How to Write an Active Vs Passive Voice for Nursing

Nursing students must navigate a complex balance between clinical objectivity and professional accountability in their writing. Understanding when to use active versus passive voice is essential for clearly documenting patient care, discussing nursing theories, and presenting evidence-based practice findings.

What Is an Active Vs Passive Voice in Nursing?

In nursing, active voice emphasizes the person performing the action (the nurse or researcher), while passive voice emphasizes the recipient of the action (the patient or the data). While the American Psychological Association (APA) generally prefers active voice for clarity, nursing documentation and research often utilize passive voice to maintain a professional distance or focus on the patient's physiological response.

Before You Start

• Review the APA Style Manual guidelines on person-first language and verb tense.
• Identify if your assignment is a reflective journal, a clinical case study, or a research proposal.
• Clarify whether your instructor permits the use of first-person pronouns like 'I' or 'we'.
• Determine the primary focus of your sentence: is it the intervention performed or the patient's reaction?

Identify the Agent of Action

Before writing, decide who is performing the clinical task. If the nurse's decision-making is the focus, use active voice.

Example: Active: The nurse administered 5mg of Morphine IV to manage the patient's acute pain.

Tip: Use active voice when documenting specific nursing interventions to show accountability.

Use Passive Voice for Clinical Observations

When the nurse's identity is less important than the patient's state, passive voice can shift the focus appropriately.

Example: Passive: A significant decrease in oxygen saturation was noted during the physical therapy session.

Tip: Passive voice is useful in the 'Results' section of a capstone project to keep the focus on the data.

Apply Active Voice to Theoretical Frameworks

When discussing nursing theorists like Jean Watson or Dorothea Orem, use active voice to describe their conceptual contributions.

Example: Active: Watson's Theory of Human Caring emphasizes the transpersonal relationship between the nurse and the patient.

Tip: Active voice makes your theoretical analysis sound more authoritative and direct.

Transition to Passive for Standardized Procedures

If a procedure follows a universal protocol where the specific actor doesn't change the outcome, passive voice is acceptable.

Example: Passive: The surgical site was prepped with chlorhexidine according to hospital policy.

Tip: Use passive voice when describing routine hospital workflows that are standardized across the unit.

Strengthen Evidence-Based Practice Recommendations

When suggesting changes to clinical practice based on literature, use active voice to make your recommendations clear.

Example: Active: This paper recommends that pediatric units implement hourly rounding to reduce fall rates.

Tip: Active voice is more persuasive when you are trying to advocate for a change in nursing protocol.

Avoid the 'Bystander' Passive Voice in Ethics

In ethical reflections, avoid using passive voice to hide responsibility for clinical errors or omissions.

Example: Active: I failed to check the patient's wristband before medication administration (Correct) vs. Passive: The wristband was not checked (Incorrect/Evasive).

Tip: In reflective writing for clinical rotations, active voice demonstrates professional growth and self-awareness.

Check for 'To Be' Verbs as Red Flags

Scan your draft for excessive use of 'is', 'are', 'was', and 'were' followed by a past participle, which indicates passive voice.

Example: Passive: Blood cultures were collected by the technician. Active: The technician collected blood cultures.

Tip: Convert passive sentences to active when they make your nursing care plan unnecessarily wordy.

Common Mistakes to Avoid

• Using passive voice to avoid saying 'I' in reflective journals, leading to awkward phrasing.
• Overusing passive voice in the 'Nursing Diagnosis' section of a care plan, which obscures the 'related to' link.
• Switching voices inconsistently within the same paragraph of a literature review.
• Using passive voice for critical lab values, which can diminish the urgency of the clinical finding.
• Assuming that 'academic' always means 'passive', which leads to dry and difficult-to-read research papers.

Pro Tips

• Use active voice when writing about patient education to show the nurse's active role in teaching.
• Check the 'Journal of Advanced Nursing' author guidelines; they often specify a preference for active voice in abstracts.
• If the subject of your sentence is 'The Study' or 'The Evidence,' use active verbs like 'suggests' or 'indicates'.
• Read your clinical narratives out loud; if you can add 'by zombies' to the end of a sentence and it makes sense, it is passive voice.
• Reserve passive voice for instances where the perpetrator of an action is unknown, such as 'The patient was exposed to an unknown pathogen.'

Frequently Asked Questions

Is active voice allowed in APA nursing papers?

Yes, APA style actually encourages active voice because it is more direct and concise. It is particularly preferred when describing the actions of the researcher or the specific interventions performed in a clinical setting.

When should I use passive voice in a nursing case study?

Passive voice is appropriate when the person performing the action is irrelevant to the clinical outcome, such as when describing how a patient was admitted to the floor or how a diagnostic test was processed in the lab.

Can I use 'I' in a nursing research paper?

While traditional nursing research often used the third person, current APA guidelines allow for the use of 'I' or 'we' when describing steps you personally took in the research process to avoid the ambiguity of passive voice.

How does voice affect the word count of my nursing essay?

Active voice is generally more concise and uses fewer words than passive voice. If you are struggling with a strict word limit on a nursing care plan or discussion post, converting passive sentences to active can help save space.

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