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An ER Meal: A Personal Story

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Pediatric Emergency Room

This is a guest blog post by Toby Amidor, MS RD

Recently, my 9-year old son fainted in religious school and needed to get checked out in the ER. Thank goodness he’s okay, but the food he got served bothered me to the point that I’m writing this blog post to gain some perspective and insight from my readers. As a parent and registered dietitian, I always take note of what my child is served no matter where we are. Here’s my story…

The Meal
After my son got checked out in the ER and was determined to be in good health, the doctor wanted to make sure that he was able to eat and tolerate “normal” food. I’m trained as a clinical dietitian and have worked in hospitals and the ER before, so this was usual protocol. My son was starving by the time they brought his tray out (which was pre-selected for him) and I was surprised to see what was on it:

  • 1 mini cheese pizza (about 6-inches)
  • ½ cup apple juice
  • ½ cup vanilla ice cream
  • 1 pack Oreo cookies

 

I calculated the nutrition breakdown of the meal. Here are the numbers:

  • Calories: 841
  • Fat: 38 grams (58% of the daily recommended amount for an adult)
  • Saturated fat: 18 grams (90% of the daily recommended amount for an adult)
  • Cholesterol: 60 milligrams (20% of the daily recommended amount for an adult)
  • Sodium: 1,122 milligrams (49% of the daily recommended amount for an adult)
  • Carbohydrates: 104 grams (35% of the daily recommended amount for an adult)
  • Fiber: 4 grams
  • Sugar: 52 grams
  • Protein: 24 grams

 

This meal was composed 40% of fat, which is above the recommended Dietary Guidelines maximum of 35%. The fat, saturated fat, and sodium high compared to the recommendations for an adult—can you imagine this was served to a 9-year old kid!  In addition, much of the carbohydrates and sugar came from the juice, ice cream, and cookies. There were no whole grains, fruits or vegetables provided. What about some steamed broccoli or baby carrots on the side? Or making the pizza from whole wheat pizza crust? Many brands are very tasty these days.

My Response
When the hospital called to follow up on my experience, I explained how the staff was amazing, compassionate and caring for my son however the food was not up to par. As I’ve previously worked in hospitals and work in the food biz, I know there are healthier options to provide kids that are also tasty.  I also know with the focus on preventing childhood obesity and the new MyPlate guidelines, this meal needs to be vastly improved.

LET’S DISCUSS: Have you had a similar experience or an opposite experience?

 

Toby AmidorToby Amidor, MS RD is the owner of Toby Amidor Nutrition, the Nutrition Expert for FoodNetwork.com, and Nutrition Advisor for Sear’s FitStudio.com. Follow her on twitter or Facebook

 

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  • Samantha Cernock

    I have.  My 7 month old had spent a lot of time in the hospital and since I’m a breastfeeding mother, I get a tray because I am her food.  I am also amazed at the choices.  During my most recent stay, I was informed that her floor did not have water (I had asked for a water) but they did have soda and juice they could give me.  So the children’s floor did not have water to give patients!  I don’t understand.  

  • Sutton08

    I still can’t believe my son was given an electric blue (sugar and chemical-filled) slushy at a great children’s hospital upon waking from his recent adenoid surgery.  He threw it up minutes later.  Why was that his only option??

  • Bsphillips3

    My 15 yr old daughter recently had an Endoscopy for stomach problems.  When she was awake enough to eat, they brought her apple juice and a pack of oreo cookies.  Those are listed as some of the top no,no’s when you have acid reflux  

    • Michelle

       Yea, go figure that one .

    • SB C

      As a Celiac (no gluten ever allowed), after a recent operation all they could come up for me was chicken broth (contained gluten) and saltine crackers (contained gluten).  My ONLY option was tea and water.  Great way to recover.  I can’t believe they didn’t have any gluten free option.

  • Dianne Bynum

    What about the lunches/breakfasts that are served to our school children? The meals contain too many fats and carbs. Many school cafeterias don’t have real ovens, only warming ovens to heat up the heavily processed foods. As parents and taxpayers we should be alarmed at what our children are buying.

    • http://kibblesbits.wordpress.com/ Ann

      They can’t afford any better, unfortunately.

    • Brian

      I would argue that children have been given too many processed foods with barely any nutritional value. Fats and carbs are irrelevant when the sources of food are devoid of any nutrition.

  • Jdzip

    I guess that hospital system has caved to “giving them what they want” instead of what they need or is healthy for them……Sad.  As a former ER RN, I have never seen a meal as bad as that come up to my unit.  But, most of what gets served is high carb in the refined variety.  Really mashed potatoes AND peas on the same plate? 

