apa referencing quick summary

Running head: APA DOCUMENTATION STYLE 1

APA Documentation Style and Writing Skills

Joan Smith

Red River College

Scholarly Writing and Documentation

Instructor: Kim Mitchell

APA DOCUMENTATION STYLE 2

Acknowledgements

I would like to acknowledge the efforts of both Karen Wall and Mary Stawychny of Red River

College whose earlier versions of this APA summary were of great assistance in producing the current

manual.

All material related to the American Psychological Association style format for referencing and

manuscript preparation, were drawn from:

American Psychological Association. (2010). Publication manual of the American psychological

association (6th ed.). Washington, DC: Author.

Please also refer to: http://apastyle.apa.org/learn/tutorials/basics-tutorial.aspx for a brief tutorial on APA

style 6th edition (APA, 2010a).

The following book was also of great assistance in providing helpful examples of the rules of

English grammar:

Zilm, G. (2009). The SMART way: An introduction to writing for nurses (3rd ed.). Toronto:

Mosby Elsevier.

Cosette Taylor who does the writing assistance at U of M, has put together a great reference section on

APA and writing on the U of M Nursing Website which can be found at:

http://www.umanitoba.ca/faculties/nursing/studentarea/110.htm

This site includes an example of the U of M required title page. Please follow this title page format for

all U of M Courses (e.g. Native Studies and fourth year JBN courses and other electives)

Kim McCormick RN MN Nursing Instructor Red River College C608-2055 Notre Dame Ave. Winnipeg, MB R3H 0J9 204-632-2920 [email protected]

© 2010 3rd edition


Contents

Structural Basics for APA Student Papers 4

APA Style Headings for Academic Papers 7

Information on Plagiarism and Penalties for Plagiarizing 9

Plagiarism definition 9 Self plagiarism 9 RRC Student Code of Rights and Responsibilities 10 Nursing Academic Honesty Policy 11 Synthesis of Data 13

Introduction and Conclusion 15

Common Grammatical Errors 16

Paraphrasing and Citing Source Materials 21

Basic citation styles 27 Secondary sources 28 Acknowledging multiple sources in one citation 28 Direct Quotation According to APA 29

Reference Lists: Where to find the information 33

Reference List Format 38

Reference List 47

Tables: Format in APA 52

Figures: Format in APA 53

Appendix A – Computer Instructions for MS Word 54

Appendix B -- Publication Locations and Abbreviations for States and Provinces 56

Sample Research Paper: Using Humor in Nursing Care Situations 59


Structural Basics for Student Papers According to APA Style

General format 1. TYPED and single sided. 2. Paper. Standard 8 ½ x 11inch (22 cm. x 28 cm.) white typing paper should be used. 3. Line-spacing. All lines should be double-spaced with no extra spaces between paragraphs. 4. Typeface. Times New Roman or Arial are the best to use, in 12 point font. Fonts lower than 12

point are usually difficult to read. Fonts higher than 12 point would increase the number of pages in a paper artificially. This would be taken into account when papers have page number requirements.

5. Margins. One inch (2.54 cm) margins on the top, bottom, right and left sides should be used. 6. Spacing. Punctuation rules for spacing.

6.1 One space should be left after all punctuation (commas, colons, semicolons) 6.2 One space follows all internal punctuation in reference lists including punctuation after

author initials in the reference list (Jones, K. M.) 6.3 An exception to the one-space rule is internal periods in abbreviations (a.m., p.m.). 6.4 Two spaces are left after punctuation at the end of sentences.

7. Justification. Only the left margin should be justified (aligned left). The right margin should

not be justified and remain ragged. 8. Indentation. Each paragraph should be indented 0.5 inches (1.27cm). The default set on the

TAB key on most computer programs is acceptable. 9. Page numbering. Arabic numerals should be used for numbering pages (1, 2, 3, 4, etc.)

9.1 The title page is number 1, and is numbered. 9.2 The pages are numbered sequentially from the title page. 9.3 The numbers should be placed in the upper right corner of the page.

10. Running head. Found flush left in the header portion of all pages of your paper; the title page

will include the running head with the words “Running head:” preceding it. The remainder of the pages will show only the ALL CAPS running head. The Running head should be in ALL CAPS, it should be reflective of the title of your paper and no more than 50 characters (see title page to this manual and the title page to the sample paper beginning on p. 59 as well as the top of the page on all pages of this booklet). See Appendix A (p. 54) for computer instructions.

11. Order of pages. Content of your paper should appear in the following order:

11.1 Title page 11.2 Abstract (if required – this is rarely used in undergraduate academic papers) 11.3 Table of Contents (Check with individual instructors as to their wishes. APA format does

not give specific instructions for table of contents.)


11.4 Text of paper 11.5 Reference List 11.6 Tables (See page 52) 11.7 Figures (See page 53) 11.8 Appendices (includes other documents referred to within the body of the paper. Labeled

A, B, C, D, etc. and each starts on a new page) – see pages 54-57 12. Citation. See pages 38-46. Throughout the nursing program you will draw information for your

paper and assignments from various sources. Consult with your instructor as to the number and type of sources that will be acceptable for your assignment. The references you use in your paper should be heavily weighted with the types found at the top of the list below. Some examples of the types of sources you might be accessing in your papers (in order of importance and degree of credibility) include:

12.1 Journal articles (peer reviewed) 12.2 Specific chapters from edited books (peer reviewed) 12.3 Reference books specific to your topic (peer reviewed) 12.4 Reputable organizational and government websites (often credible) 12.5 Generalized textbooks (peer reviewed) 12.6 Brochures (rarely considered peer reviewed but OK if they come from reputable

organizations) 12.7 Popular press such as newspaper or magazine articles including internet news services

(not peer reviewed) 12.8 Other Unmonitored Websites (not peer reviewed e.g. blogs, forums, personal websites,

websites with an agenda or something to sell) 12.9 Interviews and personal communications (not peer reviewed)

13. Use of numbers.

13.1 Numbers below ten are written out as words (one, two, three, four etc.) 13.2 Numbers above 10 are written as numerals (10, 11, 347, etc.) 13.3 Never start a sentence with a numeral. 13.4 There are exceptions to the use of words for numbers below ten including:

Numbers preceding units of measure (e.g., 3 mg) Numbers representing vague time spans. (e.g., Approximately ten months ago) Number ranges where one number is less than 10 (e.g., between 5 and 15 hours) Ratios: 16:1 and Decimals 5.65 Dates: January 2, 2007 Page numbers: p. 5

13.5 Use a zero before the decimal only if the decimal number can exceed 1. (e.g. 0.3 mg; r = .70 – correlation cannot exceed 1) 13. Tables and figures. See pages 52-53 for examples of how to present tables and figures. 14. Widows and orphans. Word processing programs are automatically set up to avoid creating

“widows and orphans.” A program will never leave one line of a paragraph at the bottom or the top of a page. It will always adjust the text so that if a new paragraph is started at the bottom of the page there needs to be room for minimum two lines or it will bump the whole paragraph to the next page. The only time the widows and orphans function fails is with headings. If you type a new heading at the bottom of the page it will remain at the bottom of the page even if the


paragraph under it starts on the next page. You will need to manually bump that heading to the next page with your return key. This act may leave your bottom margin to be visibly larger than one inch on some pages. Large bottom margins developing due to avoiding widows and orphans is acceptable.

15. Bullets and numbered lists. Bullets and numbered lists can be used in APA in select

circumstances and for limited portions of a scholarly paper. Check with your instructor to see if it is appropriate for a particular section of a particular assignment. It is still required that referencing is clear for the bulleted or numbered list. This may mean placing a citation at each bulleted point.

16. Italicizing. It is appropriate to italicize words you wish to emphasize in your writing. In addition

to the italicizing that you will do in your reference list, other places where italicizing is used is when titles of books, movies, websites, or journals (but not journal articles) are written into the body of your paper.

17. Page Break. Hitting the control key and the enter key at the same time will create an automatic page break which is a more efficient option than hitting return to get to the next page.

The majority of the set up features for APA can be preset in your computer program. Instructions on how to set Microsoft Word into APA format can be found in Appendix A (p. 54) of this manual.


APA Style Headings for Academic Papers

Headings will be required in your scholarly papers. APA describes five different levels of

headings but you will likely only use two or three at the undergraduate level. The first three levels of

headings are placed in bold type and are used consecutively depending on the hierarchy of the heading.

The idea of hierarchy will become clearer with the examples shown below.

The first heading in your paper will be the title of your paper (just as the title of this section of

the manual is APA Style Headings for Academic Papers) and will be set as a first level heading. It is

written in upper and lower case letters with important words capitalized (all words four letters and

greater) and less important words left in lower case. All major headings within your paper will be at first

level.

The first paragraph under the title of your paper is the introductory paragraph and it does not

require a heading of its own. It’s placement under the title automatically signals to the reader that it is

the introduction.

Headings for Subtopics at Second Level

If there are subtopics within your main topics, your next level of heading will be a second level

heading which is typed flush left, bolded, and uses upper and lowercase letters (again important words

starting with a capital letter and less important words remain lower case, as shown).

Further subtopics at third level. If you need to break a subtopic down into more subtopics then

you would move to a third level heading. Third level headings are indented, bolded, first letter of first

word capitalized with all other words lower case, and it ends with a period (or question mark as

appropriate). The paragraph you are typing under the fourth level heading starts immediately after the

heading as is shown at the start of this paragraph.

Confused?

If you were to write a paper about heart disease, a main heading in your paper may be “Risk

Factors for Coronary Artery Disease.” Under that title you may have two main subheadings: modifiable

APA DOCUMENTATION STYLE 8 risk factors and non modifiable risk factors and under those sub headings you may have discussion of

several of the risk factors that fit each category.

Conclusion

The last paragraph of your paper will be a conclusion. A conclusion does have a heading of its

own and it is at the first level.

Format for Levels of Headings Used in APA at the Undergraduate Student Level

Level of

Heading

Format Example

1 Centred, Boldface, Uppercase and Lowercase Heading Risk Factors for Coronary

Artery Disease

2 Flush Left, Boldface, Uppercase and Lowercase

Heading

Modifiable Risk Factors

3 Indented, boldface, lowercase paragraph

heading ending with a period.

Smoking.

Sedentary lifestyle.


Plagiarism Definition

(From: Park, 2003, p. 475)

1. Stealing material from another source and passing it off as [your] own:

a. Buying a paper from a research service, essay bank or term paper mill (either pre-

written or specially written)

b. Copying a whole paper from a source text without proper acknowledgement

c. Submitting another student’s work, with or without that student’s knowledge (e.g. by

copying a computer disk).

2. Submitting a paper written by someone else (e.g. a peer or a relative) and passing it off as [your]

own

3. Copying sections of material from one or more source texts, supplying proper documentation

(including the full reference) but leaving out quotation marks, thus giving the impression that the

material has been paraphrased rather than directly quoted.

4. Paraphrasing material from one or more source texts without supplying appropriate

documentation.

Self-Plagiarism

1. Do not hand in assignments that have been submitted and graded in other courses. You may

not get credit for the same assignment in two different courses. Look closely at assignment

guidelines. Chances are they are not the same assignment after all. Each course you take is

expected to contribute to new learning, not repeat old learning in a new setting.

2. Typically it is also unacceptable to copy small portions of previously graded assignments as a

component of a new assignment. There may be small exceptions to this rule in clinical

assignments where two different patients have the same meds or the same medical conditions

or complications.


