Monday, September 24, 2018

Interview with an Editor...Welcome to Nicole, D'Arienzo--The Wild Rose Press


Interview with an Editor…Image result for nicole d'arienzo



Welcome to Nicole D’Arienzo, senior historical editor for The Wild Rose Press! So glad you could take some time out to answer these questions and tell us about the life of an editor.

So first tell us about you and how you got into editing?
 Hmmm …I honestly don’t remember. I had a lot of positive feedback from judging contests and a lot of really nice thank you notes telling me that the way I explained things made sense for the first time, or they appreciated my gentle touch in making suggestions.  When TWRP was just starting out and looking for editors, it seemed like a good fit.  It just sort of fell into place.  Of course, it helps when your sister is the co-owner of the company and you are the only person she knows who knows anything about historical romance LOL.  I honestly only came on board to help set things up and get the department going.  I fully intended to return my focus to my own writing.  It’s been twelve years and I’ve yet to do that!

Do you write as well? (We can post your books covers and links if you want? Your choice whether or not you want to answer this one.)
Yes. I write as Nicole McCaffrey and am published with TWRP. I don’t get much time to work on my own writing these days, but I have five books out with them. 

Tell us why you enjoy editing historical stories and do you edit other genres?
I have edited—and still do edit-- other genres, but I have always been a student of history, have always been fascinated by the way the past shapes the future.  And who doesn’t love the romantic image of the Old South, the adventure of the Old West or those elegant Lords and Ladies of the Ton?  That’s my kind of escape from the busy lives we all lead.

What do your editing duties with The Wild Rose Press encompass? (What is the typical day in the life of an editor?)
Once I land at my desk for the day there are emails to answer, of course.  New queries to be reviewed and assigned, contract requests from the editors who work with me to review and approve (or not 😊 ) and then there are emails from the authors I work with, returned edits, or blurb changes etc.  And somewhere in there I still need to edit! LOL.  I’ve gotten very good at compartmentalizing my day, certain times to answer emails, certain times to edit and so on. Otherwise my head would be spinning. 

What are the three tops things you look for in a query letter?
As I’m reading a query, three questions are going through my mind:

1) How serious about writing are you? This goes hand in hand with number two, but I’m looking for things like: published elsewhere, even if it’s self-published (that tells me you can finish a story—not every author can), how long you’ve been writing, etc.

2) What, if any, are your professional affiliations? (i.e., RWA, or other writing organizations. These aren’t necessary in order to be published with us, but if you belong to a group like this, chances are you are a step ahead of some of the other authors in my query inbox on any given morning. J )

3) Can you write? Yes, I am going to look at those sample pages we request and see what you can do!

Simply put, a professional query that follows our submission guidelines and contains minimal punctuation or typing errors is always a breath of fresh air. 
How many stories do you edit per month?
It varies.  Some months I schedule more projects than others. It all depends on the way things fall, if I have a lot of things wrapping up (i.e. galley stage, or near galley stage) I won’t schedule quite so much because I know I will need time to finalize those.  And sometimes authors return their edits later than planned, which necessitates moving things around in my schedule again, or I’m asked to work on a special project that I have to squeeze in somewhere.  So there really is no way to give it a set number. 

What are some of the things you look for right off to know a story is one you are interested in contracting 
That’s actually a two-part answer.  First of all, I’m looking for the basic writing mechanics—good control of viewpoint, active versus passive writing, showing rather than telling. Seeing that definitely gets my attention. 

But that’s not a guarantee the story won’t fall apart halfway through or that the hero or heroine won’t be so unlikeable our preliminary readers can’t relate to them or that the conflict doesn’t end in chapter four and the rest of the story is just filler.  We see these things all the time. 
 

Basically, if the story telling is great, I can work with the author on cleaning up the mechanics.  But if the mechanics are solid and they still can’t create characters or a story readers will care about, I’m not sure I can help with that.

