To the Editors:

I am the nurse manager of an 18-bed MSICU at Morton Plant Hospital in Clearwater, Florida. I loved your editorial “Dying by Irreconcilable Numbers.” We work closely with a group of intensivists, and we are doing many of the things described in your article as “clear opportunities for safety improvement,” such as early enteral nutrition and the use of ultrasound guidance for cardiovascular line insertions. One thing we are not familiar with is the “continuous aspiration of subglottic secretions to prevent VAP [ventilator-associated pneumonia].” Could you please provide a reference article for us to explore this?

I also believe it is part of our obligation to make nursing more attractive. My unit has a very low turnover rate and rarely has a vacancy. I am proud of my team members, who have worked together to make our unit an attractive workplace—I only wish others would take our...

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