It’s a common struggle, a crowded Emergency room versus the rumble in your tummy. Though not often addressed, the question seems to appear just about everywhere advice is given to EM staff. What should be a mandatory part of your day is often an afterthought when you work in emergency medicine. We’ve searched the internet for the best advice and gathered it together here!
“Make time to eat. It feels selfish when the waiting room is full and patients are building up, but you can't take care of them if you don't take care of yourself. And we are not just talking about getting through a single 8-12 hour shift, or a three year residency, but building habits that will get you through a 25 year career.
I just build it into my workflow. You always have a running list of tasks in your head, right? (Gotta see the new belly pain in 3, check the CT results in 5, get 7 ready for dispo...) At about the midpoint of my shift (usually), I put a break in my list of priorities a
nd at a point where I've dealt with all the pressing tasks I go take a solid 15-20 minute break. Sure, occasionally there is a shift just too chaotic and I can't pull it off, but I get my break on 90% of my shifts.
I don't think it matters much what you eat. Sometimes I do the cafeteria. Sometimes I bring in leftovers. Sometimes it's just a tupperware of hummus and some baby carrots. Occasionally it's a proper meal I made. Sometimes i nap! But making the break a priority and making it a habit is the key thing. If nothing else the mental health element of it is huge, and the nutrition is nice, too.
Also, my motto is: "Never start a shift with an empty stomach or a procedure with a full bladder." – Attending ED Physician
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- “Fruit (grapes, cuties, cut up strawberries, blueberries) and veggies (carrots, celery sticks, cucumber slices) --> you can put it down and come back or snack whenever you are doing documentation
- A bagel with cream cheese --> easy to make quickly and portable, which also applies to...
- A PB & J sandwich
- A PB & Banana sandwich
I know you said meal prep was out due to time at home, but I make broccoli and cheddar soup or something similar in my crock pot (like 10 minutes of prep time and 5 minutes to package it at the end and wash the crockpot) and I'll have over a week's worth of lunches. Just a thought. My crock pot is a godsend.” – ED Nurse Practitioner
“Ideally trail mix, something like a naked juice smoothie - realistically the majority of the time even if I bring food, I forget to eat it because it's too busy, if I didn't bring food and I have time, I will scavenge the ED for graham crackers, peanut butter and jelly on saltines, coffee etc. If I have time before my AM shift when working at one of our smaller EDs, I will pick up bagels for all the ED staff and it guarantees me a snack midday too.” – Attending EM Physician
“This may make some people upset, but I will tell you right now that you actually do have time to eat on shift. When I was a first year resident, I would work a 12 hr shift never stopping to eat, and I would feel terrible by the end. Eventually an enlightened attending pulled me aside and told me every shift has at least one 5-10 min pause in it where you have time to eat. He told me that if I couldn't find those times, then I was doing something wrong. He was a wise man and it changed my perspective. I started finding those spots and eating meals I had prepped at home and would microwave at work. I felt much better/happier on shift as a result. That was almost 10 years ago and I still prep a lot of my meals (usually some type of meat, veggie +- a grain with some sauce) or just have the hospital deliver my meal. Their room service is available to us for free and pretty decent: steak, pizza, quesadilla, salmon, stir fry, etc.
I'm at a shop where our group sees 2.5-3.0 pph plus we see all of the Midlevel patients as well (usually another 1.5-2 pph) with an overall admit rate of 20-25%. So our pace and acuity is on the upper end of everything I see posted here and elsewhere. We all eat real food on shift and you should too.” – Attending EM Physician
- Eat your main meal before work
- Bring healthy snacks and a small balanced meal to work
- Avoid eating between 0000-0600 especially carb-rich meals (decreased attention, increased risk metabolic synd, possibly insulin-related)
- Drink plenty of water, have a water bottle by your workstation
- <400mg of caffeine/day (4 c coffee, 4 monsters, 4 mountain dew)
- No caffeine in the 4 hours before bedtime
- Avoid large meals 1-2 hours before bedtime
- Avoid alcohol after work (may disturb sleep)
*We should note that while not specifically quoted in this article, almost every site and article we read included Soylent, the latest meal replacement drink that claims it can replace any meal.
