Key Takeaways
- Commas separate items in a list, after introductory elements, before conjunctions in compound sentences, and around non-essential clauses
- Semicolons connect two closely related independent clauses without a conjunction
- Colons introduce lists, explanations, or elaborations after an independent clause
- Apostrophes show possession (nurse's) or contraction (don't); they are never used to form plurals
- A sentence fragment lacks a subject, verb, or complete thought; a run-on sentence joins independent clauses without proper punctuation
- Independent clauses contain a subject and verb and express a complete thought; dependent clauses cannot stand alone
- Parallel structure requires that items in a series use the same grammatical form
- Misplaced and dangling modifiers create confusion by not clearly connecting to the word they modify
Punctuation & Sentence Structure
Proper punctuation ensures clarity in written communication. In nursing, a misplaced comma or an ambiguous sentence can lead to errors in patient care.
Comma Rules
| Rule | Example |
|---|---|
| Items in a series | "Check the patient's pulse, blood pressure, and temperature." |
| After introductory elements | "Before administering the medication, verify the patient's identity." |
| Before a conjunction in a compound sentence | "The patient was alert, but she was in moderate pain." |
| Around non-essential (parenthetical) information | "Dr. Smith, the chief surgeon, performed the operation." |
| Between coordinate adjectives | "The patient had a high, persistent fever." |
| After transitional words | "However, the test results were inconclusive." |
Common Comma Errors:
- Comma splice: Joining two independent clauses with only a comma (incorrect)
- Wrong: "The patient was stable, she was discharged."
- Right: "The patient was stable, so she was discharged."
- Right: "The patient was stable; she was discharged."
Semicolons
Semicolons have two main uses:
-
Connect two closely related independent clauses (without a conjunction):
- "The patient's fever broke; his vital signs returned to normal."
-
Separate items in a list when the items contain commas:
- "The conference attendees came from Houston, Texas; Portland, Oregon; and Miami, Florida."
Colons
Use a colon after an independent clause to introduce:
- A list: "The nurse checked three things: pulse, respiration, and blood pressure."
- An explanation: "There was one problem: the patient was allergic to penicillin."
- A quotation: "The doctor stated: 'The patient needs immediate surgery.'"
Rule: The clause before the colon must be a complete sentence.
Apostrophes
| Use | Rule | Example |
|---|---|---|
| Possession (singular) | Add 's | "the nurse's station" |
| Possession (plural ending in s) | Add ' | "the nurses' lounge" |
| Possession (plural not ending in s) | Add 's | "the children's ward" |
| Contractions | Replace omitted letters | "don't" (do not), "it's" (it is) |
| NOT for plurals | Never use to make a word plural | "The nurses are here" (NOT "nurse's") |
Common Confusion:
- it's = it is ("It's important to wash hands")
- its = possessive ("The hospital updated its policy")
- your = possessive ("Your shift starts at 7 AM")
- you're = you are ("You're responsible for this patient")
Additional Commonly Confused Words in Healthcare
| Pair | Definitions | Correct Usage |
|---|---|---|
| than / then | than = comparison; then = time/sequence | "The patient's BP is higher than yesterday." / "Check the pulse, then document it." |
| accept / except | accept = to receive; except = to exclude | "The ER will accept the transfer." / "All labs are normal except potassium." |
| who's / whose | who's = who is; whose = possessive | "Who's the attending physician?" / "Whose chart is this?" |
| there / their / they're | there = place; their = possessive; they're = they are | "The supplies are over there." / "Their vitals are stable." / "They're ready for discharge." |
| compliment / complement | compliment = praise; complement = to complete | "She received a compliment on her care." / "The medications complement each other." |
| principle / principal | principle = rule/belief; principal = main/chief | "The principle of non-maleficence." / "The principal concern is infection." |
| stationary / stationery | stationary = not moving; stationery = writing materials | "The patient remained stationary." / "Order new stationery for the nurses' station." |
| conscious / conscience | conscious = awake/aware; conscience = moral sense | "The patient is conscious and alert." / "Follow your conscience in ethical dilemmas." |
Sentence Structure
Types of Sentences
| Type | Structure | Example |
|---|---|---|
| Simple | One independent clause | "The nurse administered the medication." |
| Compound | Two independent clauses joined by a conjunction or semicolon | "The nurse assessed the patient, and she documented the findings." |
| Complex | One independent + one dependent clause | "Although the patient was stable, the nurse continued monitoring." |
| Compound-Complex | Two independent + one dependent clause | "When the alarm sounded, the nurse rushed to the room, and the doctor followed." |
Common Sentence Errors
1. Sentence Fragment: Missing a subject, verb, or complete thought.
- Fragment: "Running down the hallway to the emergency room."
- Correct: "The nurse was running down the hallway to the emergency room."
2. Run-on Sentence: Two independent clauses joined without proper punctuation.
- Run-on: "The patient was stable she was discharged the next morning."
- Correct: "The patient was stable, and she was discharged the next morning."
3. Parallel Structure: Items in a series must use the same grammatical form.
- Incorrect: "The nurse enjoys assessing patients, to educate families, and documentation."
- Correct: "The nurse enjoys assessing patients, educating families, and documenting care."
4. Misplaced Modifier: A modifier placed too far from the word it describes.
- Misplaced: "The nurse treated the patient wearing sterile gloves." (Who wore gloves?)
- Correct: "Wearing sterile gloves, the nurse treated the patient."
5. Dangling Modifier: A modifier with no clear subject.
- Dangling: "After reviewing the chart, the medication was administered."
- Correct: "After reviewing the chart, the nurse administered the medication."
Clauses and Phrases
Understanding the difference between clauses and phrases is essential for sentence analysis:
Clause = a group of words with a subject AND a verb
- Independent clause — can stand alone as a sentence: "The patient was stable."
- Dependent clause — cannot stand alone; begins with a subordinating conjunction: "Although the patient was stable..." (needs more to complete the thought)
Common subordinating conjunctions: although, because, since, if, when, while, after, before, until, unless, even though
Phrase = a group of words WITHOUT a subject-verb combination
- Prepositional phrase: "in the hospital," "after the surgery," "under the bed"
- Participial phrase: "Running quickly, the nurse reached the patient."
- Infinitive phrase: "to administer the medication"
Direct and Indirect Objects
| Element | Definition | Example |
|---|---|---|
| Subject | Who/what performs the action | "The nurse gave the patient medication." |
| Verb | The action | "The nurse gave the patient medication." |
| Direct object | What receives the action directly | "The nurse gave the patient medication." |
| Indirect object | Who/what receives the direct object | "The nurse gave the patient medication." |
Tip: To find the direct object, ask "What?" after the verb. To find the indirect object, ask "To whom?" or "For whom?"
Which sentence is punctuated correctly?
Which sentence contains a dangling modifier?
Select the sentence with correct parallel structure.
Choose the correct use of the apostrophe.
A sentence that joins two independent clauses with only a comma (no conjunction) is called a comma _____.
Type your answer below
Which word correctly completes this sentence: "_____ important to follow the medication schedule."
Identify the sentence fragment.