Time of Meals
As a general rule the heaviest meal of the day—the dinner—should be served in a hospital at mid-day. This plan will be more satisfactory to those on whom the preparation of the meal devolves, and it is distinctly better for the patients. The time needed for the digestion of meats and vegetables is estimated at from three to five hours. If the heavy meal is served late in the day the work of the stomach cannot be completed in time for the patient to get to sleep early, and if the stomach is actively engaged in digestion the rest is likely to be retarded or disturbed. This rule of course does not apply to patients in a weak condition who must be fed at frequent intervals and in smaller quantities. And it needs also to be remembered that a perfectly empty stomach does not contribute to repose, and indeed is a frequent cause of wakefulness.
A plain, wholesome early breakfast for the “help” and for the nurses is a necessity in a hospital where the heaviest work comes in the morning hours. This should be as substantial as the appetite and digestion are equal to. With nurses who are constantly exposed to morbid and depressing influences, the breakfast is of special importance, and a nurse who does not partake of a hearty breakfast is always more susceptible to deleterious influences. The rush of work, long hours, mental anxiety, and almost constant walking or standing, which are incident to hospital life, make it very necessary for a good quality and quantity of food to be prepared for those who have the direct responsibility of the care of the sick. And while extravagance ought to be guarded against, yet no mistaken idea of economy should prevent the housekeeper from serving a well-balanced, nutritious and attractive dietary to these important members of her household.
The housekeeper should not fail to remind herself constantly that “variety is the spice of life,” and should see that “wholesome variety” characterizes her meals, for the nurses as well as patients, from week to week. The element of surprise or unexpectedness figures largely in the pleasures of every-day life. Anything that leaves out the possibility of the “unexpected,” especially on a nurses’ table, has much in it to condemn and little to commend.
On the nurses’ table clean table linen at frequent intervals ought not to be regarded as a luxury, and certainly it adds greatly to the enjoyment of a meal. A few of the flowers that are often distributed lavishly in a ward would as fully fulfil their mission there. A pretty growing plant purchased occasionally for the same purpose is an extravagance that could be forgiven. Then, besides refined surroundings and neat, attractive table service, the character of the food, the quality, could be greatly improved by a little careful planning without any great, if indeed any, increase of expense. Dr. Peters, of the Rhode Island Hospital, in an admirable paper on hospital dietaries, asked the following pertinent questions:
“Do we realize the satisfaction that a variety of soups, so easily and cheaply prepared, give to our inmates? Do we remember the many ways of preparing meats to be served with a great variety of gravies and sauces? Do we realize that mincing meat is an important method of preparation? Do we appreciate how much more satisfactory fresh vegetables are than canned? Don’t we forget the natural craving for fruit? Couldn’t we, with a little forethought, give our nurses and employes salads, ices, etc., at practically no greater cost than the routine dishes? Did you ever realize the variety of ways such common articles as potatoes, rice, apples, etc., can be cooked and served? Do we serve fish in as great a variety and often enough? Do we give attention enough to the possible varieties of dessert? Are all these questions trite? Yes; but possibly worth repeating to act as reminders.”
It is time that the system of arranging a nurses’ bill of fare for months ahead were forever abandoned in every institution. The very monotony of it makes one weary at the thought. To know that on a certain day of the week one is doomed to a dinner of corned beef and cabbage is certainly not likely to create enthusiasm for the morning’s work. To contemplate while dressing that “this is the day for fried liver for breakfast,” is sufficient to nauseate some of the less hearty members of the family. To know that of all the list of fruits in the market only about three or four are likely to appear on the nurses’ table till the authorities see fit to change the bill of fare is, to say the least, depressing. Monday, apple sauce; Tuesday, stewed prunes; Wednesday, dried peaches or apricots, etc. And the desserts are often equally monotonous: Bread pudding, rice pudding, apple pie and again bread pudding, rice or tapioca pudding; apple pie, with a dish of cornstarch—sometimes pink, sometimes white—on Sunday. It is little wonder that after two or three years of this monotony in diet, many nurses regard these articles of food as things to be avoided for the remainder of their lives.
As a general rule it is best to avoid, as far as possible, serving food that has been warmed over, or twice cooked, to sick people, though perfectly proper for those in health. It is better, however, to calculate as carefully as possible the amounts required for each meal, and cook no more than will be used. Meat, fish and vegetables, especially, are better for the sick when cooked fresh.
While many of the salads—lobster salad for instance—are not suitable for a hospital dietary, when viewed either from the standpoint of economy or digestibility, yet delicious salads may be made of very common articles without any extra expense. A salad composed of apples, celery, a few nuts and a little French dressing could scarcely be considered an expensive dish at any season, and yet such a simple combination would add a relish to an otherwise commonplace meal. A bean salad is both dainty and nutritious. Many such delightful combinations will suggest themselves to the housekeeper whose heart is in her work, and who is really mistress of her art, and these all go to make up the difference between variety and monotony.