Punctuation:
●Its role in guiding readers through sentences, avoiding
ambiguity
●Importance in academic writing: precision & clarity
●Overuse and misuse can confuse readers and weaken
arguments
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The Period (.)
1.Where to use:
a.At the end of declarative sentences
b.After abbreviations (e.g., etc., i.e.)
2.How to use:
a.Full stop signals end of a thought
b.Use periods to separate sentences, avoiding
run-ons
3.When not to use:
a.After headings or titles in research papers
(usually no period)
4.Overuse:
a.Avoid sentence fragments; do not end
incomplete ideas with periods
b.Some journals prefer no periods (eg, ie)
follow style guide APA, AMA, Vancouver).
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The Period (.)
The Period(.) goes outside the quotation marks
➤ When the punctuation is not part of the
original quote.
?????? Examples:
●The method was described as “innovative”.
●She referred to it as “a turning point”.
●The paper called the findings “inconclusive”.
?????? Use this when quoting a word or short phrase not a
full sentence.
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The Period (.)
The Period(.) goes inside the quotation marks
➤ When the punctuation belongs to the original
quote (i.e. it's part of the sentence being quoted).
?????? Examples:
●He said, “We found no supporting evidence.”
●“The study was flawed,” the reviewer noted.
●According to the author, “This changes everything.”
?????? Use this when quoting a full sentence or direct speech.
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The Period (.)
Quoted Material Example Where’s the Period? Why?
Single word or phrase The theory was “rejected”.❌ Outside Not part of the quote
Full sentence She said, “That was a
mistake.”
✅ Inside Part of the quote
Short phrase He called it “outdated”. ❌ Outside Not a full sentence
Full direct statement “The results are
misleading.”
✅ Inside Full sentence being
quoted
Sentence with comma“We must act now,” he
said.
✅ Inside (comma) Part of the original
quote
Examples:
●The patient exhibited signs of infection.
●Vital signs were recorded every 2 hours.
●The study focuses on respiratory diseases, e.g.,
asthma, COPD.
●The data were collected from 120 patients.
●This was consistent with the findings of Sharma et al.
●Common causes included infections (e.g., sepsis,
pneumonia).
●Kumar et al. (2023) supported this finding.
Examples:
⚠ Common Mistakes:
●Writing et. al ❌ (Incorrect: dot after “et”)
●Overusing e.g. or i.e. — better to integrate examples
directly when possible.
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The Comma (,)
1.Where to use:
a.To separate items in a list
b.After introductory phrases
c.Before coordinating conjunctions (and, but, or) in
compound sentences
d.To set off non-essential information
2.How to use:
a.Break up complex sentences for clarity
b.Use serial comma (Oxford comma) in lists for precision,
e.g., nurses, doctors, and patients
3.When not to use:
a.Between subject and verb
b.Before dependent clauses that come after the main
clause
4.Common errors in nursing writing:
a.Misplaced commas can change meaning, e.g., “The
patient, who was ill, recovered.” vs. “The patient who
was ill recovered.”
Examples:
●The medications included antibiotics, antivirals, and
antifungals.
●After administering the drug, the nurse observed the
patient closely.
●The study included nurses, midwives, and
paramedics.
●After reviewing the case, the supervisor approved the
procedure.
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The Semicolon
(;)
1.Where to use:
a.To join two related independent clauses without a
conjunction
b.To separate items in a complex list that already contains
commas
2.How to use:
a.Use when ideas are closely linked but could stand as
sentences
3.When not to use:
a.Between dependent and independent clauses
⚠ Common Mistakes:
●Using a semicolon with conjunctions like and or but.
●Overuse instead of breaking into simpler sentences.
Examples:
●The nurse prepared the patient for surgery; the doctor
reviewed the procedure.
●The study included patients from New York, NY; Los
Angeles, CA; and Miami, FL.
●The nurse administered the medication; the patient
responded positively.
●Participants were from Nagpur, Maharashtra; Pune,
Maharashtra; and Bhopal, Madhya Pradesh.
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The Colon (:)
1.Where to use:
a.Before a list, explanation, or quotation
b.Introduces lists, explanations, or quotations.
c.After independent clauses only
d.The clause before the colon must be
complete.
e.Avoid using immediately after a verb or
preposition.
2.How to use:
a.Introduce examples or elaborations
3.When not to use:
a.After verbs or prepositions directly followed
by a list
Examples:
●The following factors were considered: age, medical history, and
lifestyle.
●The report concluded: “Further research is needed.”
●The study focused on three core areas: infection control, patient
safety, and documentation accuracy.
●The researcher concluded: “Further clinical trials are essential.”
⚠ Common Mistakes:
●Incorrect: The causes are: fatigue, poor lighting, and distraction.
●Correct: Three causes were identified: fatigue, poor lighting, and
distraction.
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The Apostrophe (ʼ)
1.Where to use:
a.To show possession
b.Shows possession (nurse’s chart,
patients’ feedback).
c.To form contractions (limited in academic
writing)
d.Avoid using contractions (e.g., doesn’t,
can’t) in academic writing.
2.How to use:
a.Singular possession: patient’s symptoms
b.Plural possession: patients’ records
3.When not to use:
a.Do not use apostrophes to make plurals
Examples:
●The nurse documented the patient’s response to
treatment.
●The doctors’ recommendations were incorporated into
the care plan.
●The nurse’s intervention reduced patient anxiety.
●The patients’ records were securely stored.
⚠ Common Mistakes:
●Apostrophes used in plurals: The nurse’s are trained. ❌
●Confusing its (possessive) vs. it’s (it is)
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Quotation Marks (“ ”)
1.Where to use:
a.To indicate direct quotations
b.To highlight specific terms or
phrases
2.How to use:
a.Use single quotes inside double
quotes if quoting within a quote
3.When not to use:
a.Avoid unnecessary quotation
marks for emphasis
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Quotation Marks (“ ”)
1.Used for direct quotes or when referring
to specific terms.
2.Follow correct punctuation placement: in
American English, periods and commas
go inside quotation marks.
3.Overusing quotes instead of paraphrasing
in academic writing, quotes should be
limited and well-integrated.
4.Misplacing punctuation outside the
quotation marks.
Examples:
●The patient reported feeling “dizzy and nauseous.”
●The term “evidence-based practice” is central to
nursing.
●The patient stated, “I feel dizzy after each dose.”
●The concept of “therapeutic communication” is key in
psychiatric nursing.
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Question Mark (?)
&
Exclamation Point (!)
Question Mark (?):
●Used only for direct questions — not suitable for rhetorical or informal
questions in formal papers.
✅ Example:
●What are the implications for long-term care in elderly patients with
diabetes?
Exclamation Point (!):
●Rarely, if ever, used in academic research writing.
●Seen as too emotional or informal.
●Acceptable only in direct quotations or very specific case descriptions
for urgency.
⚠ Nursing Example:
●The patient screamed, “Help me!” — only acceptable if quoting
verbatim.
Final Tips & Best Practices
●Use punctuation to clarify, not complicate.
●Avoid long, unpunctuated sentences.
●Each punctuation mark must serve a clear purpose.
●Re-read sentences aloud to check for natural pauses and
rhythm.
●Always proofread. Even small punctuation errors affect
credibility.
●Use journal-specific style guides (APA, AMA, Vancouver)
to stay consistent.