Healthcare providers have needs.  Like food! As such, this my column in the September edition of Emergency Medicine News.  So grab a snack and enjoy it!  Seriously, eat something.  You look famished…

https://journals.lww.com/em-news/Fulltext/2014/09000/Second_Opinion__Elemental_Human_Needs_for_Health.5.aspx

This is the first of several columns I intend to write about physician and nurse satisfaction. We go on and on about patient and customer satisfaction. But in the end, the ‘customer’ 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.

I went to the hospital cafeteria one day last year and experienced an epiphany. It was around 4:30 pm and the place was supposed to close at 6:00. As I entered, the folks inside were covering up the food and putting it all away. ‘Did you want something, I mean, we can make something for you.’ ‘Nope, I guess not,’ I replied and walked away. It just wasn’t that important to anyone (other than those who were hungry on second shift) that it stay open. Lesson learned.

Mind you, it was the same hospital where local restaurants like Subway and Chic-Fil-A had practically begged for a presence in the facility, but had been constantly rebuffed with the old, ‘no thanks, we got this.’ If either had been in the hospital, I’ll guarantee that they would have been open in the evening. Money talks, and all that.

In many of the other facilities I have visited in the past two years or so, the cafeterias are largely non-existent. Even in larger hospitals, busier hospitals, teaching centers, I find that the cafeteria is completely closed on weekends, or never open after lunch, or some other foolishness. Maybe it’s too expensive. Maybe it’s considered a ‘luxury.’ Or maybe, it’s just bad thinking.

Let me elucidate for those who might read this, but who have never thought the problem through completely. Between 3 pm and 7 am, people are sick. Those people have families. Those families are under duress. During such times, it is commonly understood that food, drink and fellowship are great comforts. A snack, a cup of coffee, just the warmth of a cafeteria, can lift one’s spirits immensely. I speak as a Southern Baptist. Our unspoken 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.

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

Now, for those paying attention, those nurses and physicians going elsewhere for food, for dessert, for coffee, they’re spending what? Money! That’s right, they’re taking their money away and giving it to other people, who are happy to have it. Could it be going back to the hospital? Absolutely.

Obviously, in modern hospital terms, that sort of money is chump change. But economics aside, the shuttering of cafeterias, the limited hours, the the fact that evening and night shift workers have to either bring food or send out for it, all suggests a kind of dismissive attitude towards employees. Large industries often have their own cafeterias…even at night. They understand that people who work hard need to eat. They understand, I suspect, the elemental 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. And they can typically go to the cafeteria even with its limited hours. Or they can leave and drive across the street for 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 breath. Being absent for 30 minutes to an hour is not a problem.

That’s why it would be such a wonderful act of kindness, such a simple way of saying ‘we-appreciate you and your work,’ if hospitals simply made the effort to have food, and drink, available for those visitors and those providers whose jobs keep them in the hospital at ungodly hours, on holidays and on every other weekend. Even some free snacks and free coffee would go a long way towards 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 want ads and looking for new opportunities. It pays because nurses and physicians who are currently crushed by volume, complexity and rules would feel that their administrators actually cared about them; not just about their spread-sheet metrics, but about their physical and mental health and their general state of happiness.

Dear administrations across the land, for those of us 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.

And meeting an elemental human need, like food and drink, is about as easy as it gets.

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