No matter what type of writing that you do, whether you are writing an essay in a nursing class or an essay for a literature class, it has a main topic. In college level writing, most professors agree that this topic should be expressed in a thesis sentence. The thesis is a very important part of an essay because it summarizes what you have in mind for this essay and guides the reader in reading your essay accurately.
What a thesis IS:
- It is a claim (not a fact) that can be supported by a reason or reasons;
- It directly answers the question of the assignment;
- It is a statement that unifies the paper by stating the writer's most important or significant point regarding the topic;
- It is usually one sentence that does not discuss many topics;
- It forecasts the content and order of the essay;
- It is placed most often in the beginning of the essay, preferably towards the end of the introduction, but at least within the first or second paragraph; and
- It is sometimes – but rarely – implied rather than stated outright.
Developing Your Thesis
Now that we know what a strong thesis statement is, we can begin to craft one of our own. Most effective thesis statements often answer these three questions:
- What is the essay’s subject?
- What is the main idea that will be discussed about the topic?
- What is the evidence or support that will be used to support the main idea?
Let’s suppose that I want to write an essay about playing sports. I might begin with a sentence like this:
Playing sports is really good for people.
This is a good start because it does express my position without announcing it; unfortunately, it is vague and general and therefore ineffective. It is not all that exciting for my reader, and it leaves my audience too many unanswered questions. WHY is playing sports good for people? HOW does playing sports benefit people? WHICH people benefit from playing sports? Asking questions about the topic is a great way to find more specific information to include in my thesis.
Let’s suppose now that after asking these questions, I’ve decided I want to narrow my topic into children and sports. I might next have a thesis like this:
Playing sports is really good for children.
Now my thesis is more specific, but I still haven’t really answered the WHY and HOW questions. Maybe I think that playing sports helps children develop better cooperation skills, better coordination, and better overall health. I might have a thesis that ends up like this:
Playing sports is beneficial for children because it helps them develop better cooperation skills, better coordination, and better overall health.
Notice that I have beefed up my vocabulary a bit by changing “really good” to “beneficial.” For help with specific vocabulary, check out the Using Precise Language page.
Notice that I also now have the three major elements of a thesis statement:
1) A subject: playing sports
2) A main idea: playing sports is beneficial for children
3) Support or Evidence: better cooperation, better coordination, and better overall health.
Most effective thesis statements contain this type of structure, often called an action plan or plan of development. This is such an effective type of thesis because it clearly tells the reader what is going to be discussed; it also helps the writer stay focused and organized. How can you now use this pattern to create an effective thesis statement?
Remember, this is not the only type of effective thesis statement, but using this pattern is helpful if you are having difficulty creating your thesis and staying organized in your writing.
What a thesis is NOT:
- A thesis is not an announcement.
Example: I am going to tell you the importance of ABC.
I don’t need the announcement element of this thesis. I can simply write, “The importance of ABC is XYZ.”
- A thesis is not introduced by an opinion phrase such as I think, I feel, I believe.
Example: I feel that good hygiene begins with the basics of effective hand-washing.
I don’t need to write that “I feel” this because if I am writing it, then chances are that I feel it, right?
- A thesis is not a statement of fact.
Example: George Will writes about economic equality in the United States.
Discussing a statement of fact is extremely difficult. How will I continue the discussion of something that cannot be disputed? It can easily be proven that George Will did in fact write about equality in the United States, so I don’t really have a strong position because it is simply a fact.
- A thesis is not a question.
Example: What makes a photograph so significant?
Remember, a thesis states your position on your topic. A question cannot state anything because it is not a statement. A question is a great lead in to a thesis, but it can’t be the thesis.
Example 5: George Will writes, “Economic equality is good for the United States.”
This quote tells us George Will’s position, but it does not clearly express my position. It therefore can’t be my thesis.
We will identify a subset of ESI 3 patients that will be affected by this strategy. This subset will include patients (1) whose chief complaint is any of the following: abdominal pain, vaginal bleeding, pregnancy complication, vomiting, flank pain, or headache; (2) those who meet predefined criteria; and (3) those who arrive to the emergency department (ED) Monday through Friday between 4 p.m. and 11 p.m.
We plan a two-step process for expediting care for ESI 3 patients. The first step is to add a physician to triage Monday through Friday between 4 p.m. and midnight (stretch will be extra hours and 7 days if possible). The subset of ESI 3 triaged patients will be referred directly to the physician in triage who will begin the evaluation of the patient and order appropriate tests. The second step is to utilize the ambulatory surgery unit (ASU) (which is one floor above the ED) as the ESI 3 patient district (mid-track). Here a nonphysician provider (NPP) will receive the patients and coordinate their care with the physician in triage.
To implement this strategy, we first had to identify an area of the ED that we could assign as the mid-track. We attempted to do this within the ED by reassigning one of the four geographic districts. However, the other districts were quickly overwhelmed with ESI level 1 and level 2 patients, and a disproportionate amount of acuity was being handled by the remaining three districts. This resulted in a number of complaints from the staff, and we terminated the pilot after the initial 1-month period. However, we needed to identify another space to house mid-track.
The ASU is directly above the ED, proximate to the ED staff and our radiology services. This area has operations between 6 a.m. and 6 p.m., with a significant decrease in census at 4 p.m. We approached administration, and approval was obtained to use this area after 4 p.m., with certain caveats:
- We would only occupy one area of the ASU from 4 p.m. through midnight. The other areas would continue to operate, and some areas would be prepped for the next operating day and left undisturbed.
- Housekeeping had to be involved and would be responsible for cleaning the area used by the ED once we left the ASU after midnight.
- The ED would be responsible for bringing up supplies needed for our patients.
- The ED purchased 12 reclining hospital chairs for our patients to use. No stretchers would be used for this project, as we felt patients needed to be ambulatory to qualify for care in this location.
- The ED identified nursing staff and clinical staff to supervise the patients. We identified the nurse practitioners as the ones to supervise the patients and LPNs to assist them. All care would be coordinated with the physician in triage.
- Security had to be involved. We placed security personnel on scene in the ASU during the 8 hours of operation. This was done only as a precautionary measure.
- A protocol had to be developed to identify what types of patients would be best suited for care in this environment. It would also dictate the time of day that new patients would no longer be transferred to the ASU, as well as the procedure for transferring existing ED patients in the ASU back to the ED when the ASU-ED project ended for the day (at midnight).
- The medical staff had to be informed that patients might be in this area, as this was a new protocol. This could be accomplished at general staff meetings and via notices and letters.
- The ED attending staff had to familiarize themselves with the protocol and the details outlining the expectations for patient selection as well as hand-off of patients that straddled shifts. This process of education for the ED attending physicians as well as the ED staff was expected to take several months.
- Once the project was started, feedback would be requested constantly and data reviewed. Protocol adjustments could be made based on this feedback process.
We also had to identify a location within triage that the physician could occupy. We have five triage bays, and one is currently used for performing EKGs. This bay will be used for the physician. It contains a computer for documentation and an exam table/stretcher for evaluations. The physician in triage would only see a patient after the triage nurse assessed the patient and determined that the patient qualified for care under this new protocol. The physician would have the right to reassign the patient to the main ED if he or she felt that the severity of illness warranted it.
Conceptually, we realized that adding more space would not necessarily address the core problem: inpatients occupying ED beds and increasing the throughput times for all ED patients. However, given our options, this approach seemed to allow us to address the issue with expediency, while simultaneously developing programs to address the inpatient aspect of the throughput issue.