Thursday, June 28, 2012

Fat Doctor. Fat Nurse. On Hospital Food--part 2

I recently began to follow a nutritionist on Twitter. I had just posted about hospital food trying to kill me when I was in the hospital. And I asked this expert if they had any ideas on how to make the food service in a hospital better from a nutrition perspective.

The response was shocking--'Hospital food is poison, just go look at the fat doctors and nurses eating Mc Donald's in the hospital'.

It was arrogant, dismissive, and completely without understanding for the situation most of our patients, doctors, nurses, technicians and other hospital employees are in. Coming from a teaching background, where I was a University professor for eight years, trained in the notion that 'there is no such thing as a dumb question', I felt extremely dumb after seeing help from this individual.

Like Nora Ephron's parents once said, "take your misfortunes and turn them into a story", I am sharing my story now with you.

First and foremost, anyone new to the working side of medicine needs to understand this: most of your caregivers are overworked, sleep-deprived, and hungry. Yes, we are in the business of health care, and in caring for our patients we are not exactly practicing what we preach.

When I was a medical student, I ate with the team. Surgeons tend to eat their meals in the gaps between cases. But while caring for patients on the floor, the interns sometimes go without. A colleague who was in internal medicine used to have soup for lunch because 'It was faster' (he could eat it while walking around taking care of patients). When I was in charge of the ICU and Burn Unit, the nurses would look the other way while I helped myself to ensure, because they knew that I was not able to eat due to my workload while taking care of patients. I did this so often, they showed me a way to make it more palatable: mix it with equal parts milk and pour it over ice. While I was on that service I lost twenty pounds.

After I changed specialties to anesthesiology, I was given a fifteen minute break in the morning, thirty minutes for lunch, and fifteen minutes in the afternoon to attend to my personal needs. This time was watched closely. I would get in trouble if I did not return promptly from my break. If the patient was unstable, or it no one was available to give me a break, it was understood that I would go without and not ask for a make up time since I was salary, not hourly, worker. Can you imagine the lines in the cafeteria? They are long. As a consequence, I learned to eat my meals as fast as possible. At a restaurant, I eat so much faster than friends and family, that it is embarrassing to me when they point it out.

These breaks went away once I graduated from the training program. Now I eat in the gaps between surgery cases in the O.R. But when work is busy, or I have a pushy surgeon who will not begrudge me the ten minutes it takes to buy and eat a sandwich, I do not get to eat.

Everyone knows that hungry people tend to make unhealthy food choices, and overeat.  I find in the hospital, the thought about mealtimes is eat while you have the chance because you do not know when the next chance will be. I actually pack my lunch of organic, wholesome food even though I do not have to. Doctors at my hospital have access to hospital food at discounted rate. But I find my own food is faster. I don't have to run to the cafeteria. It saves time. And I feel better, too.

I think hospital workers are Innocent bystanders in the Hospital Food Conspiracy. We are a captive audience. Where else to go?  When there is time, we escape to Fast Food. One of the staff will make a food run and usually the doctor on call will treat. Many times, the food that is served at dinner in the cafeteria has been on the steam trays since lunch and is unappetizing. (I also do not eat any of the chicken dishes, because the chicken is of low quality and I suspect full of hormones and antibiotics. The same is true for beef and pork, and most of the fish that is served.)

Work hours start at seven in the morning, and often last until seven at night, or longer, for many of the workers in the medical center. Consequently, there is very little time to exercise (I take stairs whenever possible to compensate.) The hours and the workload can be stressful.  But there are always little treats around the hospital, like donuts or a candy jar. It is difficult sometimes to pass these up. The stress is even worse when we are stuck at work on holiday. Because we miss spending time with our families, we often have a pot luck to make ourselves feel better. You can imagine what kind of goodies everybody brings in.

In the hospital the work is demanding physically, mentally and emotionally. There is not much aerobic activity although we are on our feet most of the day. (I wear compression stockings to keep my feet from swelling up after my shift.). We also see misery and conditions that are disturbing, such as death, suffering, and fear. If anyone is in need of excellent fuel and optimization to do their work, it is the workers in the health care field. Many are forced to make the choice between time spent with their family and taking care of themselves with exercise during the short hours they are awake when they are away from the hospital.

What has our workplace done for this? Sneaky changes that are touted as healthy but are only stop gap measures in the big picture:

* the ice cream freezer 'broke' and was never replaced three years ago
* January 1st we learned of NEW HEALTHY FRIES! Baked, not fried. The deep fat fryer was taken away. The sweet potato and regular fries are tasteless and not edible.
* Doritos, Lays', and Fritos got the boot January 1, too.  Healthy Chip options are pita chips and whole grain baked. Not even Sun Chips. Again, Kale chips would taste better than these.
* Unfortunately they still have Coke, Snapple, Minute Maid Juice, fountain drinks, and energy drinks. But Honest Tea, sweetened with honey in glass bottles,  is gone.  Wouldn't this have been one of the first places to have made a change for health like the others?
*Although a salad bar is always open, a food worker once told me, 'you don't want to see what we have to do to the food so you can eat it--regulations'

The changes are inconsistent, without buy-in from the staff, and promote the American Heart Association recommendations for low-fat, low-cholesterol diet that is now being found to increase rates of diabetes, obesity, and metabolic syndrome.

My favorite vegan surgeon actually met with the CEO to discuss the possibility of having hospital food meet more current demand, such as organic, vegetarian, and locally grown foods. His ideas got shot down with laughter by the head of the organization, then and there in the administration's highest office.

And that, dear friends, is the opportunity that lies in front of us: to bring health back into the health care industry, one hospital, one patient, one worker at a time. Your knowledge and input is crucial to making this a reality. Ask for it. Don't accept the situation as it is. 


Reiki Doc