Final Grammar Pass on a Warfarin Discharge Handout
You are the nurse educator at a 210-bed community hospital, doing the final grammar and usage pass on a one-page warfarin discharge handout for the cardiology unit. The clinical content has already been approved by the unit manager, a pharmacist, and two staff nurses; only the wording is yours to change. The draft was written by a new graduate who is strong on detail but shaky on agreement, so you have flagged three sentences to review. Printing is scheduled for Friday at 5 p.m. The vendor charges $85 per revision cycle, and the unit has already used two of its three allowed cycles this quarter, so whatever list you send now must be complete. You also agreed to explain each correction in the margin so the graduate learns from it. The handout must stay near a sixth-grade reading level, which means you cannot fix a problem by adding long clauses or extra words.
1. The draft reads: "Each of the patients receive a copy of the handout at discharge, and the nursing staff distribute them at the follow-up clinic." Identify every agreement problem, rewrite the sentence, and explain the rule behind each fix in terms the new graduate can apply elsewhere.
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Two agreement errors, one in each clause.
- "Each of the patients receive" → "Each of the patients receives." The subject is each, a singular indefinite pronoun. Of the patients is a prepositional phrase and cannot change the number of the verb. The same rule governs every one, either, neither, anybody, someone.
- "the nursing staff distribute" → "the nursing staff distributes." Staff is a collective noun. In American English it takes a singular verb when the group acts as one body, which is what happens here - one clinic, one practice, one handout.
- Optional clarity fix: them has a fuzzy antecedent. It means copies, not patients. Because the handout is patient-facing, replace them with copies.
Revised: "Each of the patients receives a copy of the handout at discharge, and the nursing staff distributes copies at the follow-up clinic."
Test to teach: cover the prepositional phrase with your finger and read the sentence again. "Each receive" and "staff distribute" both fail the ear test, which is exactly why the phrase must be ignored.
2. A second sentence reads: "A number of patients on the unit has asked about bruising; the number of questions have increased since the new dosing protocol." Explain what is wrong and supply the corrected sentence.
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A number of and the number of look alike but invert the subject.
- "A number of patients ... has asked" → "have asked." In the idiom a number of + plural noun, the true subject is the plural noun, so the verb is plural. Meaning: several patients.
- "The number of questions have increased" → "has increased." Here number itself is the subject and means a count, so it is singular; of questions is only a prepositional phrase.
Memory hook: a number of = many (plural); the number of = the total (singular). The same logic governs a variety of (plural) versus the variety of (singular), and a percentage of, which takes its number from the noun after of.
Revised: "A number of patients on the unit have asked about bruising; the number of questions has increased since the new dosing protocol."
Note the semicolon is correct as written: it joins two independent clauses that are closely related but not joined by a conjunction.
3. A third sentence reads: "Neither the pharmacist nor the nurses has reviewed the final draft, and there is three dosing tables that still need verification." Fix it and explain both rules.
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Two agreement traps, both resolved by finding the real subject.
- "Neither the pharmacist nor the nurses has reviewed" → "have reviewed." With neither ... nor, the verb agrees with the subject closer to it. Nurses is plural, so the verb is plural. Had the sentence read Neither the nurses nor the pharmacist, the singular has would have been correct.
- "there is three dosing tables" → "there are three dosing tables." In a there sentence the subject follows the verb - three dosing tables - so the verb is plural. Writers match the verb to there out of habit; don't.
Revised: "Neither the pharmacist nor the nurses have reviewed the final draft, and there are three dosing tables that still need verification."
Rule to leave in the margin: locate the subject, ignore everything between it and the verb, and match number. Then check that it stays fixed when a phrase is moved.