  • Lindsay Dillon

    Its sad that IN a hospital setting of all places this takes place. I appreciate you writing this as its going to take alot of proactive people/parents to raise awareness of this & promote the cause for change. Regardless of costs there are ways to make appropriate, healthy meals- people (schools, hospitals, those “in charge”) need to be pushed AND educated and stop using excuses.

    • Janellelwilliams

      So what are some of the things that I can do to raise awareness???

      • Toby Amidor, MS RD

         I wrote the blog post….so that is one way. Just spread the word any way you can:)
        -Toby

        • Brian

          Some hospitals are starting to incorporate healthier eating choices in their offerings. Unfortunately, this isn’t the norm, and it’s where we need to start to begin proper healing.

  • Bethwatkins17

    I have had the same experience with my son.  I have him on a diet that eliminates food dyes, preservatives and sugar.  It was VERY difficult to feed him at the hospital.  And same as you, I was very pleased with the caring staff.  It seemed crazy to me that they would be trying to get kids healthy and serving food that was sabotaging their immune systems. 

  • Jennifer

    I wish hospitals didn’t serve juice at all. It’s full of sugar and holds very little if no nutrition. It drives me crazy when I see parents give it to thier kids never mind medical professionals. When ever my child has gone to the hospital ER, lucky the meal served was turkey and cheese on whole wheat with lettuce and tomato. They give fresh fruit, milk and water.

  • Foxmom1

    I work in a hospital, so have often been the captive to what is served that day. Once I chose eggplant parmesan and was super surprised that the plate was so heavy. I put a lid on it and went to my lab and weighed it. 2.5 lbs!. I divided it into several meals and from then on bring a healthy packed lunch….even on days when I am super busy.

  • Foxmom1

    I work in a hospital, so have often been the captive to what is served that day. Once I chose eggplant parmesan and was super surprised that the plate was so heavy. I put a lid on it and went to my lab and weighed it. 2.5 lbs!. I divided it into several meals and from then on bring a healthy packed lunch….even on days when I am super busy.

  • Michelle

    It has been a few years since I have worked in the food industry but I cooked for our high school for a few years and the government would continually tell us that our menus had to be healthier and so what happened? Nearly every school has since contracted with such as Sodexo and formed pizza and french fry lines so that the children make food choices daily of BAD food. What American kid will choose salad over pizza and fries???? Not too many. If only we could really convince everyone that pizza does not mean you get all of your food groups in one meal.

    • Maymet

      Baked potatoe would be better and pizza with vegtables

  • http://twitter.com/granolacatholic Lisa Greenwood

    When I had my first child, I asked for a meal that did not contain meat. It was a Friday during Lent. I was in a Catholic hospital. We finally convinced someone in nutrition that they were serving fish in the hospital cafeteria and that fish would work for me. I also did not want it fried or breaded. With subsequent children I just vowed that we would bring our own food to the hospital. I agree that food in a hospital is not healthy, nor tasty for the most part. 

  • Micheleburing

    My mother in law had to have a minor heart procedure in the hospital, she stayed overnight.  For breakfast, she was served a plate with bacon, greasy scrambled eggs, etc.  REALLY.  This food was served to patients in the HEART wing…. the dietitian must have graduated from degrees-r-us.  Very scary.

    • Anonymous

      There’s nothing wrong with bacon and eggs as long as you skip the toast/cereal or other carby foods (outside of salad vegetables).

      • http://tinfoiltoque.blogspot.com Justin Cascio

        Agreed. The meal Toby’s son got in the ER was a carb bomb of industrial food. Bacon and eggs would be a real step up.

      • Brian

        Assuming that the bacon and eggs were not prepared with vegetable oil, this is not a bad food source for someone trying to recover from heart disease. It would be even better if the eggs and bacon were sources from pasture raised animals. That is unlikely, though. And yes, skip any grain based carbohydrate, and focus on vegetables of all sources.

  • http://twitter.com/JollyTomato Jeanne Fratello

    I had the (unfortunate) experience of spending two months in the hospital while on pregnancy bed rest. After the first week or so, when it became apparent that I was a long-timer, the kitchen staff got to know me better. When they’d call for my daily meal order I was able to tell them very specifically what I wanted – even special orders. People laugh when I say this (especially when they know me as a person who loves good food), but even though it was miserably uncomfortable to spend two months flat on my back, the food was one of the bright spots. Go figure. Happy to share more details if you’re interested.

    • fayepolizo

       I have to say, that’s really encouraging!

  • Christina

    I have had three such jaw-dropping encounters with my family members in hospitals. I compare the scenario to looking into your dentist’s mouth and finding a mess of rotting teeth. Seriously: WHEN is the medical “industry” going to figure out that food is medicine and food is poison – depending on what and how you eat? That hospitals are so disconnected that they think they can serve “medicine” in tiny paper cups and then feed patients (what I consider nothing less than) poison is insulting to their own intelligence and to my confidence.  Until something changes, I will not trust the establishment and will avoid it at all costs. Just as I would the Dentist with the rotting teeth. 

