longer makes sense, then you're allowed to decline.

And the other thing I think to keep in mind is that if you're getting comments back, then that's actually a really big step in the right direction. Right. That's almost the end process, right? Yeah. Because I will say I have one work that I'm kind of shopping around right now that has gotten a few quick rejections. Kind of feels like when you think you're going to match with somebody on a dating app, you never do it.

And they swiped the wrong way. Yeah. And so you have to remember the right home is out there and you have to find that appropriate spot. And if you're getting feedback, that's actually great. And there are some journals that have moved to an initial sort of initial response based off of the content, which I think is helpful for authors so that you don't get too far down the process of submitting your manuscript and then going through

months of reviews to ultimately end in rejection, they've created this sort of quick look process that says, yes, this is appropriate for our journal or not. And I think that's beneficial. So you may want to look for journals that do have that. And there's also guidelines out there on their websites, on the journal websites of what is appropriate for those papers so that you don't waste too much time in one place.

But I will say if that does happen, especially if you're kind of shooting for big name journals, like mine is a small case series. So it makes sense that it's not going to be in one of those giant journals. But one of my mentors told me there's a home for every manuscript is just finding the right one. And so you don't give up on your work. You just keep trying to find where that right place is for it. Right.

What advice would you give to somebody that's just getting started and intimidated by the process? That's a great question. And this is something that I tell my students often, just get started. That is the quote, just get started. I remember when I entered my DNP program, which was awesome.

all scholarly writing. I don't think I took a single test. It was just all writing. My very first assignment, I asked the program director, I was like, you know, I'm not an expert in this area. How am I supposed to write an entire paper on this topic? She's like, just get started. Put your name on a paper,

start formatting, start outlining, start with the sections, like start with your headers, and it will come through. That's how you get started writing, putting it all together and just get started. So even with your project, again, create that question and really think through what your methodology is going to be before you get started. But think through what your methodology would be and just get started. Do that lit search. Start and look through other evidence. What methodology did they use to test this hypothesis and

why would that be good or why would it not be good for my project? So just get started. Now we talked about mentorship, but are there any resources that you know of for nurses that just want to improve how they're writing their writing style? There are a lot of resources out there. If you're associated with an academic facility, then there's typically like writing workshops that you can go to for a full weekend. That sounds torturous to me.

But I have had many friends who have enjoyed it because there are a lot of scholarly writing experts that attend these that help you frame your question and your prose and help you through the process of writing. I struggle with a lot of writer's block, and I find that there are certain days where I just can't write. And so sometimes these writing clinics will really be beneficial sometimes.

I think another thing, if you're not associated with an academic facility, is start reading. The more you read papers in that area or that expertise based on your question, the more you read will help you frame your project in a way that is solid and robust. But again, those mentors are really going to be able to help you identify some resources in your local institution as well.

Now, how is AI going to change this whole process? Oh, man. Can I just type my question into chat and see what it says? I wish. I wish. So AI is definitely an interesting beast. It's helpful on so many levels, but there's also...

the need to have your own work be submitted. A lot of journals have rules and regulations around what AI can be used for within the manuscript. Currently, you know, AI can be used for infographics or

maybe data analysis they're considering AI with these like large data analysis programs that's considered AI. But the prose and the thought process has to be all original. And that has to be disclosed what AI was used for and what was original authorship. In general, all of

the authorship should be original. There is some thought that having copy editing would be okay. You also have to be careful because whatever you put into AI stays there forever. So you don't want to upload your entire manuscript to AI and say, copy, edit this for me, because then it just goes into that world and it will be there forever. So it's public domain. It's public domain. And then I've seen some cases where AI has claimed they've written certain prose and they haven't because it was...

published prior to AI being a thing. And so it's just, you know, it's touchy. And I think even by the time this gets published and out into the world and people are listening to it, there may be even something new and different. I think that there's a new version of AI coming out, ChatGPT 5 or something. And I hear that's going to be just way more than what we're currently getting. So

As somebody that has dabbled in AI a little bit, it does make things up. So if you think you're being clever and saying, okay, well, give me like five references about this topic. Yeah. It will give you references that look very legitimate. Yes. And it's not a real reference. Yeah. And so if you think that you're not going to get caught, you are wrong.