So what are some of your pet peeves when reading a manuscript? Well since I’m an historical editor, I have to admit I hate it when authors try to get by without researching. For some reason they think if they skimp on details or are vague with descriptions, we won’t be able to tell they didn’t research adequately.  But it always shows.  I’m not saying you must go into full detail over every teeny tiny thing, but if you haven’t done your research… trust me, we can tell. 

What is the hardest thing about being an editor?
Probably when you have tried repeatedly to explain something to an author, like viewpoint or active writing and they ignore what you’ve said and continue to write the way they always have.  Sometimes they just don’t understand what it is you’re trying to help them learn. You want them to succeed, you want their “good” story to be “great”. But sometimes it just doesn’t happen.

What is the best thing about being an editor? 
The relationships I’ve developed with my authors over the years.    It’s wonderful to see their writing grow and change with each book and to see their confidence grow. Some authors I have more personal contact with than others, they share news about college graduations, weddings, the birth of a grandchild.  It’s wonderful to share those moments with them, even if only via Facebook or email.  After twelve years of this, we’ve been through a lot with some of our authors!

What advice would you have for seasoned authors submitting to The Wild Rose Press?
 To take time to learn from your edits.  If the edits in your last MS focused a lot on cleaning up passive writing or showing rather than telling, please make sure you’ve addressed that in your current MS before you submit.  I think there is a school of thought that “my editor will fix it” or that it needs to be submitted right away so you can get the ball rolling toward the next release.  In truth, the process goes much faster when you submit your cleanest possible work, it can be the difference between needing only one round of edits.  Or several. So, if your editor is giving you the same edits time after time with every story it’s probably a sign that you need to brush up on those areas.  And you will undoubtedly make her entire week if you address them in your next MS before submitting LOL. 

What advice can you give to aspiring writers?
couple of things. First, take the time to make a good first impression when submitting.  Be polite, be courteous and make sure you have checked our submission guidelines and followed them to the letter.  I’m amazed sometimes by the number of queries that lack the necessary details we require (detailed synopsis and first five pages of the MS.)  We see a lot of submissions from retirees and new writers and I must say, starting your email with “my son is sending this from his email account because I’m not so good with computers…” is probably not the best way to get my attention.  If you’re submitting to an electronic publisher, it’s probably best to brush up on your computer skills first. 
Second. Take your time.  Writing is a process we learn by doing, but it’s not something you can learn overnight.  The biggest mistake I see from new authors is being over eager.  We’ll send a nice rejection letting them know what they need to work on if they want to be published by TWRP, including links to articles, books on craft, etc. only to have the manuscript resubmitted in a matter of days, sometimes less than 24 hours. I can’t think of too many instances in the past twelve years where someone resubmitting a manuscript that fast actually focused on everything they needed to.  Rushing usually leads to a second rejection and, depending on how well the author did with the revisions, we may not ask to see it again. I promise, there is no expiration date on revising your manuscript after a rejection.  Take the time to be thorough.  The goal, after all, is not simply to be published, but to write a story readers will love.   

Saturday, September 1, 2018

Medical Writing








The last few months I have talked about the medications and injuries of the Old West but in order to bring this full circle for writers/authors I’ve got to go a bit more current or modern. First disclosure, I am not a doctor. Doctors and nurses think differently but are focused on the same goals. After 28 years in an acute care facility, it is easy to see the change in the relationship between physicians and highly skilled nurses. The docs rely on us a lot to help put together the picture that is going on with the patients. Still what is presented here will let you know that these kinds of injuries today can often result in death and even more so in your historical novels.