Red River College Student Code of Rights and Responsibilities (RRC, 2003)

Academic Integrity

http://www.rrc.mb.ca/files/File/policies/new/S4%20Academic%20Integrity.pdf

The information related to academic integrity (policy C7), the definition of all the forms of

academic dishonesty, a description of and the penalties for minor and major offences of academic

dishonesty are found in your Student Code of Rights and Responsibilities manual. Academic Dishonesty

forms will be completed for all forms of academic misconduct committed by a student and placed on the

affected student’s file.

Other Sources

For additional reading on plagiarism also consult:

University of Ontairo Institute of Technology. (2009). Nool. Retreived April 26, 2010, from

http://ow.ly/1y00l

Information related to correctly documenting and acknowledging sources using APA format is

found on pages 27, 38-46 of this booklet.


Nursing Academic Honesty – Sub Committee Recommendations

1. All academic papers in the Nursing faculty require that the student hand in one hard copy of the paper along with an electronic copy in the form of a CD of the paper.

2. When written assignments/papers require APA referencing, 0-3 inappropriate or improper

citations or errors of APA formatting will result in the following:

The errors will be noted/pointed out in writing (i.e. reference? Citation?) on the paper to be returned

The marks for improper APA referencing will be deducted as per the paper’s marking guide.

No further penalty or follow-up required.

Minor Offence When written assignments/papers require APA referencing, four or more errors (i.e.; missing or inappropriate references) will constitute a Minor offence. Criteria

The student has demonstrated some appropriate degree of citation for both paraphrasing and quotation.

There is, on average, not more than one per page times the page limit, missing or inappropriate reference.

Penalty

The student will lose the marks for the APA category on the marking guide. The instructor will complete the academic dishonesty form and check off the minor

category. The instructor will give the student his/her electronic copy so the student can fix the

errors and omissions and properly format according to the APA guidelines. The student will be advised to see the APA/writing instructor to get assistance with the

necessary corrections. The student will be given a reasonable amount of time to re-submit the corrected paper

(i.e. approximately one week) in order to be able to keep the grade they received for the paper.

If the student is late with the corrected assignment, after the mutually agreed upon due date, then late assignment penalties apply (10% per day late as per student handbook).

Failure to hand in the corrected version will result in the student being assigned a grade of 0 (zero) for the assignment.

The marks that were lost for APA can not be reclaimed once the paper is corrected. However, the student will receive the mark as per the marking guide, with no further deductions in marks.


Major Offence When written assignments/papers requiring APA referencing have, on average, more than one missed or incorrect citation per page limit of assignment.

Criteria

The student has demonstrated significant misrepresentation of written work i.e. not citing

quotations or paraphrasing material’s source. The student’s work shows evidence of obvious ‘cut and paste’ method, using someone else’s

paper in large or small part, or submitting someone else’s paper in its entirety.

Penalty The instructor will complete an academic dishonesty form and check off the category of

major. The student will receive a grade of F in the paper and the mark will be entered as zero for that

assignment. There will also be a warning issued for that student at this time, that a second infraction of

major academic dishonesty will result in the student being suspended for six months, and receive a F grade in the course.

Please note: Consideration will be given on the first academic paper submitted related to knowledge deficit regarding APA.

Note

All communications to students regarding academic honesty issues in assignments will be in writing via the Red River College academic honesty form.


Synthesis of Data

At some point in your nursing program you will hear your instructors speak about the term

synthesis of data. The act of synthesizing data is combining multiple parts to make a whole. In terms of

writing a paper, it means to take multiple sources and amalgamate all the information and ideas into one

fluent paper. Successful synthesis of data requires organizational skills, the ability to categorize

information, good use of headings, and strong writing skills. Your assignments generally require that

you research more than one source and there should be a balance in the number of times you cite each of

those sources. You have not synthesized your data well if you have five references in your reference list

and write the bulk of your paper based on information in only one source and cite the other four sources

only one time each just to meet referencing requirements.

Synthesizing data is also what makes a paper your own. I often hear from students, “I don’t feel

like any of the ideas in this paper are my own because I have a reference for everything I wrote.” This

may be true, but various factors play into making you the author of the paper and make you the owner of

how you presented your ideas and arguments for your topic:

Does your paper use multiple sources in a balanced way rather than relying heavily on one

source only?

How well did you discriminate within your paraphrasing? – meaning how well did you pick and

choose the content you paraphrased or did you include a lot of “nice to know” information that

was not really necessary to the assignment topic.

You do have your own ideas about a topic but you use your sources to provide support for your

ideas. Depending on your personal view on a topic, certain portions of articles or chapters that

you read while researching will stand out while other parts fade into the background. Some of

what you read while researching will make you think, “That is what I need to say!” while other


parts do not strike you as powerfully. What stands out for you and how you choose your

supporting/corroborating material reflects your personal view point.

How you organize your paper using headings and subheadings reflects how you organize your

thinking. Your organizational skills make your paper your own.

Did you choose to paraphrase everywhere you could or did you overly rely on direct quotations?

How well you paraphrase demonstrates how well you understand the material you are presenting.

Do you go deeper than what was discussed in class? Your classroom lectures introduce you to a

topic but there is so much more depth to that topic that any instructor has time to present. The

research you do on a topic should demonstrate that you went looking to find out more than just

the bare minimum to get an assignment done.


The Introduction and the Conclusion

The general format of a paper is often discussed as being: tell them what you’re going to tell

them, tell them, tell them what you told them. This adage reflects, in a simplistic fashion, the location of

the content for all papers: introduction, body, conclusion. All scholarly papers require an introduction

and a conclusion.

Your introduction should clearly state what the focus of your paper will be about. You do not

need to recite or list all the headings of your paper in the introduction but you do need to create a point

of interest for your instructor so that s/he can follow your line of thinking and your plan for analyzing

your topic is clear. An introduction should grab the readers’ attention without sounding like you are

writing a magazine or newspaper article.

You do not need to use the word introduction as a heading because the fact that it is an

introduction is self-evident by its position in your paper. If you have prepared, planned and researched

well, the introduction may be the first thing you write for your paper. It doesn’t have to be perfect in the

first draft. You can always go back and revise it if you change your focus while writing the body of the

paper. Some students find it easier to write the body of their paper first and then come back and write

their introduction last.

Conclusion

When you have addressed all the content of your assignment and wrapped up all your main

points, a conclusion needs to be written. A conclusion should not present new ideas or materials, it

should only summarize what was stated in your paper. Again, re-listing the headings of your paper does

not make a strong conclusion. A conclusion should sum up in one or two sentences the main ideas of

your paper. The reader should finish your paper feeling as if the issues have been resolved and that all

questions have been answered. Unlike an introduction, a conclusion does require a separate heading.


Common Grammatical Errors

1. The importance of revisions. Write your paper to attend to content first. It is more important in

the first draft of a paper to get your ideas down first and then fix the grammar and clarity issues.

The revision stage of paper writing is the most important and it may be the difference between a

failing or a C paper and getting a more desirable grade. Good revisions generally require

multiple read-throughs of your paper. Reading out loud can help locate grammar errors and

unclear sentences such as run-on and fragmented sentences.

2. Run-on and fragment sentences. These two sentence structure errors, while on the surface

appear opposite of each other are close cousins. Both are fixed using some of the same

techniques:

a. Shorter sentences are better than longer sentences.

b. Don’t ignore those green underlines that MS Word produces as you write. These

underlined areas will be the first to alert you to improper sentence structure.

c. Read your paper out loud to yourself or have someone read it out loud to you.

d. Make sure the sentences you read out loud contain completed thoughts (are not

fragments).

e. A sentence should not run on and on with use of multiple conjunctions such as and, or,

but, because, although, however etc. Make sure each sentence only contains one idea or

thought.

3. Paragraph fault. Paragraph fault is the error of not dividing your paper up into paragraphs.

Your paper may be divided up into headings but it is typically not enough to have one paragraph

per heading. Each subtopic under that heading requires a new paragraph. For example: If you are

writing a paper about obesity and you have a heading title: “Gender and Obesity,” you should

separate your discussion on men and women and have one paragraph for men and one for

women.


4. Comma fault. Reading your paper out loud will help decide where the natural pauses are within

sentences. Wherever you naturally pause while reading is where a comma should be inserted.

5. Verb tense. Scholarly papers can be in past or present tense but stay consistent. Verb tense

errors involve switching back and forth within verb tenses (e.g. past “showed,” and present

“show,” or future “will show,” and various other verb tense forms such as present perfect tense

“have shown”). These switches may occur in mid-sentence or mid-paragraph. Verb tense

problems are often the most difficult to detect. Something will not sound right when you read

your paper back to yourself. Look for clues such as:

a. The use of is and was in the same sentence/paragraph. The most common verb tense

errors arise with the verb “to be” or the verb “to have” (e.g. has vs. had).

b. Look for multiple mixtures of tenses: e.g. want, wanted, had wanted, was wanting. The

use of “ed” and “ing” at the end of verbs are also clues to verb tense and they should be

consistent throughout the sentence/paragraph.

c. Assign the appropriate verb following a pleural or singular noun. E.g. Nurses are

responsible for many complex tasks (plural). The nurse is responsible for many complex

tasks (singular).

6. Passive voice. The active voice should always be used preferentially over the passive voice at all

times. One clue to the use of passive voice is the word “by” in the middle of a sentence

describing an action. E.g. The medication was administered by the student’s buddy nurse

(passive voice). The student’s buddy nurse administered the medication (active voice). Another

more complex form of the passive voice is often used to avoid using first person. E.g. The survey

was conducted in a controlled setting (passive); The writer conducted the survey in a controlled

setting (active). Write in the active voice whenever possible. Active voice is also less wordy

which is also preferable in scholarly writing.


7. Use of the word “this” or “these” at the start of a sentence (pronoun use). The word “this”

(singular) or the word “these” (plural) is not a subject in a sentence and always requires a

clarifier. The reader should not have to search previous text to determine the meaning of your

sentence. Compare the following:

a. Incorrect: Women use household duties as a way to continue feeling valued within their

illness situation. This is dissimilar to the recovery patterns of men who are more likely to

relax and pace their recovery.

b. Correct: Women use household duties as a way to continue feeling valued within their

illness situation. This trend is dissimilar to the recovery patterns of men who are more

likely to relax and pace their recovery.

8. First person-third person. Can I refer to myself, the writer, as “I” in the middle of my paper?

Answer: Depends on the nature of the assignment. Scholarly papers should be written in the third

person. However you will be writing several assignments in this program which ask you to

discuss a personal experience such as a behaviour change or an ethical problem and when

describing those situations you will need to use first person interspersed with discussion of

theory using third person. Check with your instructor or syllabus about the appropriateness of

using first person in your assignment.

9. Avoid wordiness. This is not a short story, a poem, or a newspaper article so there is no need to

use flowery words and phrases or over-zealous vocabulary. You are not a journalist or a fiction

writer (even if secretly you may want to be). But you need to recognize the difference in the

styles of all these genres. Scholarly writing is flat and, unfortunately, without much personality.

Some tips include:

a. Keep the language simple and use the vocabulary you have. If you try to talk above who

you are as a person you will come off sounding phony and awkward.


b. Excessive wordiness can be defined as over use of adjectives (descriptors for nouns) and

adverbs (descriptors for verbs ending in “ly”). Adverbs, (generally), can be deleted.

Adverbs can be deleted and nothing is lost from the meaning of the sentence. (Did you

catch the example in the above paragraph?)

c. Other “wordy” words/phrases include: very, rather, some, lots, few, that, just, quite, in

order to, the fact that, it goes without saying that (if it goes without saying then you don’t

need to say it). If the sentence needs a word to be grammatically correct then leave it,

otherwise delete, delete, delete.

d. Avoid clichés: cool as a cucumber, good as gold etc. (You can think of many others).

e. Keep introduction of sources simple: Jones (2005) says, states, describes, explains, is

sufficient.

f. Overuse of the verb “to be” also creates wordiness. (I am, you are, s/he is, it is, they are; I

was, you were, s/he was, they were etc.) Try and use the most active verb possible.

