1. Aquino-Maneja, Emma MED, RN, CCRN
  2. Gilliam, Tashina BSN, RN, CGRN
  3. Smith, Linda S. PhD, MS, RN, CLNC

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Flu doesn't discriminate

A flu fatality struck close to home when one of our organization's senior leaders lost a close friend to influenza. This was a young, healthy individual who had no known comorbidities. The incident was a grim reminder that the flu doesn't discriminate.


I believe all nurses should get vaccinated. The CDC estimated that the flu vaccination compliance rate among healthcare workers last season was 66.7%. The most commonly cited reasons were fear of adverse reactions and disbelief in vaccine efficacy.1 As members of the healthcare profession, nurses must make a concerted effort to discern flu facts from myths, using the CDC website cited below as a resource.


Nurses are morally bound by the Nursing Code of Ethics to uphold our patients' safety at all times.2 During an airplane emergency, passengers are urged to put on their own oxygen mask first before helping others. Similarly, as healthcare professionals, we must protect ourselves first by getting vaccinated to safeguard our patients' well-being. There's no better way to demonstrate our commitment to patient safety than to lead by example.




Los Angeles, Calif.



1. Centers for Disease Control and Prevention. Influenza vaccination coverage. 2017. [Context Link]


2. American Nurses Association. The code of ethics for nurses with interpretative statements. 2014. [Context Link]


Peroral endoscopic myotomy

In "Patients with Esophageal Achalasia: Keeping Them Safe" (Patient Safety, May 2017), the author didn't address peroral endoscopic myotomy (POEM) as a treatment option. Performed only by advanced endoscopists, POEM is an endoscopic equivalent of surgical myotomy.1 I work on a unit where we perform POEMs weekly. This treatment is becoming more common, and soon nurses will encounter more patients with achalasia who've undergone this procedure.




Baldwin, N.Y.



1. Friedel D, Modayil R, Iqbal S, Grendell JH, Stavropoulos SN. Per-oral endoscopic myotomy for achalasia: an American perspective. World J Gastrointest Endosc. 2013;5(9):420-427. [Context Link]


The author responds: Thank you for this thoughtful letter, which supports my impression that esophageal achalasia is more common than statistics seem to demonstrate. In my article, I identified surgical myotomy as a treatment option for some patients meeting established criteria, but the patient in this case wasn't a candidate. As a kind of hybrid myotomy procedure, POEM is the newest and least studied invasive treatment option for esophageal achalasia.1 Access to a skilled endoscopist qualified to perform POEM isn't guaranteed, and research evidence to support the procedure is pending.2




Horseshoe Bend, Ark.



1. Pandolfino JE, Gawron AJ. Achalasia: a systematic review. JAMA. 2015;313(18):1841-1852. [Context Link]


2. Spechler SJ. Patient education: achalasia (beyond the basics). Up To Date. 2016. [Context Link]