As a speech pathologist with six years of nursing experience, I found there wasn't much support from the speech pathology field when I first developed an interest in dysphagia in the mid-1980s. Speech pathologists have since contributed immensely to the research, literature, and clinical practice of dysphagia, but our success in managing patients with dysphagia still relies heavily on the nursing staff.

One source of the speech pathologists' ongoing frustration is the lack of adherence to our recommendations on the part of the nursing staff. Adherence is an important concern-failure to follow instructions, whether they be for diet modifications or swallowing techniques, may lead to aspiration pneumonia and its sequelae, which are aptly depicted in Toni J. Galvan's comprehensive article, "Dysphagia: Going Down and Staying Down" (January). All staff members feel pressured by time constraints and by the demand for increased productivity and often say there just isn't enough time to communicate with one another. But we can't afford not to communicate. Patients suffer for this lack of communication with prolonged hospital stays and avoidable complications.

Sharing our knowledge in articles such as Galvan's is a valuable way of meeting the educational needs of nurses. Please continue to explore topics that overlap disciplines.

Mary Spremulli, MA, CCC/SLP

Punta Gorda, FL

Section Description

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