  • BekLeonard

    All I know is I’m always relieved that I get my nutrition from Lactated Ringers whenever I’m in the hospital….. the food always smells really bad and it’s a total carb fest.

  • Micknaim

    While I do feel that Our hospitals and schools need to do a better job feeding our children the Er is not a place to judge what food they serve.. As a pediatric Er nurse I am surprised he got a full food tray… I just don’t want folks coming to my Er and judging the food we serve.. We have more important things to worry about… If you can drink liquids you don’t need to be in the ER

    • Michele

      Wow, very compassionate. If you’re conscious, get the F out! But first, eat this junk food.  So if a person has, let’s say, whooping cough, but can still drink liquids, he doesn’t need to be in the ER?  You sound like you’re in the wrong line of work, kid.

  • Janespratt

    Several years ago, while my very picky and allergic-to-dairy son was in the hospital, I suggested they just give him a peanut butter sandwich for his lunch. I was told by a nurse that “obviously he couldn’t have peanut butter because he was allergic to butter, wasn’t he?” I’ve never forgotten…

    • Anonymous

      I had a LONG discussion about food allergies with my neighbor, a nurse, whose child was allergic to milk. Then she went home and gave him a grilled cheese sandwich.

  • Hdjd

    My husband spent 2 months in the hospital fighting for his life. The food he was served during that time should not be fed to a healthy person! It was not edible. We brought in fresh homemade food daily and gave back the packaged crap they offered.

  • Cate

    When my son was only 15 months old he had such a bad case of gastroenteritis he was hospitalised for 5 days.  They served him chicken nuggets and fries (I wish I was kidding).  In a hospital!!  I should say, they TRIED to serve him that.  I had to provide my own food.  I am sorry, but Micknaim, I disagree with you on every level and I totally agree with Christina.  I WILL judge an ER by what food they provide.  It is bark raving mad to think the quality of food doesn’t aid a person’s recovery.

  • Anonymous

    That’s completely appalling!!!!!!!!!!! How come hospitals are suppose to be where you’re suppose to get “healthier” yet their foods are only making you sicker? When I was in the hospital and was finally allowed to eat again after 5 days of ice chips and gum (oh my it was just such a scrumptious time), they offered me CRAP as food… that I decided to subsist on ice chips until I could GET OUT OF THERE! I wouldn’t even eat their chicken broth because it was made with trans fatty acids! Seriously? What are these hospitals THINKING!!
     

  • Kylienicolecampbell

    Yes, we are are disapointed at the food choices our daughter has in hospitals. She has been admited to 3 hospitals, had numerous admissions and she’s just turned five, we tend to provide our own food for her these days, especially as in the last 9mths we have gone additive, colour and preservative free. But highly sugared Apple juice, salty pizzas, hot chips and fish fingers are regulars as well as highly processed meats, cheese, and frankfurts always seem to be there.

  • running__nurse

    I’m an ER nurse. When we do an oral challenge, you get a pack of graham crackers and some ice water. If you keep it down, go home and get your own lunch. I’m not a waitress; I’m not here to serve you food. Feel free to complain about bad nutritional choices for inpatients, but the ER is not the place to judge. You come in, get fixed, and go home. It is not a restaurant.

    • Cas

      Honestly you should find a different line of work. People like you put patients at risk with their ignorance.

    • Jnwalsh1

      Really? That’s what the ER is to you, like a Jiffy Lube?  Nice.  Fortunately, the nurses and doctors at the ER I work in (as just a registrar) actually treat patients like people, not cars to patch up and send out…as do I.  FYI, the post didn’t criticize the medical care the son received and none of the commenters think nurses are in charge of the food provided to ER patients.

  • Jnwalsh1

    I believe it was Weighty Matters that posted a story last year about hospital food (for patients…what’s served in cafterias to staff/visitors is another whole scary story) and a woman wrote about her diabetic mother, who was inpatient for a procedure, whose doctor/dietitian had ordered her a diabetic menu for her stay…and the patient was served pancakes drowned in artificially flavored syrup and a fruit cup for breakfast every day on a tray marked “diabetic meal.”

  • http://www.susanruns.com/ Susan

    I’m a nurse on an inpatient unit in a hospital that serves all ages (youngest patient I’ve had was 10 weeks and the oldest 95 years old…), and the unit I work on REQUIRES you to eat in order to heal.  (Many of our patients get feeding tubes.)  I will admit that the food isn’t good at all…I probably wouldn’t eat it.  There are healthy options that people can get, but many times people will order a hamburger or pizza.  When a kid isn’t feeling well, the chances of him eating broccoli over mac and cheese are slim.  Plus, most people in the hospital never really had good eating habits to begin with…

    I’m always torn on the food issue in the hospital…it’s an expensive operation to run (many of our patients don’t have insurance), and many of the cheaper food options are not all that healthy for you.  Obviously you can get healthy, cheap food options, but not everyone is going to eat them.  We do serve healthy food where I work, but it doesn’t taste very good.  Our best eaters are the homeless people who get admitted, and they’re some of our best patients because they eat so well and nutrition is so important to their healing.

