This blog post is the latest release from the StE team around clinicians’ wellbeing.
We often forget that despite being superheroes on a daily basis (we save lives after all – let us celebrate it) we are also all human. It is not easy to incorporate a regular and healthy diet in the 24/7 shift pattern that defines EDs and many other specialities around the globe. We love our profession and try to cut down on our meal breaks to get back out there and do what we enjoy doing. We do, however, need to improve on this as you cannot look after others if you do not look after yourself.
This post is best read in conjunction with our other wellbeing posts: how to prepare for your night shift (1), how to look after your own mental health (2), sleep hygiene in the ED (3), be well and be a better critical care clinician (4) etc…
Here comes the usual disclaimer: the following is based mostly on personal experience having worked as a medical doctor for well over a decade now. I am sharing this hoping that my colleagues will not make the same mistakes I did years ago. You might want to adjust these suggestions to your own lifestyle or ignore it in full!
Bring your own food
This is recurrent and basic advice but let us be honest: most of the hospital restaurant do not provide healthy, varied food options. These places are designed to feed a large cohort of staff, relatives and visitors so their emphasis is on producing large quantities at rapid speed and this often comes at the cost of quality. Who has not come across “chips and cheese” or “dry empty salad” as the only options in their canteen? The last thing you fancy is a light salad when you are working a long shift constantly on your feet, tirelessly using your neurons burning carbohydrates at an unimaginable rate. You often opt for the easy option of buying the unhealthy meal (of which I indulge myself very often with a colleague – you will recognise yourself) or you go for the salad but do not feel satisfied. This is then more likely to be followed by unhealthy snacks to stop that remaining stubborn hunger or exhaustion.
Cooking a larger portion at home the night before and taking the rest for lunch the next day is an easy way around this problem. You can not only design a balanced meal (low carbs and fat, more protein, varied in consistency) but you can also bring your favourite food to work. It is a win-win situation. This should result in less frustrations and you are more likely to regulate your satiety. It slid means if you only have a short opportunity treat, you will not waste any time visiting and waiting at the canteen.
We are genetically programmed to eat as much as we can in order to tackle periods of low food. This might have been true some thousands of years ago when we were cavemen. Look at those horror stories on National Geographic of snakes swallowing whole mammals and then going without food for weeks, or of squirrels collecting food for the winter to come.
This probably does not apply to us anymore in the 21st century. I know sometimes a shift feels like an eternity (!) but we rarely work a shift that is longer than half a day (well, I hope so!). We therefore do not need to fill our stomach up with (junk) food. You are also more productive with a half full stomach only as precious blood circulation does not get stolen from your brain to supply digestion. Have a glass of water before you start your meal in order to decrease the amount you will eat.
You can also tackle this problem if you combine the next three pieces of advice.
Have healthy snacks between meals
Ever seen those unhealthy cookies and sweets left on the nurses ‘ desk by your colleagues? Of course, you have and we are all guilty of it! I do this often to build staff morale (there is a positive correlation reportedly via endorphins pathway) and help my colleagues who did not get on their break on time. There must have been again something evolutionary behind it engrained deeply in the primitive part of our brain. I never bring back healthy fruits or carrot sticks. We all find them rather unsatisfying and we tend to reach for the biscuits. Most of the cheapest, unhealthy options are invariably strategically placed at tills at retailers so you are more likely to get them than actual “proper” food. They play with human psychology and we can actively fight this.
So next time, bag an apple, nuts or even a protein bar in your lunch box. I try to keep one of these on my desk often. When that sugar dip happens, reach for a healthy snack between meals or before your evening commute home rather than those doughnuts!
Sit down at a real table
This is very important. Why would have your lunch standing or during a walk to the other side of the hospital? “I will grab a sandwich as I walk there” is not good habit at all. Animals demarcate their territory and most dog-related incidents I see are when a toddler has stepped on the dog’s bone. Animals are very precious about their eating territory (their “table”).
It is so much nicer to enjoy your lunch/dinner when you sit at a proper table with a comfortable chair. Also, you have just been up on your feet for the few past hours so why would you not just sat down for those 30 minutes of self-enjoyment? This can also be the perfect opportunity to have a social chat with colleagues or simply have some time out.
Do not multi-task during eating
I am guilty of this all the time. I sit down, start eating and then undertake to check my work/personal emails (and yes, Twitter or Facebook!) whilst I am chewing my food. My colleagues and I know that I am not great at multi-tasking despite being an emergency physician (I keep being reminded by my female nursing colleagues!).
I also love watching the news in our staff room whilst I am eating. Not a good idea either, especially as most of the news lately seems to be related to catastrophe and political battles. Do we not see enough of those at work?
So, switch off your bleep (if you can), turn away from your desktop screen, put your smart phone in your pocket, and contemplate the nutritious food you have prepared for yourself earlier in the day. Close your eyes a few seconds to enjoy the moment: you are on your break. This is “me time” after you have spent hours sorting out other people’s problems. Digestion reportedly works better if you eat slowly, as you chew more effectively and this puts less stress on your digestive system. Eating plenty with intention or mindfully also means you usually feel more full for longer.
Avoid fizzy and sugary drinks that are again so easily available in most hospitals either from retailers or strategically positioned in waiting rooms/hospitals corridors. They have a high glycaemic index but you’re best getting your “carb fix” from healthier sources (like the above-mentioned fruits). Bubbles will fill up your stomach, and whilst you’re likely to eat less as a result, you are also more likely to feel bloated and this will increase the energy you need to digest your meal. So the best option is… plain water!
We are very bad at hydrating ourselves anyway during a shift as we are constantly busy, so at least try and compensate for this by assuring adequate water intake during your break. Also, we are guilty of sipping coffee or tea to keep us going but both have diuretic effects and therefore more likely to dehydrate us even more. Cut down on fizzy drinks and tea/coffee and drink the basic element on which life has thrived on this planet: water! Drinking too much caffeine during a shift can stop you from having much needed sleep in between shifts.
Relax during and after eating
Try and combine the above tips to enjoy not only your break but your meal. Eating is a basic and essential physiological need.
Finished your food and still have some time before getting back on the shopfloor? Now, you can turn on the radio or listen to some light, relaxing and chilling music. It helps digestion but you are also more likely to return to your clinical activities refreshed and with a smile.
Keep well people!
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