Instead of “Mr. B was walking”, write, “Mr. B. walked.” Or, instead of: “the patient was

in bed”, write “the patient lay in bed”. Lay is a more active verb that provides a better

visual of the patient’s location.

10. Other common problems.

a. Jargon – overuse of technical words when not necessary.

b. Euphemism – using softer terminology e.g. passed away for died.

c. Colloquialisms – slang

d. Rhetorical questions – questions asked for the sake of pondering without the expectation

of an answer. Do not do this in scholarly writing. It disrupts flow.

e. Redundancy and repetitiveness– absolutely essential to avoid; has been previously found,

completely unanimous. Do not write two sentences in a row that mean the same thing. Do

not repeat information twice in different sections of a paper.


f. Contractions – don’t use them (incorrect); do not use them (correct)

g. Who’s vs. whose – who’s, is a contraction for “who is” or “who has.” If you can’t

substitute “who is” or “who has” then use whose. And then refer back to letter “f.”

h. It’s vs. its – it’s, is a contraction for it is. If you can’t substitute “it is” into your sentence

then use its. And then refer back to letter “f” again.

i. Affect vs. Effect – affect is a verb, effect is a noun.

j. Acronyms – need to all be written out in full the first time used in a paper. E.g. Canadian

Nurses Association (CNA) – then abbreviate as CNA thereafter. There are some

exceptions to this rule such as when the acronym is used more commonly in language

than its full meaning (e.g. AIDS, HIV, IV, IQ, SCUBA).

11. Voice or Tone: Make sure you are writing a scholarly paper in a scholarly tone. The most

common voice or tone error observed in scholarly writing is trying to be too entertaining and

write as if you are writing a newspaper or magazine article. Remember your audience is your

instructor, not the general public. You are not trying to sell anything. You are just trying to get a

good grade.

12. Reading. One rule of good writing for which there is never an exception: If you read a lot you

will be able to write well (or at least, adequately), because you will be able to recognize clear

effective writing and, perhaps, imitate it. If you are not a reader you will have problems writing.


Paraphrasing and Citing Source Material

Paraphrasing is a very complex process. Success takes practice, patience, and persistence. Good

paraphrasing also comes from being widely read on your topic and having prepared yourself to write by

doing extensive research. Understanding what you have read is an important component of good

paraphrasing. A passage is considered paraphrased if it accurately reflects the meaning of the work from

which it was taken and it is presented using a different sentence structure than the original statement.

You can paraphrase from both small (one sentence) and large passages (entire books). You practice

paraphrasing material you have read or heard informally on a daily basis. For example, if someone asks

you, “What was the movie you just went to see about?” or “What happened in class today?” or “What

did Jill tell you about Jack?” your response will be a paraphrase of what you observed or heard or read.

Paraphrasing for scholarly writing is just a more formalized version of these daily activities. If you are

asked to describe the plot of a novel in one sentence or summarize a research study in one sentence, you

are, in effect, creating a paraphrase of that entire work.

All paraphrased material reworded from another author’s ideas must be acknowledged by a

reference citation. You also must support (or corroborate) every idea you present in a paper with an

expert’s published work. If you read it somewhere, heard it in class, know it from personal experience,

at an undergraduate level, all information requires a primary source citation. Here are some

paraphrasing/citation misconceptions and faux pas that you need to avoid:

Myth #1 – If it is in my own words I do not need to put a reference

Re-writing material from a source you have read and putting it in your own words is the definition of paraphrasing. All paraphrases need to have a reference citation. The intention of reference citation for a paraphrased idea is that you are giving credit for the ideas – not the words.

Myth #2 – It is OK to directly quote a source and not put page numbers or quotation marks. As long as I cite the source with author and year of publication that is sufficient.

Do not re-write a source word for word, insert that source’s writing into your paper and not acknowledge that you are quoting rather than paraphrasing the source. If you use a source’s ideas word for word, then there needs to be “quotation marks” around those sentences or phrases. Not putting page numbers and quotation marks implies that you have paraphrased that source and put their ideas into your

APA DOCUMENTATION STYLE 22 own words. If you use their exact words and do not give a page number or use quotation marks you are being deceptive and are plagiarizing (whether that be intentional deception or not) because you are claiming you wrote those words. The passage also has to be sufficiently different from the original source to be considered paraphrased. Changing a word here or there is not paraphrasing. Myth #3 – If I know something from memory that I learnt in a class or during clinical practice then it is automatically common knowledge and I don’t need a reference for it.

If you know a piece of information about a particular component of an assignment because you have been exposed to it in your life, read it in the newspaper, or learnt it in another class, you can’t just put that information in your paper without a reference citation. You will need to go find a reference or corroborating source that expresses the same idea. Taking this action demonstrates that you have well researched your topic.

Myth #4 – If I use a thesaurus and change a few words in the sentence then I have paraphrased appropriately.

No. Changing a word here and there but basically using the same sentence structure as was in the original source is still plagiarizing that source and is poor technique for paraphrasing. Myth #5 – Paraphrasing is too hard. I’m too scared I am going to be cited for plagiarism. I am going to directly quote everything that I take from a source.

It is true you will not be cited for plagiarism if you use direct quotes for every citation and cite those quotes correctly. However, you have not demonstrated that you understand how to synthesize data (i.e. pulling together multiple sources and creating a coherent organized discussion or argument on a topic – see page 20 of this manual for more information.)

Citation of Paraphrased Material

The act of appropriately citing paraphrased material is highly situation dependent. The process of

correctly citing your paraphrased materials will be dependent on your paper topic, how many sources

you have used, how you have organized your paper. The easiest way to discuss some of the

paraphrasing/citation situations that you might encounter while writing a paper in the nursing program is

to illustrate by example. The following examples are by no means an inclusive list of all possible

situations that might arise in your writing. Please also note that the original passages that these

paraphrasing examples have been drawn from have been included in a footnote at the end of this section

on page 26.

APA DOCUMENTATION STYLE 23 Your Personal Experience

When discussing your personal experience in a paper, no reference citation is required. (If you

are discussing someone else’s personal experience or story then you would cite using a personal

communication which is discussed on page 46). Placing a reference citation in your paper implies that

your reader can retrieve a source for the material you have cited from a library or from the internet.

Material that describes something that happened to you personally or describes an action that you took

does not need a reference but using material like this is specific to assignment guidelines (e.g. using a

situation you experienced clinically to form an example of ethical decision making). You should not use

your own experience to support scientific facts or scholarly ideas.

When an Entire Paragraph Comes From the Same Source

If you write an entire paragraph and the information comes from the same source, you should

reference the author at the start of the first sentence and again at the end of the paragraph. Instructors

will then assume that everything in between is from the same source. For Example:

According to Hinds et al. (2007) many hospital related events disrupt children’s sleep when undergoing treatment for cancer. Multiple entries to hospital rooms, the timing of interventions, the type of chemotherapy medications received, and how many nights the child has been in hospital all affect how well these children sleep. The researchers found that children who had a parent sleep at their bedside slept better than those who did not because the parents’ continual presence meant less entries and exits to the hospital room. Children slept best on their first night in hospital as compared to their second night because on the first night they were overtired from their outpatient activities as well as there were less cancer treatment therapies taking place the first 24 hours after admission (Hinds et al., 2007).

Synthesizing Multiple Sources Within One Paragraph

If you write a paragraph where every sentence is paraphrased from a different source or if you

write a paragraph with three sentences and the first sentence is paraphrased from one source, the second

from a different source, and the third is from the same source as the first sentence, then you need to put a

reference after every sentence in this paragraph. For example:

Views on toilet training vary among experts from waiting until the child demonstrates they are ready, to completing the process as early and as fast as possible (Feldman, 2005). No matter what method is used, parents should approach toilet training in a non-controlling manner


that avoids creating feelings of shame in the toddler (Berk, 2008). Methods that provide rewards for staying dry are typically more successful than methods that involve punishments (Feldman, 2005).

Does Every Sentence in My Paper Require a Reference?

Not all sentences will require a reference citation. If two sentences in a row are expressing a

single idea and if something in the second sentence directly connects it to the previous sentence then the

reference can be located after the second sentence. For Example:

New graduates require experience to gain comfort with caring for dying patients. Education programs assisting new nurses to understand their own anxieties with death and dying can act as a bridge to helping new graduates gain this experience (Dunn, Otten, & Stephens, 2005).

A Common Error in Paraphrased Sentence References

It is not necessary to reference more than once in a paraphrased sentence. The following example

demonstrates overkill in referencing. The second reference could be eliminated or the opening

“according to” can be left out. You need one or the other not both:

According to Dunn et al. (2005) new graduates require experience to gain comfort with caring for dying patients (Dunn et al., 2005).

Citing from Limited Passages or Phrases with Words That Cannot be Paraphrased

Most of the information that you cite in some undergraduate papers will be facts and data rather

than ideas/concepts. There is a lot of terminology within facts and nursing information that you cannot

paraphrase. For example if you are writing a paper and discussing esophagectomy, you cannot change

the word esophogectomy when you paraphrase the passage from the source. You also cannot change

statistical numbers or the names of the diseases those statistics refer to. For example: “In 2000, 171

heart transplantations and 4 heart and lung transplantations were carried out in Canada” (Heart and

Stroke Foundation of Canada [HSFC], 2003, p. 44). If you want to use the information contained in this

sentence in your paper, you can rearrange the sentence structure a little bit but you can’t change the

wording of the underlined sections. However, you can change the sentence structure to some degree and

the way you lead into presenting this information, and the context in which it is used. In Canada, 171

APA DOCUMENTATION STYLE 25 heart transplantations and 4 heart and lung transplantations were done in 2000 (HSFC, 2003). How this

information is contained within your paper and within the paragraph that you write would make it

acceptable to cite without quotation marks despite how similar it is to the original. If you are in doubt

about what freedoms you have in using the exact words in a passage then that is a good time to discuss it

with me or with your instructor. In some cases you may be advised to directly quote.

You will rarely need to paraphrase from such a short, limited phrase such as the example given

above. Usually you will be paraphrasing from large passages and trying to boil those large passages

down to their essence. To paraphrase well you will have to learn to discriminate between what is

important information for your topic and what is not as important to use in supporting your argument.

Only practice and extensive reading will help you be successful at this.

Other Terminology Which Cannot be Altered in a Paraphrase

Other terminology that you cannot change will be names of stages of theories such as Erickson’s

stages of growth and development (initiative versus guilt, autonomy versus shame and doubt etc.) or the

names of the core ethical principles (beneficence, non maleficence, autonomy, veracity etc.) or nursing

values discussed in the Canadian Nurses’ Association’s (2008) Code of Ethics for Registered Nurses

(providing safe, compassionate, competent and ethical care, promoting health and well-being, promoting

and respecting informed decision making, preserving dignity, maintaining privacy and confidentiality,

promoting justice, being accountable). You can also use this terminology within your paper without

putting quotations around the original words. This rule applies to ANY framework you may use to

organize your paper.

Not Sure if You Should Cite?

If you are in doubt about whether a sentence or passage needs a reference citation, then you are

best to cite it. It is better to over-cite than to not reference at all.


