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Taking Food and Drink Away From Docs and Nurses Is Just Cruel

Taking Food and Drink Away From Docs and Nurses Is Just Cruel

By Edwin Leap, MD–

It’s hard to explain what we do. And so maybe, it’s hard for others to sympathize with our situations. I mean, physicians, mid-levels, and nurses in emergency departments are tied to computers in often cramped work-spaces, even as they are required to be at the bedside almost constantly for the latest emergency or (in other cases) the latest bit of pseudo-emergency drama.

If you haven’t worked there, or haven’t for a long time, it could be that this lack of understanding is what leads hospital administrations to do one of the stupidest things imaginable. What is that thing? Banning food and drink from our work-spaces.

Now, this isn’t the case in my current job. But it is the case in all too many facilities. I talk to people. I hear things. And it’s usually justified with some unholy combination of infection control, Joint Commission and public health clap-trap, coalesced and refined, then circulated as a cruel policy.

When it’s enacted, clinical staff have their water bottles taken away. Nobody is allowed to eat where they work. Dedicated, compassionate staff members grow tired and dehydrated and hungry. (Maybe it’s a good thing. They often don’t have time to urinate anyway, and water just makes that happen more often.)

Mind you, the water bottles are sometimes kept in a nearby room, or on a nearby shelf. It’s an act of kindness, I guess. And the food? Well, all you have to do is take your break and go to the cafeteria or to the break room, right?

Those who come up with these rules don’t understand that a scheduled break is a great idea … that never happens. It’s an emergency department. It isn’t (technically) a production line; however, we try to impose time restrictions and through-put metrics. It isn’t “raw material in/product out.”

It’s “sick, suffering, dying, crazy human being in” and if all goes well, “somewhat better (at least no worse) human being evaluated, stabilized, saved, calmed, admitted, transferred, and sometimes pronounced dead” out of the other end of the line.

Those Herculean efforts can take anywhere from, oh, 20 minutes to 12 hours. During which time, it’s pretty hard to leave the critical patient in the understaffed department, with the “five minute to doctor” guarantee and the limitless capacity for new tragedy rolling through the door.

That setting makes it remarkably hard for breaks or even meals to happen at all.

As such, it’s nothing short of cruel and unusual for anyone to say to the staff of a modern emergency department, “you can’t have food or drink” — especially when it’s typically uttered by people who have food and drink in their offices and at their desks. People who have lunch meetings with nice meals or who have time to walk to the cafeteria or drive off-campus. And who feel so very good about protecting the staff from their deadly water bottles.

The argument, of course, is that the clinical staff work in a “patient care area.” Even when they aren’t at the bedside but are, for instance, behind a glass wall at a desk. If this is the case, then one could argue that the entire hospital (including administrative suites) is a “patient care area.”

They are afraid we’ll catch something. That it’s unsafe for us to eat or drink where we work. Of course, this is while we positively roll around in MRSA and breathe in the fine particulate sputum of septic pneumonia patients. This is while staff clean up infectious diarrhea and wear the same scrubs all day.

This is after we intubate poor immigrants who may well have tuberculosis and start central lines on HIV patients. This is after we wrestle with meth-addicts who have hepatitis C. And this concern for our “safety” occurs in places where physical security, actual security against potential violent attack, is a geriatric joke which is often tabled until the next budget cycle.

And as for our patients? Our food and drink are no danger to them. They and their families fill the exam rooms with the aroma of fried chicken, fries, and burgers, eaten at the bedside (often by the patient with abdominal pain). Their infants drag pacifiers across floors that would make an infectious disease specialist wake from bacterial nightmares in a sweat-soaked panic. In short, our food or drink are no threat to them and no threat to us.

But the absence of food and drink? That’s a problem. Because the ED is an endless maelstrom of uncontrollable events and tragedies, of things beyond our control for which we are responsible. It is a place of physical, emotional, and spiritual exhaustion where we rise to the challenge and manage (against the odds) to do so much remarkable good by virtue of our knowledge, our training, our courage, and our compassion.

In the midst of all that, a bottle of water, a cup of coffee, a glass of Diet Coke, a Styrofoam cup of iced tea is an oasis in the desert. And that sandwich, slice of pizza, cupcake, or salad is the fuel that helps make it happen.

More than that, food and drink are among the few pleasures we have time for each shift. They serve as bridges to the end of the day, small reminders of normalcy in a place where so little is normal.

Doubtless, one day someone will take away our music so that it doesn’t hurt our ears, or offend our patients. We’ll fight that battle when it comes.

But until then, depriving staff of food and drink proximate to where they work is of no health value and strikes me as just one more way of exerting control over the people actually engaged in the hard, grinding work of saving lives.

And worse, it’s just mean.

Originally published in MedPage Today

Research of the Week: Resisting the Slow Undoing of Human Rights

Research of the Week: Resisting the Slow Undoing of Human Rights

This week we’re featuring Resisting the Slow Undoing of Human Rights , a Nursing Knowledge Activities column from the journal Research and Theory for Nursing Practice. Author Debra R. Hanna, PhD, RN, ACNS-BC, provided some insight as to how she prepared this column to write about the Transcultural Nursing Society. Read more below:

The column about Nursing Knowledge Activities, is intended to inform readers about events and developments in nursing knowledge. Having had a long-term interest in theory and research I wrote a series of columns to showcase different professional organizations dedicated to nursing theory activities.

 

Usually I write the Nursing Knowledge Activities column about 4-6 months before it  appears in print. In October 2017 I began writing the May 2018 column. Having already written about several nursing theory organizations, I  wanted to write about the Transcultural Nursing Society started by Madeleine Leininger. That Fall, I was doing background reading about twentieth century American history for a book I am currently writing. Each evening, the national news mentioned Congress wanting to overturn the Affordable Care Act. Also, there were news stories about refugees fleeing crisis situations from several parts of the world. Our politicians seemed divided about wanting to help refugees. That news broke my heart since it seemed that some politicians were not interested in helping humanity.

 

My first column for May 2018 was focused on a different topic. But then things came together on December 12, 2017. I decided to write a completely different column for May 2018. That morning I had read President Kennedy’s speech during my background reading. It reminded me of Leininger’s approach to human beings that was so nurturing, caring, and respectful of human dignity. The stark contrast between Kennedy’s approach to humanity and current political conversations, created a clear insight. I then examined the Transcultural Nursing Society’s website equipped with that insight. Once I saw the rich treasures that the Transcultural Nursing Society has to offer nurses today, I scrapped my other column. Within a half hour I wrote May’s column from beginning to end.

You can ready Dr. Hanna’s column, Resisting the Slow Undoing of Human Rights, here. To subscribe to Research and Theory for Nursing Practice, click here.