Nurses are no longer thought of as bedside hand maidens as they were back in the 1800’s and before. If your heart stops in the hospital, it isn’t the doctor doing what is needed. He is probably there shouting the orders, but it is the Registered Nurse who is pushing the medications. It is the Registered Nurse who is starting the IV and inserting an enterotrachial tube so you can breathe. It is the Registered Nurse who is monitoring your vital signs and it is a Registered Nurse who is monitoring the screens and equipment that tell how you are doing. But it is also the RN who is outside the room, holding your husband’s hand. It’s the RN who is the first one to hold your child once the physician passes off the bundle. It is the RN who sits with you when you are afraid and who offers you a smile when the diagnosis seems grim. You don’t know it but she had prayed for you, cried about your pain and researched hard to find the answers. She is the one who says you can do this during your recovery. She is the one who cheers you when you reach even the small goals and she might ever be the only one there when you take your last breath. She cried then too, but there is reward in being a nurse and many of us have found that. That’s the pretty picture. Here is the reality. I have been hit, bitten, scratched, spit on, cursed, pee’d on, pooped on, shoved, degraded, badgered, threatened and that is just before lunch, but the good always seems to out weight the bad, like just one patient who really appreciates what you do.


But onto the writing medical things…
What I find when I am reading stories where characters are injured is that often times the medical information isn’t correct or isn’t what a nurse would say. I’ve also read a few where the medical position isn’t described as it really is. So first let me discuss the roles in a hospital beginning with nurses and techs. So I have several things I can cover.
Nurses Defined
Licensed practical nurses (LPNs)---licensed vocational nurses (LVNs)-Work under the direction of an RN and train most often in Technical Colleges, though a lot of these programs are being phased out. 
Registered Nurses-Usually a 4 year Bachelor’s of Science Degree from a college or university. Practice under physician orders, but most often independently.
Advanced Practice Nurses:
Nurse Anesthetists-(CRNA)-Nurses who train further to administer anesthesia. They often work under the orders of an Anesthesiologist but do practice independently.
Clinical Nurse Specialists-Often in Educator Roles, but this seems to be phasing out in most programs where Nurse practitioner programs are growing.
Nurse Practitioners-Work in a variety of specialties from offices to hospital setting and even public health. A degree higher and specialized such as geriatrics, family practice or emergency medicine. NP’s have prescriptive rights in most states and are highly paid in rural areas where doctors are not available.
Certified Nurse Midwives-Highly Trained to deliver babies under a physician’s guidance. Prescriptive rights also. 
Ancillary Nursing Staff:
Certified nursing assistant- Assists RNs and LPNs with vital signs and basic patient care from baths to potty help. This is obtained in six or eight month certificate programs, but they are not nurses.
Nurse Tech-Patient Care Tech-Often trained to do a little more than a CAN. For the most part candy stripers and orderlies are non-existence. There are also a large number of male nurses these days.
Orderlies and Candy stripers rarely exist any longer. There are transport teams to move patient from one place to another but most of those employed in the role have some medical training. The emergence of HIPAA laws on confidentiality had made it where you can no longer have as much access to medical facilities or patient information so be careful in writing what is happening to your characters on what may be told over the phone or what may be seen or done while in a medical facility.