Check my Paraphrasing

The following are select original sources for the paraphrasing done for the above examples:

Hinds et al. (2005, p. 399) The patients in the present study experienced as many as 40 nocturnal awakenings during each night of their

hospitalization. The awakenings may be attributed partially to the number of times that family members or staff members entered and exited patients’ rooms during the nocturnal sleep period and visibly disturbed patients’ sleep. Of interest was the finding that patients experienced fewer awakenings when parents or guardians were sleeping in the children’s hospital rooms. The result could be secondary to the reduced number of times that parents entered and exited the rooms, but it also could be secondary to what staff members described as their concerted efforts not to awaken sleeping parents in patients’ rooms or to children’s comfort in having their parents in the hospital rooms contributing to a higher-quality sleep that is less vulnerable to certain environmental sounds or conditions. Fewer awakenings also were noted on the first night of hospitalization as compared to the second and third nights. Potential explanations include (a) the child or adolescent typically was admitted in the late afternoon or evening after a day of usual outpatient activity, whereas subsequent days of hospitalization may have altered the rest and activity ratio for each patient, (b) the prehydration routines of the first night of an admission that precedes a chemotherapy regimen administered during an inpatient stay may require fewer room entries and exits by staff members compared to the subsequent nights of chemotherapy administration and monitoring, or (c) the chemotherapy may itself affect the children’s normal sleep cycles and contributed to more night awakenings. Feldman (2005, p. 226) Few child-care issues raise so much concern among parents as toilet training. And on few issues are there so many opposing opinions from experts and laypersons. Often the various viewpoints are played out in the media and even take on political overtones. For instance, the well-known pediatrician T. Berry Brazelton suggests a flexible approach to toilet training advocating that it be put off until the child shows signs of readiness (Brazelton, 1997; Brazelton et al., 1999). On the other hand, psychologist John Rosemond, known primarily for his media advocacy of a conservative, traditional stance to childrearing, argues for a more rigid approach, saying that toilet training should be done early and quickly.

. . . Complete toilet training eventually occurs in almost all children as they mature and attain greater control over their muscles. However, delayed toilet training can be a cause for concern if a child is upset about it or if it makes the child a target of ridicule from siblings or peers. In such cases, several types of treatments have proven effective. In particular, treatments in which children are rewarded for staying dry or are awakened by a battery device that senses when they have wet the bed are often effective (Wagner, Smith, & Norris, 1988; American Psychiatric Association, 1994). Berk (2008, p. 141) According to Erickson, the parent who is over- or under-controlling in toileting is likely to be so in other aspects of the toddler’s life as well. The outcome is a child who feels forced and shamed or who doubts his ability to control his impulses and act competently on his own. Dunn et al. (2005, p. 103) Results from this study suggest that the more experience that nurses have with dying patients, the more positive the care experience becomes. . . . Developing continuing education programs that teach effective coping strategies that aim to prevent death anxiety may benefit nurses who have had little experience with dying patients and their families.


Basic Citation Styles (Adapted from: APA, 2010b, p. 177)

You will see a lot of examples of how to cite works paraphrased from other authors in this booklet.

Sometimes you will use authors’ name(s) in the body of your paper to introduce an idea. E.g., According

to Smith and Jones (2010)…. and other times you will write a paraphrased sentence that needs a citation

and choose only to cite the authors’ names at the end of the sentence in parentheses (Smith & Jones,

2010). Use the following table to assist you in identifying the correct format for in body of text citations

in your papers and assignments. Please also see the table on pp. 38-46 for additional examples (e.g.

works with no authors, works with no date).

Type of citation First Citation in

text

Subsequent

citations in

text

Parenthetical

format, first

citation in text

Parenthetical

format, subsequent

citations in text

One work by one author Manias (2010) Manias (2010) (Manias, 2010) (Manias, 2010)

One work by two authors

Buckley and Matteucci (2009)

Buckley and Matteucci (2009)

(Buckley & Matteucci, 2009)

(Buckley & Matteucci, 2009)

One work by three authors

Sticher, Smith, and Davidson (2010)

Sticher et al. (2010)

(Sticher, Smith, & Davidson, 2010)

(Sticher et al., 2010)

One work by four authors

Reid-Searl, Moxham, Walker, and Happell (2010)

Reid-Searl et al. (2010)

(Reid-Searl, Moxham, Walker, & Happell, 2010)

(Reid-Searl et al., 2010)

One work by five authors

Field, Diego, Pelaez, Deeds, and Delgado (2009)

Field et al. (2009)

(Field, Diego, Pelaez, Deeds, & Delgado, 2009)

(Field et al., 2009)

One work by six or more authors

Irwin et al. (2008) Irwin et al. (2008)

(Irwin et al., 2008) (Irwin et al., 2008)

Organizations (readily identified through abbreviation) as authors

Canadian Nurses Association (CNA, 2010)

CNA (2010) (Canadian Nurses Association [CNA], 2010)

(CNA, 2010)

Organizations (no abbreviation) as authors

Heath Canada (2010)

Health Canada (2010)

(Health Canada, 2010)

(Health Canada, 2010)


Secondary Sources

Secondary sourcing is only used for information such as another author’s research results found

cited by a second party author. Whenever possible you should use primary sources. Check with your

instructor about secondary sourcing. You may not be required to use this method depending on who the

primary source is. For example: ALL information in textbooks such as med surg or psychology is from a

secondary source. The process of citing a secondary source is as follows:

O’Connor and colleagues (as cited in Lockyer & Bury, 2002) identified that women had a

mortality rate of 7.1% for coronary artery surgery while men’s mortality rates were significantly

lower at 3.3%.

or

Mortality rates for coronary artery surgery are 7.1% (women) and 3.3% (men) (O’Connor et al.

cited in Lockyer & Bury, 2002).

Your reference list will contain the reference for Lockyer and Bury (2002) as that is the source you

consulted and read. O’Connor will not be in your reference list.

Acknowledging Multiple Sources in One Citation

In some circumstances you may have a situation where you have two sources that have the same

research findings or two sources that present the same idea. You should acknowledge both sources in

your citation within your body of your text. Sources are listed in one bracket alphabetically by first

author’s last name and separated by a semi-colon. For example:

With good intentions, humor can be uplifting, dampen an emotionally distressful situation, create

a positive environment, enhance human connection, provide comfort in times of distress, release

tension, and lead to bonding between patient and nurse (Dean & Major, 2008; McCreaddie &

Wiggins, 2007; Ulloth, 2003).


Direct Quote Citation

It is always preferred that you choose to paraphrase rather than continuously use direct quotes

from sources (see Myth #5 above on p. 22). On some occasions you will need to quote passages from

your sources. Quoting should be used infrequently (at the absolute most, once per page in an assignment

– preferably less than that). All direct quotes must be reflected exactly as the original author presented

the material including any punctuation, any italicizing, even spelling errors if they are present.

There are only three situations in which direct quoting is essential:

1. Definitions – If you are defining a term it should always be directly quoted.

2. Passages in which it is critical that the original meaning is maintained, such as when reflecting a

rule of conduct such as the direct quote on page 9 of this manual describing and defining what

constitutes plagiarism.

3. Honoring eloquence – something poetically phrased or a powerfully stated opinion. There are no

hard fast rules for deciding what is too eloquent to paraphrase. Making that decision is

subjective. The best way I can describe it is to say that it is a sentence or a phrase that knocks

you off your seat when you read it. It gives you that “Ah Ha!” feeling. It makes you wish you

had written it yourself.

The Process of Direct Quoting

Page Numbers and Quotation Marks

A critical element in telling your reader that you are using a word for word citation from a source

is that the borrowed passage must be enclosed in “quotation marks” (when less than 40 words are being

used directly). When citing the reference, include a page number for a paginated source or a paragraph

number for an electronic source such as a website.

1. If a source has clear page numbers such as a peer reviewed journal, a book, or a PDF form of a

website document, reflect the page location of the source with the exact page it appears on in the

bracket with the author’s name(s) and the year of publication.


“In this study, fatigue was the most prevalent symptom reported by a cohort of older patients

with cancer at the time of and up to six months following consultation for treatment at a cancer

center” (Luctkar-Flude, Groll, Woodend, & Tranmer, 2009, p. 198).

If the direct quote falls over two pages of the original source acknowledge both pages:

“Physical activity scores gradually increased over the six-month period. Because many subjects

had surgery prior to their cancer center consultations, their baseline scores may have been low”

(Luctar-Flude et al., 2009, pp. 198-199).

2. If the source is a website and no page numbers are present and the paragraphs in the website are

numbered then reflect the location of the direct quote using the paragraph number in place of the

page number (para. 23), although it appears sources that use this format are rare.

3. If the source is a website and the paragraphs are not numbered but the document is broken up by

headings, then include the heading name in the citation and count paragraphs under the heading

to direct your reader to the exact location of the quote.

“Source evaluation – the determination of information quality – is something of an art. That is,

there is no single perfect indicator of reliability, truthfulness, or value. Instead, you must make an

inference from a collection of clues or indicators, based on the use you plan to make of your

source” (Harris, 2007, Source evaluation is an art, para. 1.).

APA DOCUMENTATION STYLE 31 Incorporating a Short Quote (Less than 40 Words) into the Body of Your Text

Passages less than 40 words are incorporated directly into the paragraph you are writing.

Quotation marks are used to identify the passage as a direct quote.

Incorporating a Long Quote (40 Words or More) into the Body of Your Text

Passages 40 words or more are done in a block quote, separated out from the main text and

quotation marks are omitted. The block quote is indented 0.5 inches from the left margin, and remains

double spaced like the rest of your paper. The need to block quote at this level of the program is rare. It

may only be required to reflect a passage where it is critical that the original meaning is maintained such

as when reflecting a rule of conduct. In the majority of cases a passage that is greater than 40 words can

be paraphrased. For example, if I wanted to provide evidence to my readers that APA format and style

takes the act of acknowledging another author or individual’s work seriously, I may wish to show you

the exact passage in the APA manual (APA, 2010b) that demonstrates this:

Researchers do not claim the words and ideas of another as their own; they give credit where

credit is due. . . .Quotation marks should be used to indicate the exact words of another. Each

time you paraphrase another author (i.e., summarize a passage or rearrange the order of a

sentence and change some of the words), you will need to credit the source in the text . . . . The

key element of this principle is that authors do not present the work of another as if it were their

own work. This can extend to ideas as well as written words. If authors model a study after one

done by someone else, the originating author should be given credit. If the rationale for a study

was suggested in the Discussion section of someone else’s article, that person should be given

credit. (APA, 2010b, pp. 15-16)

Notice in the above passage that the words each time are italicized because they are italicized for

emphasis in the original source. The four dots. . . . that appear in the middle of the passage are called

“ellipses” and reflect a place where I left out a portion of the original passage. The first period ends the

sentence and the remaining three represent the missing content. If you turned to pp. 15-16 in the

APA DOCUMENTATION STYLE 32 original APA book, you would find a section at the point where I’ve placed ellipses where the author

gives an example of how to paraphrase. I left that portion out because I didn’t feel it was necessary in

illustrating the point about the importance of citing paraphrased material. (And because I’ve already

demonstrated paraphrasing in a previous section of this manual – repeating yourself is not good writing).

If you leave out information from the original source, even if only a few words, you must alert your

reader to this fact by using ellipses. If the missing content occurs in the middle of a sentence only three .

. . ellipses are used.

A Summary of Key Points in Successful Direct Quoting

1. Direct quotes must be presented exactly as the original quote. All alterations from the original

passage must be acknowledged in [square brackets] or with . . . ellipses.

2. Don’t forget your page number or paragraph number of the original source. Don’t forget

quotation marks for passages less than 40 words and your half inch indent for block quotes.

3. Ellipses . . . are used when you leave out information from the original quote even if it is only a

few words. An ellipses is usually three periods with spaces between.