Yes. And that has happened. I have found made up references all the time. And so you have to do your due diligence. Again, just doing it yourself is going to be your best bet, but it does make up things. So Heather, guess what happened today? Oh, what? I opened my email and I...

And I got an email from a journal that said, oh, Dr. McLaughlin, we've read your recent work. And they have invited me to submit an additional work on the same topic to their journal and also to go to another country to give a big presentation on it. That's awesome, right? Congratulations. It only costs a couple thousand dollars to do this, but that's a big deal, right? Yeah.

You know, there are predatory journals out there and it sounds great, especially when you're starting out because you're like, I will do anything to get something published because I'm just now starting out and I've got to get my name out there. But you have to be careful of these predatory journals and they will, they will reach out to you just like you said through email and they'll say, come to our conference and give a lecture and it's in somewhere, I

luxurious like Hawaii and it only costs you a few thousand dollars to upload your paper. I will say that there are some reputable journals out there that there is a price for submission. The more we move to open and online access, the more there will be a price associated with submitting an article. But you want to make sure that it's a reputable journal and then have

how do you do that? I am always asking my mentor, you know, is this legit? And a lot of times if it is a legit group, the email will be very personal. It won't seem auto-generated. Again, there's been journals that have reached out to me and I've forwarded them to my mentor and I've said, is this a real thing? And they've said yes or no based on what their thoughts are. So having a friend that can help you review those things is definitely vital. But

You've just got to be careful. It's just like buying gift cards for people, right? Just make sure you know who you're sending your money to. Well, that just crushed my dreams. I'm sorry. It sounded lovely though.

All right. So now that we've talked about kind of the dark side of publishing, anything that you're looking forward to in the future, other than getting our shared work hopefully published in the future? So I've just recently taken over an associate editor role with Critical Care Explorations. And I'm really

looking forward to having more nurses serve as peer reviewers. I'm interested in nurses being elevated to be a peer and to review some of the evidence, the new evidence that's coming through and to really get thoughts and their feedback. Like you mentioned earlier, our nurses are at the bedside. They see things that other healthcare providers may not see. They are in the thick of it. And I'm looking forward to hopefully getting more folks involved with that. And I'm

I know your follow-up question is going to be like, well, how can they get involved? The Society for Health and Health Medicine does have a peer reviewer academy. They host usually a session during Congress. There won't be one this coming 2025 Congress, but hopefully the following year. And then there are a series of online peer review sort of tutorials to help you understand the process and really help you to figure out how to get started in that world. And if you're interested in peer review programs,

please email me because I would love to use your help moving forward. But that's just another way of getting involved and really starting to read the evidence and developing some of those skills that are necessary to run projects and do research.

So you recommended the Peer Reviewer Academy to me years ago, and it also helps you as a writer too. Right. So that was a great resource. Yeah. And there is a publication, just, you know, get back to your Google Scholar and type in Society Critical Care Medicine Peer Reviewer Academy, and there's a publication and it really helps to outline a lot of the topics we've talked about, how to get started, what to look for, how to spot predatory journals, things like that. So there's a really good reference out there if you're interested in that.

Awesome. Any closing comments? You know, I'm really thankful for being here today and sort of just raising awareness to the fact that our nursing colleagues can and should be producing high quality evidence. Your colleagues across the nation are really interested to hear what you're doing at the bedside and to hear what is working and what may not be working. So I just encourage everyone to get started. Just get started.

Find a problem that can be fixed and move forward. Get that evidence out there so that the nation can benefit from what you're doing at the bedside.

And with that, we will conclude another episode of the Society of Critical Care Medicine podcast. And don't forget, if you're listening on your favorite podcast app and you liked what you heard, consider rating and leaving a review. Heather, thank you so much for being here and giving all of your pro tips and continuing to mentor all of us. Well, thank you so much for having me. It's been a joy. And so for the Society of Critical Care Medicine podcast, I'm Diane McLaughlin. Talk to you guys next time.

Diane C. McLaughlin, DNP, AGA, CNP, BC, CCRN, FCCM, is a neurocritical care nurse practitioner at University of Florida Health Jacksonville. She is active within SCCM, serving on both the APP resource and ultrasound committees, and is a social media ambassador for SCCM.

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