Would like your input as a RN if your hospital has room service

Little Panda RN, ASN, RN · Apr 17, 2013

We have room service at our hospital. The pros are the patient can call anytime from 6 am to 9pm and order anything off the menu. So those who eat breakfast at 10 am don't have to eat a cold breakfast that came at 8 am. The patients seem to like this. Also if you have a patient on a cardiac or consistent carb diet, dietary is aware and will guide them in the choices they have when the patient calls. We have different menus for the different diets.

The cons are some patients are unable to call for themselves either due to hearing difficulties or just not remembering they have to call an order if they want to eat. Hope this helps.

dandk1997RN, MSN, RN · Apr 17, 2013

Insulin timing has to be an issue. We don't do this at my hospital, but one of my clinical sites did. If you have a heavy pt load, a less-than-with-it pts food might get overlooked. I mean, I had two totally A&O pts today tell me they never got fed...WAY after it was too late to call for a tray, and after the previous RN had gone home. And they don't have to even order at my hosp.

PediLove2147, BSN, RN · Apr 17, 2013

We have room service where I work and I think patients really like it. We like Little Panda RN have menus for each type of diet so patients can choose what they want and have it delivered when they are hungry. Issues I have seen include: patients that are unable to order for themselves occasionally do not get dinner. Our techs most of the time do a very good job but if it's a very busy day a patient can fall between the cracks. Our kitchen calls patients' rooms/secretary close to 630 (this in it self is a problem, who closes the kitchen at 630?!) so it happens rarely.

Insulin administration isn't actually an issue for me. I mean there is the occasional A&O patient that forgets to let us know they are ordering so we don't get a FS but like I said it happens rarely. Our patients that need help with ordering just get a FS when the tech orders the dinner.

I think once it starts and you get past the initial "newness" of it all you and your coworkers will really like it.

psu_213, BSN, RN · Apr 17, 2013

One hospital I worked for had room service, however, the nurse could enter into the computer system that a given pt was not able to order for themselves. In this case the got the "specials of the day," so to speak, delivered at standard meal times.

dirtyhippiegirl, BSN, RN · Apr 17, 2013

Insulin timing. Would be less of an issue maybe if room service didn't deliver at shift change?

RNlmk · Apr 18, 2013

We have room service but meals don't arrive at shift change. They can't get breakfast til after 815. Dietary calls the floor ahead with delivery times for all the diabetics meals and the nurses are given the list. If a pt forgets to order a meal by the end of the meal time 8:15-11a breakfast -dietary rounds the floor when they deliver and reminds pt to order if they haven't. If you don't order dinner by 7pm you automatically get a "bag dinner" Pts unable to order are flagged and get a standard meal or the family can order for them. I thought it would be such an inconvenience but really if your facility does it right with a good dietary service dept it is great for the pts

gcupid · Apr 18, 2013

Insulin timing is the biggest issue. I've had a couple of patients use control tactics based off of food arrival. I don't feel comfortable admin sliding scale insulin for blood sugars taken hours ago and if I recheck the blood sugar and decide to give insulin it is far out of scheduled time compliance to admin insulin. The correct thing to do would be to come up with standard sliding scale insulin time protocols for food delivery times as oppose to calling the doctor to see if its okay to admin insulin every time a patient is eating at a different schedule.

I had morbidly obese patients ordering outside of diet guidelines. Also had obese patients using the majority of their calories on one meal and starving the rest of the day and being a complete b**** to the staff in the process. And I've experienced patients that ordered a dish every 3 hours...

amoLucia · Apr 18, 2013

My first thought was about the insulin timings with fingersticks. But then I also thought of all the meds that are "before meals", "after meals", with meals", and "give on n empty stomach". If the pts are ordering meals at varying times, how in the world do you schedule meds?

eatmysoxRN, ASN, RN · Apr 18, 2013

Ours works by dietary calling everyone starting an hour before delivery. They can choose something within their diet to eat and trays are delivered like they want. If they don't answer or don't call back to order something specific, a standard tray is brought. Everyone with a diet entered gets a tray. It includes what you want only if you call. Patients like it pretty well.

amygarside · Apr 18, 2013

Actually, the kitchen and nurse station should work closely when room service is available. Some patients tend to sway from their prescribed diet.

Sun0408, ASN, RN · Apr 18, 2013

Diets are entered into the computer and only that diet can be ordered, the kitchen staff is great with helping the pts order.. On admission we click if the pt is able to order or not.. If not a standard tray for their diet is brought up automatically. I am not sure how it works on the floor for reminding pts to order and what happens if they don't. As for the ICU, since there is no phones, we order for them.. Meds are generally not a problem. Our room service stops at 7 so if you didn't order before then, you are pretty much out of luck. We can get a late tray but that might be a turkey sandwich