4. If you need to change a word in any direct quote to make it, for example, grammatically correct

with the verb tense of your paper or to make a personal pronoun clearer, place the changed words

in [square] brackets. See page 9 of this manual for an example of a direct quote where the word

one’s was changed to [your] and placed in square brackets.

5. If you add anything to the quote such as italicizing of words for emphasis that did not appear in

the original, you must alert your reader to your alteration with the phrase (italics mine).

6. If there is a grammatical error or spelling error in the original quote you have two options: You

can correct the mistake and use square brackets to indicate an alteration, or you can you leave it

as incorrect (usually this is a deliberate choice) and place the wird (sic) in brackets after the error

so that your reader knows that the error was in the original and not made by you. (Note: “wird” =

“word” spelt incorrectly – just in case you missed it.)


Reference Lists

Reference lists are ordered alphabetically by first Author’s last name. Reference lists appear in

hanging indent format and double spaced throughout. See pages 47-51 for sample appearance of a

reference list.

Where do I Find all the Information I Need to Make a Reference List?

You will have to print out or save the links to your sources to use to make your reference list. For

a journal reference, the front page of the article is generally sufficient but sometimes you need other

pages of the article. For a book, you will need the title page and the publisher page of the book. This

means, photocopy these components prior to returning the book to the library. For a website you

generally will only need to look at the home page. If you have to dig deep or do an extensive hunt

through a web page to identify things such as author, or date, then I would question the credibility of the

website you are using.

Author Names

Journal article. Some articles list their authors by First Middle Last (names) (e.g. Jean A.

Gilmour) and some articles list authors as Last, First Middle (e.g., Gilmour, Jean A.). If there is more

than one author to an article, your reference list should list them in the order they appear on the article.

Do not re-alphabetize. Authors’ first and middle initials are only used in reference list entries and not in

citations in the body of your paper. [Exception: two different authors with the same last name and article

published in the same year.]

Author names can be confusing. Some authors use a maiden name as a middle name and others

hyphenate the two names. Use an entire hyphenated name as a surname (Lisa Smith-Jones would be

cited as Smith-Jones, 2008). Use an unhyphenated maiden name as a middle name (e.g. Lisa Smith

Jones would be cited as Jones, 2008)

Book sources. Book authors are very clearly listed on the front cover or title page of the book. If

the book is an edited book then the editors will be listed in this location. Use only the editors listed on

APA DOCUMENTATION STYLE 34 the title page of the book (some books have dozens of editors). Also in edited books each chapter will

have author(s) identified either on the first page of the chapter or under the chapter title in the table of

contents. It is these authors that will be used in your in-text citations and in your reference list you will

use the chapter in an edited book format.

Web page. In the majority of web pages the author will be an organization or group. If a

particular page or article of a web page is authored by a human author and this is clearly identified, then

this author will take priority over the organization.

No author. If a source has no author identified, then the title of the work will move to the author

position prior to the date of publication.

Dates of Sources

Journal sources. Use year of publication only, month of publication is not required. This date

will be most clearly located in the running footnote on the bottom of each page of the journal article.

Sometimes the date of publication will also appear in one of the top corners of the first page of the

article or at the bottom of the abstract. Format and location will be dependent on the journal. Do not

confuse the date of publication with the date reviewed for publication or the date of acceptance for

publication.

Book sources. Books will often place the date of publication on the title page of the book but if

it does not appear here it will be found as a copy write date on the publication page of the book: ©

2010.

Web pages. A web page date will often appear at the bottom of the home page and will also

appear as a © date. Web page dates may also be identified by the words, “Last updated on” or “Last

reviewed on.” News sources may place the date right at the top of the article. Some web pages have a

running date that will always show the current date. This is not the same as the date of publication of this

web page and you must look elsewhere for the date the material was published.


No date. If a source has no publication date, the date portion of the reference is replaced by n.d.

(no date). The citation in the body of the text will also acknowledge the lack of date (Jones, n.d.). Please

always be suspect of the credibility of a source with no clearly stated date of publication.

Titles of Documents

Journal sources. Journal articles have two titles that appear in the reference list: the title of the

article and the title of the journal. Article titles are found at the top of the first page of the article. Journal

titles are found in the running footnote on each page of the article. Sometimes Journal titles are

represented by abbreviation only on the pages of a journal article (e.g, JOGNN). If this is the case, you

will need to locate the full title of the journal for your reference list by searching Google by the

abbreviation or by going back to the original source such as EBSCO host. JOGNN is actually Journal of

Obstetric Gynecologic and Neonatal Nursing.

Book titles. Use the book title found on the title page of the book. Books sometimes have

subtitles which are not printed on the front cover graphic.

Web pages. Web page titles can be confusing and there may appear to be multiple options but

use the most prominent title that best reflects the material you are reading.

Publishing Information

Journal article volume and issue numbers and page numbers. Journal volume, issue, and

page numbers are found in different locations depending on the publishing style of the journal.

1. In a running footnote on each journal page.

2. At the end of the abstract.

3. In one of the top corners of the first page of the article.

4. If you retrieved the article from EBSCO host, the EBSCO abstract page or other notation

will also clearly state this information.

Every journal uses a different format to communicate this information so use a clever eye to spot it.

Sometimes you can only identify the page range of the article by looking at the entire article and

APA DOCUMENTATION STYLE 36 identifying the number of the first page and the number of the last. Peer reviewed journals have

continuous numbers throughout a volume. The first page of Vol. 26; issue 1 will be p. 1. The first page

of Vol. 26; issue 12 may be p. 897.

Book publishers and publishing cities. The information on book publishing is most easily

located on the title page of the book and or on the publishing page of the book. The city of publication

will use the city name and the state/province in abbreviation. If more than one city is listed, use the first.

Publisher names can be confusing because large publishing houses buy up small publishing houses and

often books are published with the names of both publishers (e.g., Elsevier a subsidiary of Mosby

Publishers). If the book has two publishing company names, use both together (e.g., Mosby Elsevier) or

use the most prominently displayed name. If there is no publisher named and the author is an

organization, then likely the publisher is the author and the word “Author” gets placed in the publisher

name location.

Retrieval Information

Journal sources. Journal articles today are available in both print forms (from the library shelf)

or electronic form. Probably 95% of the journal articles you use for assignments will come in an

electronic format from a password protected database (such as EBSCO host) or via a universally

available web source (like PubMed or Google Scholar). Even if a Journal article is found on the web it

must be referenced as a journal/periodical. If you retrieve a journal article from an electronic source,

retrieval information will be included in the reference list entry. It is no longer required to include a date

of retrieval for journals or periodical items or websites. There are three possible situations that may arise

when looking for retrieval information to include in your reference list entry:

1. DOI. The method of choice for communicating retrieval information is the use of the Digital

Object Identifier (DOI). If a DOI is available for the article you are including, it will be used in

place of all other formats for providing retrieval information regardless of where you obtained

the article. DOI’s can be found on the first page of the article, at the end of the article prior to the


reference list, or it is only located on the database abstract information page. Use this method of

identifying your electronically located journal article whenever it is available.

2. URL. If no DOI is available, wherever possible use the direct URL web link for the article you

are referencing.

3. Name of database. For password protected databases use the name of the specific database in

the retrieval information location. E.g. Retrieved from CINAHL with Full Text database,

Academic Search Premier database, Nursing Reference Centre database.

Web pages. Supply the direct URL for the web page being viewed and cited at the end of the

reference list entry. Retrieved dates are only required for sources that are frequently changing or

updated.


Reference List Format

General Format For Journal Article References and Other Periodicals Author, A. B., & Author, C. D. (2010). Title of journal article. Title of Journal, Volume#(Issue#), page range.

Notes: Author names by last name first. Use initials only for first and middle names. If more than one author of the article, list the authors in the order they appear listed in the article. Do

not re-alphabetize. Journal article titles are written in all lower case letters except the first word, any proper nouns, and

any words that come after punctuation in the middle of the title such as : -- . etc. No italics. Journal titles: capitalize all key words and italicize. Volume numbers are italicized; issue numbers are in brackets and not italicized. E.g., 22(4). If there

is no issue number visible on the article, it may be omitted from the reference. Page range extends from the first page of the article to the last page of the reference list separated by a dash (22-36)

If the article was retrieved in full text from a database such as EBSCO Host, CINAHL, or is an online version, then this must be acknowledged either with DOI or database acknowledgement. See below for various examples.

Reference List

Citation in Body of Text

Journal Article – 1 Author (with DOI) Manias, E. (2010). Medication communication: A concept

analysis. Journal of Advanced Nursing, 66(4), 933-943.

doi: 10.1111/j.1365-2648.2009.05225.x

Manias (2010) states that . . . . . At the end of a sentence the reference falls within the period (Manias, 2010). Do not use author initials in a citation.

Periodical (Evidence Based Care Sheets) – 2 Authors (no DOI

and from a password protected database)

Buckley, L., & Matteucci, R. (2009). Deep venous thrombosis:

Prevention. CINAHL Nursing Guide. Retrieved from

Nursing Reference Center database.

Buckley and Matteucci (2009) stated that . . . . (Buckley & Matteucci, 2009). Note: use the word “and” when the names are written within the text and the symbol “&” when in the bracketed form

Journal Article – 3 Authors (with DOI)

Sticher, M., Smith, C., & Davidson, S. (2010). Reducing heart

disease through the vegetarian diet using primary

prevention. Journal of the American Academy of Nurse

Practitioners, 22(3), 134-139. doi:10.1111/j.1745-

First citation: According to Sticher, Smith, and Davidson (2010) . . . (Sticher, Smith, & Davidson, 2010) Second and subsequent citations: Sticher et al. (2010) discussed . . . (Stitcher et al., 2010)


7599.2009.00483.x

Journal Article – 4 Authors (With DOI)

Reid-Searl, K., Moxham, L., Walker, S., & Happell, B. (2010).

Supervising medication administration by

undergraduate nursing students: Influencing factors.

Journal of Clinical Nursing, 19(5/6), 775-784.

doi:10.1111/j.1365-2702.2009.03074.x

First citation: Reid-Searl, Moxham, Walker, and Happell (2010) states…… (Reid-Searl, Moxham, Walker, & Happell, 2010) Second and subsequent citations: Reid-Searl et al. (2010) states….. (Reid-Searl et al., 2010)

Journal Aricle – 5 Authors (no DOI and from password

protected database)

Field, T., Diego, M., Pelaez, M., Deeds, O., & Delgado, J.

(2009). Breakup distress in university students.

Adolescence, 44(176), 705-727. Retrieved from

CINAHL with Full Text database.

First Citation: Field, Diego, Pelaez, Deeds, and Delgado (2009) states….. (Field, Diego, Pelaez, Deeds, & Delgado, 2009) Second and subsequent citations: Field et al. (2009) states…… (Field et al., 2009)

Journal Article – 6 or more Authors (no DOI and retrieved from

public web database)

Irwin, D., Vaillancourt, R., Dalgleish, D., Thomas, M.,

Grenier, S., Wong, E., . . . Gaboury, I. (2008). Standard

concentrations of high-alert drug infusions across

paediatric acute care. Paediatric & Child Health, 13(5),

371-376. Retrieved from

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC253288

8/

All citations (including first) will read: Irwin et al. (2008) states . . . (Irwin et al., 2008)

APA DOCUMENTATION STYLE 40 Peer Reviewed Newsletter (no author listed) Retrieved from

password protected database

A new way to control blood pressure. (2007, May). Harvard Heart

Letter, 17(9), 3. Retrieved from Academic Search Premier

database.

Alphabetize in reference list by title (excluding the word “The” if the title begins with “The”).

