Serenity Toney

Happy Stomach, Healthy Patient

Being sick or ill is awful. On top of being sick, sometimes eating is hard or there’s a loss

of appetite. But when you’re sick, what your body needs is a nice balanced meal to make you

happy and rest. For some people in health care getting both is hard to get. I was aware that this

issue was present, but not how much it could affect a person’s health and mood. Most people that

have been or visited a hospital long enough to have a meal or two knows that the options are

limited and more often than not, very american.

This topic was brought up by my dietetic mentor who has worked in the same hospital for

over 35 years, and in those years hasn’t seen much change in the menu. In this hospital, there is a

wide demographic. This is a great thing, but some hospitals don’t take this into account when it

comes to the menu. I asked my mentor if there was anything in the hospital that she wished she

could change, and one thing that stuck with me was that she wished she could change the type of

food she could offer to patients. In this example, she was saying that we may be used to

sandwiches and chips, but for other people things like tortillas and rice are staples in their homes

and cultures, so when they come to the hospital it’s different and that many patients she worked

with brought it up. This sparked the idea of accommodation in the five A’s of access we learned

in class. Accommodation in healthcare terms as defined in lecture is “the organization of

resources in relation to patients’s preferences and constraints.” (Module 2 Lecture 2, pg. 15).

This is important because it allows people to be the most comfortable in an unfamiliar or scary

environment or have things catered to their needs.

 When a patient is in the hospital, one of the last things they would want to do is shovel

down unfamiliar food they don’t usually eat. This can cause the patient to lose their appetite,

possibly refuse to eat, and also dampen their mood. Without food, the person cannot get better.

“Undernutrition is independently associated with a number of negative clinical outcomes,

including increased complication rates, mortality, longer hospital stays and increased costs.”

(Naithani et al., 2008). Undernutrition in hospitals is not uncommon and I’ve learned that some

patients experience hunger and have difficulties accessing food past their scheduled eating times

for a variety of reasons on top of being fed something out of their usual diet. According to a

study published by Health Expectations, almost half of patients they studied felt hungry during

their stay. They observed that over half of the ethic patients did not feel like the food was to their

taste, did not seem appetizing or was not served attractively (Naithani et al., 2008). This shows

that there is common dissatisfaction with the food when it is not your typical cuisine. There were

also issues addressed by patients about consumption issues. For example in the study, they said

cancer patients brought up problems of swallowing and elderly and stroke patients had the

greatest difficulty in manipulating and transporting food to the mouth (including the inability to

open certain packages) which affects the amount the person can consume. One last example from

this study is that they observed that patients with dietary restrictions were not given enough

information about the nutrition in the meals they had to choose from. Both examples show that

accommodation was commonly neglected. Another important issue on accommodation would be

the reluctance of some patients to eat because of religious reasons. In Islamic and Jewish

cultures, they don’t eat pork. In a research article in Nursing Open about the food disparities of

muslim patients, they observed that “when coupled with uncertainty over whether the dishes

served are in compliance with Islamic dietary rules, Muslim patients are particularly vulnerable
to undernutrition, a problem that “affects 30%–50% of [all] adult patients admitted to hospitals in

Western countries, and is associated with increased mortality, morbidity, length of stay, and

costs” (Thibault et al., 2011, p. 289).

Gaining knowledge on how food can really impact patients and especially minority and

ethic patients unproportionately makes me strive to be an observant, inclusive, and

accommodating dietitian. It also makes me think about how much the healthcare system can do

to change these issues that affect a patients’ outcome. I think that when a patient is admitted, they

should be immediately offered food and water especially if they had been waiting hours to be

admitted. This would solve some issues with hunger right in the beginning of the patient’s stay,

and demonstrate quality hospitality which is very important when showing patients you care

about them, and is an overall sign of quality care. Hospitals should also have a form to collect

information on food preferences and accommodations whether it is when a patient has to fill out

other important info or the task is given to a clinical dietitian who has vast knowledge. In a

Forbes article about malnutrition in hospitals, their opinion on how to change these issues aligns

with mine. “...having a registered dietitian assess hospitalized patients upon admission may help

to assess any deficiencies, and craft a plan based on specific medical or surgical needs.”(Robert

Glatter, 2019). This ensures that someone is working to help heal and prevent later nutritional

issues that could slow the healing process of the patient before and after treatment, then

encouraging higher success rates, lower costs for the hospital, lower length stays in a hospital,

and happier patients.

 Works Cited

Alpers, L. M. (2019). Hospital Food: When Nurses' and ethnic minority patients'
understanding of Islamic dietary needs differ. Nursing Open, 6(4), 1455–1463.
https://doi.org/10.1002/nop2.343

Laur, C., McCullough, J., Davidson, B., & Keller, H. (2015, June 1). Becoming food aware
in hospital: A narrative review to advance the culture of nutrition care in hospitals.
Healthcare (Basel, Switzerland). Retrieved October 1, 2021, from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4939541/.

Malnutrition in hospitalized adults. Effective Health Care Program. (2020, October 30).
Retrieved October 1, 2021, from
https://effectivehealthcare.ahrq.gov/products/malnutrition-hospitalized-adults/protocol#1.

McCluskey, M. (2020, March 16). Healthy eating is key to well being. so why is hospital
food always so bad? HuffPost. Retrieved October 2, 2021, from
https://www.huffpost.com/entry/bad-hospital-food-healthy_n_5e5d3de2c5b63aaf8f5b0390.

Naithani, S., Whelan, K., Thomas, J., Gulliford, M. C., & Morgan, M. (2008, August 18).
Hospital inpatients' experiences of access to food: A qualitative interview and
observational study. Health expectations : an international journal of public participation in
health care and health policy. Retrieved September 29, 2021, from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5060454/.

Robert Glatter, M. D. (2019, January 31). Malnutrition in hospitals linked to greater risk of
death, study finds. Forbes. Retrieved October 2, 2021, from
https://www.forbes.com/sites/robertglatter/2019/01/30/malnutrition-in-hospitals-linked-to-
greater-risk-of-death-study-finds/?sh=120c4d8312fb.