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Second Opinion

Second Opinion

Elemental Human Needs for Health Care Providers

Leap, Edwin MD

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doi: 10.1097/01.EEM.0000453995.45496.8f

    I experienced an epiphany in the cafeteria last year. It was 4:30 p.m., and the place was supposed to close at 6:00. The folks inside were putting the food away as I entered. “Did you want something? I mean, we can make something for you,” one asked.

    “Nope, I guess not,” I replied.

    It just wasn't that important to anyone (other than those who were hungry on second shift) that it stay open. Lesson learned.

    This was the same hospital where local restaurants like Subway had practically begged for a presence, but had been constantly rebuffed with, “No, thanks. We got this.” If Subway had been in the hospital, I guarantee they would have been open in the evening.

    Cafeterias are largely nonexistent in facilities I have visited over the past two years. They are closed on weekends and never open after lunch even in larger hospitals, busier hospitals, and teaching centers. Maybe it's too expensive. Maybe it's a luxury. Or maybe it's just bad thinking.

    People are sick between 3 p.m. and 7 a.m. They have families under duress. It is commonly understood that food, drink, and fellowship are great comforts in these situations. A snack, a cup of coffee, just the warmth of a cafeteria can lift one's spirits. I speak as a Southern Baptist. Our motto is, “Jesus would want you to eat something.” If someone is sick, you take them a casserole. If someone is sad, you make them a cake. If someone is dead, you bring their family gallons of soup to put in the freezer for years of culinary comfort.

    Many members of the hospital staff, notably in patient care areas, cannot leave the hospital for food. It's even more difficult as volumes rise and staffing gets tighter. You can tell because most floors have menus tucked away somewhere, so on slow nights they can send their cash and debit cards with a selected messenger who brings back sustenance. Even a fast-food burger or an early morning plate of home fries is a small comfort in the chaos of the modern hospital. It's even more difficult for anyone to leave the emergency department. Thank heavens for pizza delivery.

    Those nurses and physicians going elsewhere for food, for dessert, for coffee are spending what? Money! That's right; they're giving their money to other people who are happy to have it. Could it be going back to the hospital? Absolutely.

    Obviously, that sort of money is chump change in modern hospital terms. But economics aside, the shuttering of cafeterias, the limited hours, the fact that evening and night shift workers have to either bring food or send out for it all suggest a dismissive attitude toward employees. Large industries often have their own cafeterias, even at night. They understand that people who work hard need to eat, the psychological value of having a place to escape, if only for 30 minutes.

    Perhaps those who make the rules, who run the numbers, and try to cut here and cut there are simply unaffected. They tend to work in the daytime. They can go to the cafeteria even with its limited hours or they can leave to get food. Their desks may be cluttered and their work important, but they aren't directly caring for someone who is bleeding, whose chest pain is evolving into an MI, or who is struggling to breathe. Being absent for 30 minutes is not a problem.

    That's why it would be a wonderful act of kindness, such a simple way of saying that they appreciate us if hospitals had food available for visitors and providers whose jobs keep them in the hospital at ungodly hours, on holidays, and every weekend. Even some free snacks and free coffee would go a long way toward happier, more satisfied employees.

    Sure, it costs something, but it pays something. It pays by creating staff who want to stay, who aren't endlessly searching ads for new opportunities. It pays because nurses and physicians currently crushed by volume, complexity, and rules would feel their administrators cared about them and their physical and mental health, not just about spreadsheet metrics.

    Administrations across the land, for those on the front line, our customers are sick people. Your customers are not. Your customers are those of us who provide the care, and it's a fairly simple thing to make our work more pleasant. Meeting an elemental human need like food is about as easy as it gets.

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    This is the first of several columns I will write about physician and nurse satisfaction. We go on and on about patient satisfaction, but the customers of administration must be the providers of the care. This point is typically missed by those who feel that the real business of health care is administration. Nothing could be further from the truth. — EL

    © 2014 by Lippincott Williams & Wilkins