According to the article A new way to control blood pressure (2007) . . . (A new way to control blood pressure, 2007) Note: Month of publication not indicated in the citation

Peer Reviewed Newsletter/Bulletin, Organizational Author,

Retrieved from Web Source

Canadian Nurses Association. (2007, April). Improving practice

environments: Keeping up the momentum. Nursing Now:

Issues and Trends in Canadian Nursing, (22). Retrieved

from http://www.cna-

nurses.ca/CNA/documents/pdf/publications/NN_

Improving_Practice_Environments_2007_e.pdf

First citation: Canadian Nurses Association (CNA, 2007) (Canadian Nurses Association [CNA], 2007) Second and subsequent citations: CNA (2007) (CNA, 2007)

Magazine Article

Bushe, F. (2005, March). Five things you should know about:

Varicose vein treatments. Canadian Living, 30(3), 50.

Bushe (2005) states . . . (Bushe, 2005) Note: month not included in citation

Newspaper Article

Lett, D. (2005, April 10). An accident waiting to happen:

Manitoba’s efforts at road safety woefully inadequate,

experts say. The Winnipeg Free Press, pp. B1-B2.

Note: if the newspaper or magazine article is on non-continuous pages then separate page numbers by a comma (e.g. 50, 72) (e.g. 53-65, 99) (A1, A4)

Lett (2005) (Lett, 2005) Note month and day portion of date is omitted in in-text citation.

Newspaper Article; no author

Hospital privacy. (2002, May 28). The Winnipeg Free Press, p. A12.

“Hospital Privacy” (2002) indicates . . . . (“Hospital Privacy”, 2002)

APA DOCUMENTATION STYLE 41 News Article: Online source

Ellis, C. V. (2010, May 3). Obese women at risk for larger tumors,

later-stage diagnosis of breast cancer. Medscape Medical

News. Retrieved from

http://www.medscape.com/viewarticle/721195

Ellis (2010) (Ellis, 2010)

Dictionary in a password protected database

Against medical advice. (2005). In Taber’s Cyclopedic

Medical Dictionary (20th ed.). Retrieved from the

Nursing Reference Center Database.

Against medical advice (2005) (Against medical advice, 2005)

General Format for Website References Organization Name or Author. (2008). Title of web page. Retrieved from web link. Notes:

If the author is a government or other organization, a period is still placed at the end of the organization’s name.

Website titles are all lower case except: first word, words after main punctuation (: -- . etc.), and proper nouns

Italicize website titles. Give the exact web link that takes you to the web page you cited the material from. The underline should be removed from the web link (but we are not too strict about this). Web links, because they don’t contain spaces, will be viewed by your word processing program as

one word and will often automatically bump to the next line leaving large blank spaces in the previous line. Don’t worry about this and leave it as is. If you break the web link up (by pressing return in the middle) it won’t work if clicked on in an electronic copy. You want a working web link so your instructor can check your website while marking your paper if necessary.

Each page of a website, if it has a different link, gets referenced and cited as a separate entry. If you cite from three different pages/sections/links of the same website you will have three different reference list entries. If properly cited, you will have several pages of one website that all have the same author and same publication or copyright year. Your reader needs to be able to distinguish between the different pages/links. In the reference list, list these sources alphabetically by title and label by a, b, c so they can be distinguished from one another (see example below).

Reference List Citation in Body of Text

Website document or page – Government Author

Government of Manitoba. (2008). Adult literacy in Manitoba: A

discussion paper. Retrieved from

http://www.gov.mb.ca/adultliteracystrategy/pdf/booklet_en.p

Government of Manitoba (2008) states . . . (Government of Manitoba, 2008)


df

Website document or page – Organizational Author

Heart and Stroke Foundation of Canada. (2006). Tipping the scales

of progress: Heart disease and stroke in Canada 2006.

Retrieved from

http://www.heartandstroke.com/atf/cf/%7B99452D8B-

E7F1-4BD6-A57D-

B136CE6C95BF%7D/Tipping_the_Scales_new.pdf

First Citation: Heart and Stroke Foundation of Canada [HSFC] (2006) describes . . . . . (Heart and Stroke Foundation of Canada [HSFC], 2006) Second and subsequent citations: HSFC, (2006) states . . . . (HSFC, 2006)

Task Force Report

Government of Manitoba, Healthy Kids Healthy Futures Task Force.

(n.d.). Healthy kids, healthy futures task force report.

Retrieved from

http://www.gov.mb.ca/healthykids/docs/finalreport.pdf

If a report number is available, include it in brackets following the document title.

First citation: Government of Manitoba, Healthy Kids Healthy Futures Task Force [HKHFTF] (n.d.) Second and subsequent citations: Government of Manitoba, HKHFTF (n.d.)

Website – Multiple pages of same site; same publication year Health Canada. (2009a). Getting ready to quit. Retrieved from

http://www.hc-sc.gc.ca/hc-ps/tobac-tabac/quit-cesser/ready-

pret/index-eng.php

Health Canada. (2009b). Second-hand smoke. Retrieved from

http://www.hc-sc.gc.ca/hc-ps/tobac-tabac/second/index-

eng.php

Health Canada. (2009c). Smoking and your body. Retrieved from

http://www.hc-sc.gc.ca/hc-ps/tobac-tabac/body-corps/index-

eng.php

According to Health Canada (2009a) . . . . . (Health Canada, 2009a) Health Canada (2009b) states . . . . . . (Health Canada, 2009b) HealthCanada (2009c) indicates that . . . . . (Health Canada, 2009c) Web pages with the same author and same date are ordered in the reference list alphabetically by title of article regardless of the order in which they are cited in your paper.

APA DOCUMENTATION STYLE 43 Online Dictionary Entry – no author or editor

Plagiarism. (2010). Dictionary.com. Retrieved from

http://dictionary.reference.com/browse/plagiarism

Plagiarism (2010) (Plagiarism, 2010)

Blog Post Bike Snob NYC. (2010, May 3).Keeping up appearances: Filling

the house, clearing the bike lane [Web log post].

Retrieved from

http://bikesnobnyc.blogspot.com/2010/05/keeping-up-

appearances-filling-house.html

Blog titles are not italicized. Use author moniker or screen name as the author (or authors full real name as applicable).

(Bike Snob NYC, 2010) Bike Snob NYC (2010)

General Format For Book and Book Chapter References Author, A., & Author, B. (2008). Title of book (2nd ed.). Publishing City, State/Province: Publisher Name. Notes:

Titles of books are all lower case and italicized except: first word, words after main punctuation (: -- . etc.), and proper nouns

See Appendix B (p. 56) for a list of abbreviations for all states and provinces in North America. Publisher stems such as “press” or “inc.” or “company” can be omitted from publisher name. If no publisher is mentioned for the book, assume the author is the publisher and use the term

“Author” in the publisher name location. This is true of most government and organization published books.

If you only use one chapter from a book and each chapter has been authored by a different individual(s) then choose this method of referencing over making reference to an entire book. Each chapter you use is a separate reference list entry. If every chapter in the book is authored by the same individual then reference the entire book and not the chapter.

When referencing a specific chapter from an edited book, the page range should reflect the entire chapter and not just the pages within that chapter that were cited.

Reference List Citation in the Body of the Text

Book – Reference to an Entire Book -- where all chapters are

written by the main author(s)

Berk, L. E. (2008). Exploring lifespan development. Boston:

Pearson Allyn and Bacon.

Berk (2008) states . . . (Berk, 2008)

APA DOCUMENTATION STYLE 44 Book – No author or editor (5th edition)

Stedman’s medical dictionary for the health professions and nursing

illustrated (5th ed.). (2005). Philadelphia, PA: Lippincott

Williams & Wilkens.

Alphabetize in reference list by the first word of the title if the first word is not “the.” If the title starts with “The” alphabetize by second word.

Steadman’s Dictionary (2005) states . . . . (Steadman’s, 2005) Use, a few words of the title or the whole title, if short, in place of the author’s name in the citation

Book – Entire Book; 3rd edition (same authors all chapters)

Valanis, B. (1999). Epidemiology in health care (3rd ed.). Stamford,

CT: Appleton & Lange.

Valanis (1999) states . . . (Valanis, 1999)

Organizational Author as Publisher

Canadian Nurses Association. (2008). Code of ethics for

registered nurses. Ottawa, ON: Author.

First Citation: Canadian Nurses Association [CNA] (2008) states . . . (Canadian Nurses Association [CNA], 2008) Second and subsequent citations: CNA (2008) states . . . . (CNA, 2008)

Book Chapter Edited Book (2nd Canadian Edition)

Malick, L. B., & Sanchez, O. (2010). Fluid, electrolyte, and acid-

base imbalances. In S. M. Lewis, M. M. Heitkemper, S. R.

Dirksen et al. (Eds.), Medical-surgical nursing in Canada:

Assessment and management of clinical problems (2nd

Canadian ed., pp. 362-391). Toronto, ON: Mosby Elsevier.

Malick and Sanchez (2010) state . . . (Malick & Sanchez, 2010) Cite in body of text by chapter author not by book editors

Book Chapter Edited Book (4th edition)

Balakas, K., & Solberg, S. (2009). Conception through adolescence.

In P.A. Potter, A. G. Perry, J. C. Ross-Kerr, & M. J. Wood

(Eds.), Canadian fundamentals of nursing (4th ed., pp. 329-

362). Toronto, ON: Elsevier.

Balakas and Solberg (2009) state . . . (Balakas & Solberg, 2009) Cite in body of text by chapter author not by book editors

Other Sources of Data

There are many other possible sources of data that you may wish to use as part of your paper. In a scholarly paper, the bulk of the material you use as references should come from strong peer reviewed sources such as peer reviewed journals, books specific to the topic, and governmental or


reputable organizational reports or documents. Check with your instructor and assignment guidelines for the appropriateness of using other source types.

If you wish to use sources in your paper for which examples have not been given in this booklet, please contact the writing instructor.

Reference List Citation in Body of Text

Brochure – No date (n.d.)

Heart and Stroke Foundation of Manitoba. (n.d.). Hearts in motion

Brookside hearts in motion trail: Walk ‘til your heart’s

content [Brochure]. Winnipeg, MB: Author.

First citation: Heart and Stroke Foundation of Manitoba [HSFM] (n.d.) states . . (Heart and Stroke Foundation of Manitoba [HSFM], n.d.) Second and subsequent citations: HSFM (n.d.) states . . . (HSFM, n.d.)

Video (DVD or VHS)

American Psychological Association. (Producer). (2000).

Responding therapeutically to patient expressions of sexual

attraction [DVD]. Available from

http://www.apa.org/videos/

The weblink is to alert readers as to the company who made and distributed the video and this will likely be found on the video sleeve for the movie or film.

(American Psychological Association [APA], 2000) American Psychological Association (APA, 2000) (APA, 2000) APA (2000)

Video (Motion Picture Movie – General Format)

Producer, A. A. (Producer), & Director, B. B. (Director). (Year).

Title of motion picture [Motion Picture]. Country of Origin:

Studio.

Producer and Director (Year) showed in their film…… (Producer & Director, Year) This example is general format only. Insert actual movie credit info when using.

Video blog (U-tube) Polyhealth. (2009, November 25). Skills in nursing: Correct aseptic

hand wash [Video file]. Retrieved from

http://www.youtube.com/watch?v=ERBucHPy-_M

In this situation, the title of the video is not italicized. The author is the moniker or screen name of the poster.

Polyhealth (2009) (Polyhealth, 2009)

APA DOCUMENTATION STYLE 46 Personal Communications

Does not appear in the reference list because this information is not directly retrievable by your readers (e.g. personal interviews or emails). You should not be using personal communications for information provided to you by instructors in their lecture notes. Check with your instructor for their original source. Ensure that you use an actual person’s name in the personal communication and not a generalization such as “A nurse at Klinic”. The exception to this would be in the case of a confidential interview such as with a patient’s personal information protected by PHIA, where the use of initials/pseudonym would be acceptable.