Other Roles in the Hospital:
Physician Assistants-Trained to work alongside a physician, making rounds and even assisting with orders and the plans for patient care. Highly skilled.
Hospitalists/Internists-Hospitalists are hired physicians that work on staff to monitor patients within the hospital. Internists specialize in the care of ICU patients.
Anesthesiologist-Administer Anesthesia for surgery cases and or pain blocks such as epidurals.  
Pharmacists-Specialize in measuring and mixing medications that are ordered for patients.
A note to writers: Not all docs are rich, some have a years of student loans to pay back and others pay dearly for the required malpractice insurance. For example the insurance for an OB/GYN physician can be in excess of 150,000 a year. Today’s physicians often work in large group offices and time is money. Physicians do not typically work for the hospital but have privileges to admit and treat their patients. A lot of people think the doctor works for the hospital.
Emergency Medical Technicians (EMTs) and Paramedics-Most often are firemen with advanced training for responding to accidents and injuries outside medical facilities. EMT do first aid type care and emergency care, but paramedics are trained to push medications in the field and are highly skilled.
Medical Assistants (MA). Trained to run the front and back offices or clinics. Can draw blood and also run the billing of an office for example.
Occupational Therapists—Work to assist for instance stroke patient to regain functional use of limbs at least to be able to perform the activities of daily living.
Physical Therapists—Assist with regaining full use of injuries, to help relieve pain, to assist patients who have been bedridden to get up and about again after surgery, plus much much more.
Speech-Language Pathologists-Assist with feeding issues and regaining speech after stroke or other injuring.
Most people in these positions are happy to allow an interview of what they do on a day to day basis. HIPAA laws sometimes limit shadowing experiences, but most will answer phone interview questions or meet away from actual patients. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal law that requires employers to protect employee medical records as confidential. HIPAA includes regulations that cover how employers must protect employees’ medical privacy rights and the privacy of their health information. Tis law also means that staff do not discuss patient information over the phone except to give a basic condition: Stable, critical etc.
Even if you are not writing medical romance, your hero or heroine may be injured and often times the care or the scenes are not described correctly. Do your research! Interview your doctor or a nurse friend.
Writer Tips: Remember a couple of things. Your hero is not going to bounce back from some of these injuries very quickly. Don’t give him a concussion and fractured ribs and then have him making love the next day or in the next chapter.  Broken bones can take 8 or more weeks to heal and it isn’t likely he’ll feel up to it for a while even if he is a Scottish Highlander or Hot Cowboy.
Vital signs are the first thing often checked on a injured patient, so let’s talk about the normals. Most searches for medical information will offer you similar parameters. There are all kind of medical websites offering free information. I have not listed any here because there are so many. My favorite book for research is the Merck Manual-. I lived with that in my hands as a nursing student and new nurse. It sits on my desk at work still. It runs from $50 to $75.00 but is well worth it.
And to understand the life of a nurse, Echo Herron wrote Intensive Care and Condition Critical. The first is the best example of how it was to survive nursing school and the later is how it is in the real world of nursing. Both are great reads.



So on to vital signs. I think a lot of writers have trouble describing vital signs in rescue scenes for instance.
Temperature: Normal is 98.6--Children can run a high fever up to 104, but at 104 the adult is really ill. Ice packs, not heavy blankets, but cooling blankets.
Pulse: Normal 60-90.  Describing Pulses: (Never check a pulse with your thumb-because you will count your own pulse and not the patients!)
Strong-normal rhythm
Bounding-unusually strong rhythm-running or the heart working hard

Thready-pulse beats are weak-losing blood or in shock

Irregular-does not have a regular beat, skipping beats-heart issues

Regular-regular rhythm- “The pulse is regular, 80”
Respirations: 12-20. Someone having an asthma attack might breath as rapidly as 60 breath a minute, but they are having symptoms. Audible wheezing etc. After a time of not getting in enough oxygen, the rate might begin to fall as you lose the person.
Blood Pressure:  Systolic (top number) 100-130    Diastolic (bottom number) 60-90. If someone is injured or in pain the blood pressure will initially rise, but if they continue in crisis or are losing blood and the loss isn’t stopped, the blood pressure will then fall. This is when you are losing the patient. The newest guidelines on blood pressures is systolic under 120 and diastolic under 80 or the patient is labeled pre-hypertensive.
Nursing Duties beyond Vital Signs: Coordinating and prioritizing multiple patients doses of daily medication which must be given within thirty minutes of the time due. This might involve by mouth pills and tablets, injections and Intravenous fluids. Follow the plan of care: Nursing Diagnosis and Assessment of each patient multiple times a shift, implementing nursing diagnosis, interventions and assessing outcomes. Record and document all necessary information, communicate with peers, subordinates, supervisors and other members of the healthcare team, research, follow legal and facility standards, teach patients, resolve issues, inspect and work equipment, maintain patient confidentiality.
Don’t forget that in history while many survived the injury, they often died of bleeding and infection some days later. Gunshot wounds-might have died right away, but many died days or even week later of infection/gangrene. Stabbings-some died right away but others might have developed infections that took them weeks to die from. Disease and illness-no antibiotics, but often herbal remedies and many died from the things we easily cure today. Writer Tips: Hand washing was a huge issue along with sanitation and cleanliness, often leading to infection if someone did survive the injury.

Stay Tuned next month for Emergencies then and now!