All this over a turkey sandwich

[ellemae93]

I'm so upset. Tonight we had an 8-year-old post-op patient arrive to our floor. She was doing fine, getting settled, and decided she was hungry. At my hospital we offer post-op patients who missed one of their meal-times an after hours menu. They circle their choice of whatever cold-cut sandwich, canned, soup, and side and we fax it down to the cafeteria and go to pick it up for them, which is what we did for this kid.

So I go down to pick it up and the dietary assistant VERY rudely tells me "This was faxed down at 1:31! Cut off time is 1:30AM! She's not getting anything!" I was sort of dumbfounded at this response and reminded her that this was a kid who hadn't ate all day. She still refused. The cafeteria is open until 2AM, and there were still plenty of employees purchasing food and being served, so it wasn't like I went down there 5 minutes before closing, it was just after 1:30. I asked if there was really no one who could slap some turkey on a piece of bread for the kid. They still refused and told me I had to go to the ER and see if they had any leftover sandwiches. The kid had also wanted a milkshake, which I knew they would never give to me, so I just paid for it myself to give to her.

What's really upsetting is that when a similar incident happened in the past, our manager and the dietary manager reached an agreement and decided that kids were an exception to the rule when it came to after hours nutrition. If a kid wants an extra fruit cup, so be it. So I was really shocked when they didn't miss a beat in telling me that this kid couldn't have a sandwich. (the pt's age is listed on the fax so they knew it was a child) It's also not like I was asking them to fire up the grill and make her something fancy - the kid wanted a cold turkey sandwich, chips, and chicken noodle soup, which we prepare on the floor after they give us a small can and styrofoam bowl. And a milkshake.

I fully understand the dietary department has their own manager and rules but I just found it really upsetting that no attempt was made to provide some nutrition to this kid. If they didn't want to make a sandwich they could have at least offered me a can of soup and a bag of chips, I think.

Oh... and the kid's father was standing in line waiting to pay for the snack he had bought himself and his wife and overheard the whole exchange. Real nice. At least he heard it happen and knew it wasn't just the nursing staff screwing around and not feeding his kid. He was very pleasant about it all, but needless to say was not happy. Nursing staff told the kid she could have whatever she wanted off the menu and here she was, getting almost nothing. What a bunch of drama over a sandwich that was ordered one minute too late.

[amoLucia]

First, I'd call Nsg Supervisor to intervene.

Then, I think I would document it somehow as an 'incident report' type of occurrence and submit copies to your nsg management, dietary and your facility's Public Relations Dept (unless your supervisor has other directions). In this day & age of those 'satisfaction scores', I think someone might be VERY interested in this family's satisfaction - considering that the family was witness to dietary's response.

This situation also points to a greater facility need - how can a unit provide for a late, late admission. I'm sure that this happens often enough that there is most probably a need.

[~PedsRN~, BSN, RN]

I would have sent some emails out for sure. That is ridiculous. And if that is truly the policy, then that policy needs to change - or your floor needs to be staffed with some meals somewhere for instances such as this.