The writer discussed the format of the Teen Talk program with a nurse coordinator at Klinic who confirmed that peer counselors needed to be under the age of 19 (Jane Jones, personal communication, April 25, 2010) According to Jane Jones (personal communication, April 25, 2010) a nurse coordinator at Klinic . . . . .


References

A new way to control blood pressure. (2007, May). Harvard Heart Letter, 17(9), 3. Retrieved from Academic

Search Premier database.

Against medical advice. (2005). In Taber’s Cyclopedic Medical Dictionary (20th ed.). Retrieved from

the Nursing Reference Center Database.

American Psychological Association. (Producer). (2000). Responding therapeutically to patient expressions of

sexual attraction [DVD]. Available from http://www.apa.org/videos/

American Psychological Association. (2010a). The basics of APA style. Retrieved April 22, 2010, from

http://apastyle.apa.org/learn/tutorials/basics-tutorial.aspx

American Psychological Association. (2010b). Publication manual of the American psychological

association (6th ed.). Washington, DC: Author.

Balakas, K., & Solberg, S. (2009). Conception through adolescence. In P.A. Potter, A. G. Perry, J. C.

Ross-Kerr, & M. J. Wood (Eds.), Canadian fundamentals of nursing (4th ed., pp. 329-362).

Toronto, ON: Elsevier.

Berk, L. E. (2008). Exploring lifespan development. Boston: Pearson Allyn and Bacon.

Bike Snob NYC. (2010, May 3). Keeping up appearances: Filling the house, clearing the bike lane [Web

log post]. Retrieved from http://bikesnobnyc.blogspot.com/2010/05/keeping-up-appearances-

filling-house.html

Buckley, L., & Matteucci, R. (2009). Deep venous thrombosis: Prevention. CINAHL Nursing Guide.

Retrieved from Nursing Reference Center database.

Bushe, F. (2005, March). Five things you should know about: Varicose vein treatments. Canadian

Living, 30(3), 50.

Canadian Nurses Association. (2008). Code of ethics for registered nurses. Ottawa, ON: Author.

Canadian Nurses Association. (2007, April). Improving practice environments: Keeping up the

momentum. Nursing Now: Issues and Trends in Canadian Nursing, (22). Retrieved from


http://www.cna-

nurses.ca/CNA/documents/pdf/publications/NN_Improving_Practice_Environments_2007_e.pdf

Dean, R. A. K., & Major, J. E. (2008). From critical care to comfort care: The sustaining value of

humour. Journal of Clinical Nursing, 17, 1088-1095. doi:10.1111/j.1365-2702.2007.02090.x

Dunn, K. S., Otten, C., & Stephens, E. (2005). Nursing experience and the care of dying patients.

Oncology Nursing Forum, 32(1), 97-104. doi:10.1188/05.ONF.97-104

Ellis, C. V. (2010, May 3). Obese women at risk for larger tumors, later-stage diagnosis of breast cancer.

Medscape Medical News. Retrieved from http://www.medscape.com/viewarticle/721195

Field, T., Diego, M., Pelaez, M., Deeds, O., & Delgado, J. (2009). Breakup distress in university

students. Adolescence, 44(176), 705-727. Retrieved from CINAHL with Full Text database.

Feldman, R. S. (2005). Development across the life span (3rd ed.). Upper Saddle River, NJ: Pearson

Prentice Hall.

Government of Manitoba, Healthy Kids Healthy Futures Task Force. (n.d.). Healthy kids, healthy futures

task force report. Retrieved from http://www.gov.mb.ca/healthykids/docs/finalreport.pdf

Government of Manitoba. (2008). Adult literacy in Manitoba: A discussion paper. Retrieved from

http://www.gov.mb.ca/adultliteracystrategy/pdf/booklet_en.pdf

Harris, R. (2007). Evaluating internet research sources. Retrieved from

http://www.virtualsalt.com/evalu8it.htm

Health Canada. (2009a). Getting ready to quit. Retrieved from http://www.hc-sc.gc.ca/hc-ps/tobac-

tabac/quit-cesser/ready-pret/index-eng.php

Health Canada. (2009b). Second-hand smoke. Retrieved from http://www.hc-sc.gc.ca/hc-ps/tobac-

tabac/second/index-eng.php

Health Canada. (2009c). Smoking and your body. Retrieved from http://www.hc-sc.gc.ca/hc-ps/tobac-

tabac/body-corps/index-eng.php

APA DOCUMENTATION STYLE 49 Heart and Stroke Foundation of Manitoba. (n.d.). Hearts in motion brookside hearts in motion trail:

Walk ‘til your heart’s content [Brochure]. Winnipeg, MB: Author.

Heart and Stroke Foundation of Canada. (2003). The growing burden of heart disease and stroke in

Canada 2003. Retrieved from http://www.cvdinfobase.ca/cvdbook/CVD_En03.pdf

Heart and Stroke Foundation of Canada. (2006). Tipping the scales of progress: Heart disease and

stroke in Canada 2006. Retrieved from http://www.heartandstroke.com/atf/cf/%7B99452D8B-

E7F1-4BD6-A57D-B136CE6C95BF%7D/Tipping_the_Scales_new.pdf

Hinds, P. S., Hockenberry, M., Rai, S. N., Zhang, L., Razzouk, B. I., McCarthy, K., … Rodriguez-

Galindo, C. (2007). Nocturnal awakenings, sleep environment interruptions, and fatigue in

hospitalized children with cancer. Oncology Nursing Forum, 34(2), 393-402.

doi:10.1188/07.ONF.393-402

Hospital privacy. (2002, May 28). The Winnipeg Free Press, p. A12.

Irwin, D., Vaillancourt, R., Dalgleish, D., Thomas, M., Grenier, S., Wong, E., . . . Gaboury, I. (2008).

Standard concentrations of high-alert drug infusions across paediatric acute care. Paediatric &

Child Health, 13(5), 371-376. Retrieved from

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2532888/

Lett, D. (2005, April 10). An accident waiting to happen: Manitoba’s efforts at road safety woefully

inadequate, experts say. The Winnipeg Free Press, pp. B1-B2.

Lockyer, L., & Bury, M. (2002). The construction of a modern epidemic: The implications for women of

the gendering of coronary heart disease. Journal of Advanced Nursing, 39(5), 432-440.

doi:10.1046/j.1365-2648.2002.02308.x

Luctkar-Flude, M., Groll, D., Woodend, K., & Tranmer, J. (2009). Fatigue and physical activity in older

patients with cancer: A six-month follow-up study. Oncology Nursing Forum, 36(2), 194-202.

doi: 10.1188/09.ONF.194-202

APA DOCUMENTATION STYLE 50 Malick, L. B., & Sanchez, O. (2010). Fluid, electrolyte, and acid-base imbalances. In S. M. Lewis, M.

M. Heitkemper, S. R. Dirksen et al. (Eds.), Medical-surgical nursing in Canada: Assessment and

management of clinical problems (2nd Canadian ed., pp. 362-391). Toronto, ON: Mosby Elsevier.

Manias, E. (2010). Medication communication: A concept analysis. Journal of Advanced Nursing,

66(4), 933-943. doi: 10.1111/j.1365-2648.2009.05225.x

McCreaddie, M., & Wiggins, S. (2007). The purpose and function of humour in health, health care and

nursing: A narrative review. Journal of Advanced Nursing, 61(6), 584-595. doi:10.1111/j.1365-

2648.2007.04548.x

Park, C. (2003). In other (people’s) words: Plagiarism by university students – literature and lessons.

Assessment & Evaluation in Higher Education, 28(5), 471-488. Retrieved from Academic

Search Premier database.

Plagiarism. (2010). Dictionary.com. Retrieved from http://dictionary.reference.com/browse/plagiarism

Polyhealth. (2009, November 25). Skills in nursing: Correct aseptic hand wash [Video file]. Retrieved

from http://www.youtube.com/watch?v=ERBucHPy-_M

Red River College. (2003). Academic integrity. Retrieved from

http://www.rrc.mb.ca/files/File/policies/new/S4%20Academic%20Integrity.pdf

Reid-Searl, K., Moxham, L., Walker, S., & Happell, B. (2010). Supervising medication administration

by undergraduate nursing students: Influencing factors. Journal of Clinical Nursing, 19(5/6),

775-784. doi:10.1111/j.1365-2702.2009.03074.x

Sheilds, M. (2004). Measured obesity: Overweight Canadian children and adolescents. Retrieved from

http://www.statcan.ca/english/research/82-620-MIE/2005001/pdf/cobesity.pdf

Stedman’s medical dictionary for the health professions and nursing illustrated (5th ed.). (2005).

Philadelphia, PA: Lippincott Williams & Wilkens.

APA DOCUMENTATION STYLE 51 Sticher, M., Smith, C., & Davidson, S. (2010). Reducing heart disease through the vegetarian diet using

primary prevention. Journal of the American Academy of Nurse Practitioners, 22(3), 134-139.

doi:10.1111/j.1745-7599.2009.00483.x

Taylor, C. (2005). Help from the communications instructor. Retrieved from

http://www.umanitoba.ca/faculties/nursing/studentarea/110.htm

Ulloth, J. K. (2003). A qualitative view of humor in nursing classrooms. Journal of Nursing Education,

42(3), 125-130. Retrieved from CINAHL with Full Text database.

University of Ontairo Institute of Technology. (2009). Nool. Retrieved from http://ow.ly/1y00l

Valanis, B. (1999). Epidemiology in health care (3rd ed.). Stamford, CT: Appleton & Lange.

Zilm, G. (2009). The SMART way: An introduction to writing for nurses (3rd ed.). Toronto: Mosby

Elsevier.


Table 1 Overweight Canadian Children and Adolescents: Difference Between Self-Report and Directly Measured Height, Weight and BMI in Adolescents Ages 12 to 17

(Sheilds, 2004, p. 10) Notes on table presentation. The majority of tables that you may use in your papers and assignments will likely be cut and paste from other sources. In these situations you need to reference your table as a direct quote with a page number. Tables you design as part of your assignment may or may not need a reference depending on the source. If you are presenting your own data (e.g. such as statistical results in your research study or a summary of behaviour change activities) then no reference is required. If you are presenting data in a table that you have summarized from another source (but was not in a table in that other source) then a reference will be required but a page number may not be needed.

Tables need to also be discussed in the body of the text. They should not be tacked on at the end of your paper without discussion or explanation. For example the table above might be described in the body of your paper as follows: Boys have higher rates of obesity than girls and, generally obesity rates are higher by direct measurement versus self-report (Sheilds, 2004). See Table 1 for a full presentation of the data.

Tables are numbered consecutively in the order they are discussed in your paper and require a heading that is flush left and italicized (see above, Table 1 for heading example). Tables are placed at the end of your paper after the references and appendices.


Figure 1. Overweight and obesity rates, by province, household population, aged 2 to 17, Canada

excluding territories, 2004 (Sheilds, 2004, p. 24).

Notes on figure presentation. Any diagrams that are not presented in table format are called figures (graphs, pictures, photographs, drawings etc.). Similar to tables, if they are cut and paste from another source they need a reference and a page number (as shown above, Figure 1). They need to be discussed in the body of the text of your paper, and numbered consecutively in the order they are discussed. For example the above table could be discussed in the body of your paper as follows: Obesity rates amongst children ages 2 to 17 are highest in Newfoundland and Lowest in Alberta (see Figure 1, Sheilds, 2004).