    I do agree with other people who said the ER is not the place to judge.  The hospital itself is a strange environment that most people on the outside don’t really understand.  Nevermind the fact that as a nurse I’ve had to skip meals (on a twelve hour shift) because I’m too busy taking care of patients to eat!

  • Alextialex

    I am a dietetic intern and through my clinical rotation, food service management, and clinical enrichment rotations, what I noticed (which may be obvious to some) is that the hospitals that had RDs in the food service manager positions were really putting an effort toward having a healthy and palatable menu for peds and adults.  There NEEDS to be more RDs in those decision making ppositions so that real changes can be made.  Clinical RDs don’t have alot of power against the food service manager they can state their professional opinion but the food service manager needs to want it.  We are educated and trained as RDs to work in these positions to be able to make those changes to better nourish our vulnerable populations (schools, hospitals, and nursing homes). 

    • Alextialex

      Unfortunately, from what I have noticed in the early stages of my career is that new RDs including myself want to do community, clinical, sport nutrition all the “funner” areas.  Not many want to be stuck in a kitchen.  However, I have been in management in my past career and have made the choice, if the opportunity arises to work in food service management, I WILL do it to help change what our vulnerable populations eat.  I

      • Alextialex

        Actually, at the hospital I am at right now has given me the project of formulating a healthy menu for their new peds unit and have been able to put together a pretty alaborate menu without resorting to poor options. 

  • Brian

    It’s a travesty that nutrition is not top of mind in hospitals. Why is it that the place we go to heal gives us some of our least nutritious food? They just don’t get it, and it is a microcosm of our health system in general.

    In your article, you talk about how the meal was 40% fat, but not one word about how nearly everything in the meal is a processed food (actually, everything probably was a processed food). And you didn’t even mention that oreos were included in your critique. That should have been the starting point. Of all the food choices that were given to your child, that is the most nutritionally devoid source… but no mention?

  • Ann

    Are you kidding me? There are much more important things that we are worrying about in the ED besides the food that people who can walk out are eating. And I hope someone says I’m in the wrong line of work like the comment below. You can tell me I’m in the wrong line of work after I’ve saved 10 lives in one day and put up with the most obnoxious people who would go to jail if they acted in such a way anywhere else. If you wanted your son to have such nutritious food you should have had someone bring it in. Fresh produce in hospitals? Next thing you know people will be suing for the germs it brings in. 

    • Sarah

      I am not sure what your definition of hospitals are, but mine is that they heal the sick and nutrition has a lot to do with it. How hard it is to provide water instead of juice, a piece of fruit instead of biscuits?? The person who write the blog is not critizing the staff but the policies of the hospital. Maybe you should take a break away from your job and realize that you are dealing with people, and that you can promote health in many ways. And before you say that I don’t know the challenges that you face, I do. I am a nurse that has worked in many eds.

      • Ann

        What kind of ED did you work in where the nutrition of the food was the priority, honestly I’m curious? It’s not about the challenges I’m facing but about people expecting hospitals to walk on water. Take ownership and if you don’t want your kid eating that, bring something else. In other countries hospitals don’t even supply the bed sheets and families bring in the food. I don’t think it’s the best thing to offer the sick but I don’t see where it’s the hospitals responsibility, at least not in the ED. 

  • susie

    I’ve spent time in hospitals(kid with cancer) and never worried too much about the nutrition.  The worst part was the food poisoning I got from eating the cafeteria food.  It was horrible being sick and wanting to take care of my child. 

  • Sara Thompson

    I find complaints about hospital food interesting.  I live in Eastern Washington, south of Spokane.  We’ve had to be in the local hospital and the children’s hospital in Spokane.  Both have amazing food.  They have strived over the years to provide nutritious and delicious food.  It’s so good that on occasion my son will ask if we can have lunch at the hospital just because we’re in the neighborhood.  Food is part of our health and it takes just as much effort to prepare healthy tasty food as it does to prepare non-healthy food.

  • Annekbarna

    My daughter has been hospitalized several times in two different hospitals in Michigan.  They both use the “order yourself off the menu” a la carte system.  While this may reduce food waste, it was quite a bother to have to call three times a day to order a meal — and to try to figure out what a balanced meal would be.  I would have rather someone plan a variety of balanced and healthy meals, then let me sub out things if necessary.