Food in the Emergency Department

In the emergency department, patients wait for hours once they are inside the doors and being seen by nurses and doctors. They need to wait for us to put their tests and imaging together, actually have it done, wait for the results and possibly start again if our differential diagnosis was incorrect the first time.

If a patient is admitted to the hospital, food is ordered for them. Otherwise they are left on their own. Sometimes dietary has extra meals if the patient it was directed to has already made it to the floor. This meal can be used but only if the nurses have the time to make it happen and if the patient advocates for themselves and asks for it.

Even if the stars align and there is food and someone to give it to you, you may be kept npo - nothing by mouth - in case you need to have surgery. The thing with emergency surgery is it can take days to get. It doesn't feel very emergent if it's you who isn't eating. By the time we do all the necessary tests in the ED, get someone from the surgical service to consult and decide if you do indeed need emergent surgery then book the surgery, it can be the better part of a day.

Anesthesia wants to keep your belly empty to make the surgery as safe as possible since it's fairly common for the anesthesia to make you nauseous and they don't want you aspirating vomit. Kind of nice of them really. Very often, towards the end of a day, surgeons and nurses of pts will call the OR and ask if they can "feed the patient".

On the other hand are the patients who are "frequent flyers" in the ED. These include those with chronic illnesses requiring multiple transfusions, sub- optimally managed epilepsy, and my personal favourite, the street folks with substance abuse problems who often pass out and get picked up to ensure they are OK.

An old favourite from clerkship was a woman with a bright orange jacket - always knew it was her. I sincerely enjoyed seeing her. Her drink of choice was listerine because it was cheap and easy to steal. For those that don't know, the listerine drunk is a stinky drunk. She was grumpy but only half-hearted at it. She'd swear at me while I was making sure she hadn't aspirated but wink at me before I left her cubicle. Her sandwich of choice from the patient fridge was chicken salad. If it wasn't there, it was only a very brave person who dared bring a turkey sandwich instead.

It is a little disturbing that so many patients do demand food be given by the department. It seems like a part of the service driven culture that health providers are expected to be a part of. If you were waiting for your car to be fixed, you don't expect a free meal. Often car repair shops have a cafeteria or a vending machine just for this. It's strange that there's an expectation for food and snacks when getting your body checked out.

I can understand the patients there on their own with no source of food otherwise, but I'm grateful for the patients with families who ask if they can eat then go to the cafeteria or Tim Horton's to get something. Hospital food is not good, emergency food even more so.

- Posted using BlogPress from my iPad