Please also note that many tables and figures have their own source printed below the table (as this example does). You still need to identify your source in proper APA format.

Figure titles are also required and presented as shown above, below the figure with the figure number italicized followed by a period and the explanation/title following.

Figures are inserted into your paper after the reference list, appendices, and tables and numbered consecutively according to when they are discussed in your paper.


Appendix A

Computer Instructions (MS Word Office 2007)

1. Margins: a. Page layout tab; b. Margins select “normal” which gives 1” margins around.

2. Font:

a. Home tab; b. Select Times New Roman or Arial as font options on drop down. c. Font size should be selected as 12

3. Spacing: You must set this before starting to type or it will be problematic to change later.

a. Home tab; b. Within the paragraph sub section, click on “line spacing” (it is a symbol only with and up

and a down arrow and four lines) and a drop down menu will appear; c. Select “line spacing options . . .” and a box will pop up. d. Ensure that the indents and spacing all read “0” e. The drop down box under special should say “none” and that the drop down menu under

line spacing says “double.” f. OR -- Page layout tab; paragraph section indent should be left 0, right 0; spacing should

be 0 in before and after boxes

4. Tab indent: a. Hit the tab key on your keyboard to indent paragraphs. b. This key is defaulted at 0.5 inches.

5. Justification:

a. Home tab; b. Justification buttons are found in the paragraph section and is defaulted as Left

justification or “Align Text Left” (which leaves a ragged right margin such as what you see on this page).

c. To center text select the button where both margins are ragged.

6. Headers and page numbers (all pages of paper except title page):

a. You must be on page 2 (or higher) of your paper. b. Insert tab; c. Click header button; select “blank.” d. The program will automatically create a header footer tools design tab e. Click the box for “Different First Page” f. Type in CAPS LOCK a header that is reflective of paper title and less than 50 characters

including spaces g. Hit tab twice or as often as necessary to get to the far right margin of the paper. h. Click on design tab or insert tab and “page number” button. Select “current position” and

“plain number.”


i. Return to home tab and change font and font size to the same font as body of paper (Times New Roman or Arial 12 pt). You will have to highlight what you’ve typed into the Header section to do this.

7. Header (title page) – Which includes “Running head”

a. Return to page 1 which should be your title page. b. Type into header the words “Running head:” (without quotation marks) c. Type the same Running head in CAPS LOCK as you did on page 2 or onward d. You will have to change font and font size again.

8. Block quote indentation:

a. Page layout tab; b. indent left should be at 0.5 inches. c. You will have to manually set the indents back to zero when you are finished with the

quote in order to continue typing your paper.

9. Hanging indent (for the Reference List page): a. It will save a lot of trouble when typing your reference list to preset this option prior to

typing out your reference list. b. Home tab; c. “Line spacing” button. d. Under line spacing options the dropdown menu under “special,” select the option of

“hanging”.

10. Italicizing: a. Select text you wish to italicize b. Select the I button the home tab. c. Unclick the button to go back to regular type.


Appendix B

Publication Locations and Abbreviations for States and Provinces

Abbreviations for U.S. States and Territories

Alabama AL Alaska AK

American Samoa AS Arizona AZ

Arkansas AR California CA

Canal Zone CZ Colorado CO

Connecticut CT Delaware DE

District of Columbia DC Florida FL

Georgia GA Guam GU

Hawaii HI Idaho ID

Illinois IL Indiana IN

Iowa IA Kansas KS

Kentucky KY Louisiana LA

Maine ME Maryland MD

Massachusetts MA Michigan MI

Minnesota MN Mississippi MS

Missouri MO Montana MT

Nebraska NE Nevada NV

New Hampshire NH New Jersey NJ

New Mexico NM New York NY

North Carolina NC North Dakota ND

Ohio OH Oklahoma OK

Oregon OR Pennsylvania PA

Puerto Rico PR Rhode Island RI

South Carolina SC South Dakota SD

Tennessee TN Texas TX

Utah UT Vermont VT

Virginia VA Virgin Islands VI

Washington WA West Virginia WV

Wisconsin WI Wyoming WY

APA DOCUMENTATION STYLE 57 Abbreviations for Canadian Provinces and Territories

Alberta AB British Columbia BC

Manitoba MB New Brunswick NB

Newfoundland NF Northwest Territories

Nunavut

NT

NU

Nova Scotia NS Ontario ON

Prince Edward Island PE Quebec QC/PQ

Saskatchewan SK Yukon YT

Running head: HUMOUR IN NURSING CARE 59

Using Humour in Nursing Care Situations

Nursing A. Student

9999999

Red River College

Scholarly Writing and Documentation

Instructor: Kim McCormick

HUMOUR IN NURSING CARE 60

Using Humour in Nursing Care Situations

Humour can be an effective communication tool in patient care and has potential benefits

for both physical and psychological well-being (McCreaddie & Wiggins, 2007). While humour

can be defined in many ways, the most effective humour in heath care settings is spontaneous,

timed in a relevant way to the present circumstances, and born from a place of instinct rather

than from planning (Dean & Major, 2008). The following paper will examine the use of humour

in nursing interactions. Topics such as appropriate versus inappropriate use of humour, humour

as a covert message, and teaching nursing students about the use of humour will be considered.

Appropriate Versus Inappropriate Humour

Some individuals are easily able to look at the absurd and imperfect nature of the human

condition while others struggle with this perspective (Shuster, 2000). There has been some

question in the literature about whether or not humour and professionalism are mutually

exclusive conditions (Dean & Major, 2008). With good intentions, humour can be uplifting,

dampen an emotionally distressful situation, create a positive environment, enhance human

connection, provide comfort in times of distress, release tension, and lead to bonding between

patient and nurse (Dean & Major, 2008; McCreaddie & Wiggins, 2007; Ulloth, 2003). What

makes humour successful is the effective use of the element of surprise (Arnold, 2007).

McCreaddie and Wiggins (2007) report that specific pre-existing conditions must be met prior to

the effective use of humour in the clinical setting including: a rapport with the patient, pre-

established nursing competency, trust, and empathy. Without an established relationship between

the nurse and the patient or if a careful assessment of the emotional state of the patient has not

been performed, humour can fall flat, be misinterpreted, or be taken with offence (Schuster,

2000).


Humour is not appropriate in circumstances where the patient is psychologically

impaired, when serious dialogue is required, or when the attempt at humour involves jokes

against a particular gender, ethnic group, political affiliation, or uses profane or sexually overt

language. Humour under these circumstances would be both hurtful and damaging to patient care

relationships (McCreaddie & Wiggins, 2007; Ulloth, 2003). Put-downs and humour delivered for

purposes of humiliation or at someone’s expense is often delivered by insecure individuals who

use this type of communication to build their self-esteem (Shuster, 2000).

Humour as a Covert Message

Patient communication with the health care team. Research evidence suggests that

humour in health care is used most frequently in situations where there is an imbalance in the

hierarchical power between those interacting. Humour acts as a way to counterbalance the power

differential, thus it has been observed that patients are more likely to initiate humour with health

team members (McCreaddie & Wiggins, 2007). Given these observations, humour then

becomes a mechanism for communicating an indirect message. Patients who make self

deprecating statements in a humourous tone may be expressing an underlying fear or anxiety or

trying to ask a question that makes them feel vulnerable and the onus is placed on the nurse to

assess the interaction for the hidden message (Dean & Major, 2008). A patient who jokes around

and appears to be coping well may be using humour to cover up negative emotions. Humour,

regardless of its positive benefits, can also act as a method of denying the reality of a serious

situation (McCreaddie & Wiggins, 2007).

Nurses’ communication with physicians. Nurses use similar techniques, primarily with

physicians, to express an opinion or communicate displeasure with a physician’s choice of

therapeutic treatment. For example, a nurse who disagrees with continuing treatment on a


patient, instead of making a direct statement, may make a joke in the middle of a resuscitation

which implies that the next treatment they attempt might be to stand the patient on his/her head

(Dean & Major, 2008).

The purpose of such black humour is that it can regulate highly emotional states

(McCreaddie & Wiggins, 2007). Death and dying, impossible workloads, and poor working

conditions are frequent targets of black humour amongst nursing staff. If a situation can be

viewed as ridiculous then it cannot be emotionally threatening. Since nursing is a form of

“emotional labour,” situations of a high emotional intensity occur on almost a daily basis

(McCreaddie & Wiggins, 2007, p. 589).

Teaching Humour to Nursing Students

While the benefits of appropriately delivered humour are well known, when and how new

nurses learn about humour for therapeutic purposes has not been closely examined in nursing

education research (Adamle, Chiang-Hanisko, Ludwick, Zeller, & Brown, 2007). One qualitative

study (Ulloth, 2003) examining instructor use of humour in nursing classrooms suggested that

using humour in the classroom did not replace instructor preparation and demonstration of

competence. Humour was an additional teaching method rather than a primary teaching method

(Ulloth, 2003). Adamle et al. (2007) observed in their study examining teaching about the use of

humour that older instructors and those with higher levels of education were less likely to teach

about the appropriate use of humour in their nursing courses.

One unique example of humour being used to benefit patients and educate students is The

Humour Group implemented in a nursing program in Wisconsin (Minden, 2003). The intention

of the program was to use humour in a therapeutic manner with forensic psychiatric patients and

put a humourous spin on psychiatric therapy, an experience which is often frightening to these


patients. Nursing students attended a two hour class on the therapeutic benefits of humour and

then were each required to deliver one session in the clinical area. Benefits of the participation

for students included a sense of personal connection, improved social skills and communication,

emotion management, benefits to stress levels through relaxation and laughter, improved coping

skills, and new perspectives on psychological therapy (Minden, 2003).

Conclusion

Humour can be an effective way of expressing a vulnerable question, fear, or an

unpopular opinion, but it can also be a way to enjoy the absurdity of life. Nurses must always be

cognizant of the hidden message when patients or other team members use humour as a

communication tool. Humour can also have positive effects on student learning however, given

the highly emotional nature of nursing care situations, students must also be taught to use

humour appropriately and deliver it within an empathetic atmosphere.


References

Adamle, K. N., Chiang-Hanisko, L., Ludwick, R., Zeller, R. A., & Brown, R. (2007). Comparing

teaching practices about humor among nursing faculty: An international collaborative

study. International Journal of Nursing Education Scholarship, 4(1), 1-16. Retrieved

from CINAHL with Full Text database.

Arnold, E. C. (2007). Developing therapeutic communication skills in the nurse-client

relationship. In E. C. Arnold, & K. U. Boggs (Eds.), Interpersonal relationships:

Professional communication skills for nurses (5th ed., pp. 199-228). St. Louis, MO:

Saunders Elsevier.

Dean, R. A. K., & Major, J. E. (2008). From critical care to comfort care: The sustaining value of

humor. Journal of Clinical Nursing, 17, 1088-1095. doi:10.1111/j.1365-

2702.2007.02090.x

McCreaddie, M., & Wiggins, S. (2007). The purpose and function of humor in health, health care

and nursing: A narrative review. Journal of Advanced Nursing, 61(6), 584-595.

doi:10.1111/j.1365-2648.2007.04548.x

Minden, P. (2003). The humor group: More than a joke. Psychiatric Services, 54(1), 106.

Retrieved from http://psychservices.psychiatryonline.org/cgi/content/full/54/1/106

Schuster, P. M. (2000). Communication: The key to the therapeutic relationship. Philadelphia,

PA: F. A. Davis.

Ulloth, J. K. (2003). A qualitative view of humor in nursing classrooms. Journal of Nursing

Education, 42(3), 125-130. Retrieved from CINAHL with Full Text database.