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Letter From the Editors

Providing a Voice for Our Littlest Patients

Strategies for Writing Case of the Month Manuscripts

Section Editor(s): Schierholz, Elizabeth MSN, NNP-BC; Brandon, Debra PhD, RN, CNS, FAAN; McGrath, Jacqueline M. PhD, RN, FNAP, FAAN

Author Information
doi: 10.1097/ANC.0000000000000274
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I always did something I was a little not ready to do. I think that is how you grow. When there is that moment of “wow, I am not really sure I can do this,” and you push through, those moments, that is when you have a breakthrough. Sometimes that's a sign that something really good is about to happen. You're about to grow and learn a lot about yourself.

Marissa Meyer1

Whether you are a New Year's resolution type of person or a not, we each seek something out of life. We each have a dream. Some dreams are big, others might fit more in the “great things come in small packages” size. Regardless, it is hard not to let the New Year arrive without pausing to look at what was a part of our previous year and what we might want to be in the year ahead. We have the opportunity to let go of what did not serve us and to make room for new things, and embrace possibilities.

At this time in my life, I seem to be collecting “I am not really ready for this” moments. This past year I completed a Yoga Teacher Training Program and, shortly thereafter, moved from the sunny beaches of Southern California across the country to start a PhD program. I ended the year by bringing home a new puppy. None of these happened by chance, but on the first day of each journey, I certainly did think I was not quite ready. I am so grateful I pushed through. I have learned a lot and really good things are happening.

In this New Year, I encourage each of you to try something you might be “a little not ready to do.” Maybe you will try yoga, take a class, or adopt a puppy. I would like to suggest that you write a case study and submit it to Advances in Neonatal Care. You might feel a little not ready, but hopefully, if you read on, I will convince you otherwise.

To begin, let us define a case study. I suggest that a case study is a story. We all love stories. Why? Stories connect us, inspire us, encourage us, and challenge us. Stories give meaning to what we do. The story you share has infinite possibilities, but only if you share it. Your story may inspire change, a new practice, or new research, or it may be the missing puzzle piece to someone's research. It may give hope to a struggling family. By sharing a story—a case study—you empower and humanize the experience of the healthcare team, the infant, and the family.

I will provide some helpful practical tools, but first I want to encourage you to start by writing the story without format and without guidelines. Yes, we want to know all the facts, numbers, data, etc, but what makes the case or story memorable is why you remember it, why it is important to share. We want the heart and passion of the story—the part that connects us together as one team that learns and grows from our collective experiences. Tell us how it changed you and the team taking care of that infant and the family. What did you do differently? What do you wish you would have known that will help others take care of a similar infant in the future?

Now that you have the heart of the story in mind, pull out the guidelines for publication.


The case of the month article could include a presentation of a unique clinical issue, an atypical presentation or outcome of a common disease, an infant with a diagnostic challenge, an unusual disease process, a unique social or ethical challenge, or a challenging transport case. The general structure for the case of the month manuscript may be as follows: Introduction, Case Presentation, Discussion, and Conclusion. You may choose to also include the family perspective.

  • Introduction: The goal of the introduction is to provide a brief background including the disease/disorder/diagnosis, with concise explanation of presentation and progression. First, provide a very brief literature review. Then give a brief introduction to the case report with clear explanation of the topic to be discussed. End with a very short statement of what is being reported in the case presentation. Be concise. Have enough information to interest the reader but not so much that you would skip reading the entire article.
  • Case presentation: This is the story; provide all the details of the case. Include birth history/maternal history as appropriate for the case, followed by presenting signs and symptoms, initial workup, treatment, and interventions. If many systems are involved, you might want to break up the presentation into subsections. Tell this part of the story in a concise manner and in a chronological order. Include physical examination(s), vital signs, studies, and results. Include medical and social collaboration and referrals. Be sure to stay close to the theme presented without straying or adding confusing information not relevant to the case/diagnosis.
  • Discussion: Here you can include the related anatomy/physiology or pathophysiology and compare/contrast this case with what is known in the current literature. You should also discuss the impact of the knowledge gained in this case to the field of nursing? How can this knowledge change practice in the neonatal intensive care unit and what family considerations should be addressed? Are there special considerations for discharge and follow-up, and/or recommendations for community resources? Finally, include any teaching points for both the nursing staff and the family.
  • Conclusion: Summarize the main conclusions and the primary and significant findings and clearly state their importance and relevance. Emphasize the clinical significance. Answer, how will knowledge of this case advance practice? Define and state clearly the take-home messages, and incorporate the heart and passion for your story into the final ending.
  • The family perspective (optional): If the family is available and willing, allow them to share their point of view/experience. Give a voice to the patient/family side and let the family tell the story.

Once you have put together your entire story, review it according to the rule of “C's.” Is it clear, concise, coherent, compassionate, and competent? Then ask a trusted colleague to read it and give you feedback.

As a nurse you have the opportunity to care for one patient at a time. I encourage you to tell one story at a time. Speak for our littlest patients who do not yet have a voice to share their own story. Be their voice. I hope that this year you will find the courage to consider “something [you are] a little not ready to do.”

Here in Advances in Neonatal Care, we have the opportunity to share a story in the Case of the Month section. I encourage you to be the storyteller. I encourage you to push through.

Elizabeth Schierholz, MSN, NNP-BC

Guest Editor; Advances in Neonatal Care

Debra Brandon, PhD, RN, CCNS, FAAN

Co-Editor; Advances in Neonatal Care

Jacqueline M. McGrath, PhD, RN, FNAP, FAAN

Co-Editor; Advances in Neonatal Care


1. Hoare R. Marissa Mayer: six lessons from Yahoo CEO. CNN. Published 2012.
© 2016 by The National Association of Neonatal Nurses