“Try Not To, As Often As You Can”: The Word Curmudgeon Waxes Acrimonious on Acronyms

A word curmudgeon would have nothing against which to curmudge if writers stopped coming up with newer and stranger ways to say things.

Take the acronym (or initialism, which looks just like an acronym but doesn’t make a pronounceable “word”: HPV is an initialism; HIPAA is an acronym). Use too many acronyms in your article and the introductory paragraphs become de facto glossaries, which the reader will have to return to repeatedly in order to decipher the paper.

At AJN our rule on acronyms is try not to, as often as you can. (Put another way, that’s use as few as you can get away with.)

I separate acronyms and initialisms into the following categories, which I hope will be useful to anyone trying to submit an article to AJN:

Necessary
Example: CABG; coronary artery bypass graft (or grafting). You have to use the acronym in an article on, say, CABG, because spelling it out 20 times would be onerous and annoying—and it takes up too much column space.

Perfectly Acceptable
Example: ECG; electrocardiogram (or electrocardiograph or electrocardiography). Many articles that employ the term do so early and often, so it’s a handy little acronym. (Warning: make sure that once you’ve defined it—ECG can stand for a bunch of things—it has to keep that definition throughout your paper. It can’t mean electrocardiogram

[the strip of paper] in one sentence and electrocardiography [the recording of electrical activity in the heart] in another.) (Note: ECG should not be EKG, even though it’s commonly called that in the hospital; EKG comes from the German spelling: Elektrokardiogramm.)

If You Must
Example: CAD; coronary artery disease. There’s nothing wrong with CAD, per se, although it’s not necessary to use the initialism if you don’t repeat the phrase a lot. Don’t use abbreviations for the sake of using them. (You know who you are.)

Please No
Example 1: BP; blood pressure. Yes, it’s ubiquitous in clinical practice—and in some journals—but it’s not part of AJN style, being not as scholarly and sophisticated as “blood pressure.” (Of course, that’s a matter of opinion, but it’s my opinion, and I wrote the style guide. Sorry. Call me a snob. I certainly do.)

Example 2: PHI; protected health information. It’s apparently used in the context of the Health Insurance Portability and Accountability Act. But how many nurses are going to know it—or use it without blushing? (“It’s a HIPAA thing,” she stammered, looking at the floor. “You wouldn’t understand . . .”).

Ridiculous
Researchers jump through hoops to extract an acronym from an interminable study name. Many of those could fit into this category (ridiculous), although some of them actually work (APACHE II, for instance: Acute Physiology and Chronic Health Evaluation II), but let me give you my absolute favorite ridiculous study-name acronym:

The Epidemiologic International Day for the Evaluation of Patients at Risk for Venous Thromboembolism in the Acute Hospital Care Setting.

Its acronym? ENDORSE.

How humiliating. I’ve tried (really) to figure out where they got that: Epidemiologic iNternational Day for the evaluation Of patients at Risk for venous thromboembolism in the acute hospital care SEtting?

I suppose it’s better than EIDEPRVTAHCS.

(What about EIDERVAC? At least it sounds like something!)

Stupid
Example 1: IB; ibuprofen.
Example 2: TB; tuberculosis.
My favorite, the stupid acronym. Any acronym or initialism that has to stop in the middle of a word to create itself should just be ashamed. What were the makers of Motrin IB thinking? It sounds impressive, until you realize that IB stands for ibuprofen. Get it? That’s IBuprofen. (Please shoot me.) And yes, tuberculosis has been known as TB for decades. Everyone calls it that. TuBerculosis. And when I was a kid, it was even stupider. They told us (and I’m sure “they” were school nurses) that TB stood for Tickle Bubble, as in the skin-prick test that neither tickled nor (in my case) bubbled. Being a term used commonly inside health care and out doesn’t keep “TB” from being stupid. Remember the tow truck character, Mater, in the movie Cars, when he explains how his name is pronounced? “It’s like ‘tomater,’ without the ‘tuh.’” TB stands for “tuh” and “ber.” There’s no earthly reason for them to be the initialism.

Or maybe I’m splitting tubers.

—The Word Curmudgeon (Doug Brandt, AJN associate editor) provides occasional and crusty contemplations for the writing nurse, from a copyeditor’s perspective.