After pressure from ACEP on behalf of our members, The Joint Commission (TJC) has clarified that emergency physicians, contrary to popular belief, can eat and drink at their ED workspaces.
Most emergency physicians have suffered on the job, unable to eat and drink to maintain the energy necessary for long shifts in the emergency department. Caring about our members’ well-being, ACEP worked with TJC to issue a formal clarification in the March issue of its newsletter Perspectives that explains how the Occupational Safety and Health Administration (OSHA), hospital, and TJC policies work together to protect both clinicians and patients.
“Our job is so hard, for people to make it harder is just unfair,” said Sandy Schneider, MD, FACEP, a practicing emergency physician and ACEP’s associate executive director of practice. “I think it seems like such a small thing, but ACEP has really done something huge here. Not only has ACEP helped clarify that we can eat and drink, ACEP has also said, ‘When we can, we’re going to make things better for you.’”
In the article, TJC explained its role in regulating food and drinks in the emergency department. TJC’s responsibility is twofold: 1) to make sure facilities are conforming with OSHA regulations and 2) to help enforce each hospital’s own internal policies.
TJC standards do not specifically address where staff can have food and drink in work areas. OSHA also does not have a prohibition against the consumption of food and beverages at workstations, including those in the emergency department.
“When I started out practicing, we were able to eat and drink during our shift, within reason. Gradually, that was taken away from us, “ Dr. Schneider said. “We weren’t sure where this was coming from. They kept saying it was The Joint Commission, it was OSHA, we had to do this, it was against the law, etc.
“All I know is … after a shift, I was tired. My hips and knees hurt. I’d come home and just go to bed. Now, [at my current job], I have a place to eat and drink. I actually work a longer shift, and I see more patients! It’s interesting. Just the ability to eat and drink makes you feel more human.”
OSHA does have a bloodborne pathogen regulation that forbids eating, drinking, and storing food in areas that could be exposed to blood or potentially infectious materials. OSHA regulations also require hospitals to evaluate work areas to determine which could potentially be contaminated and to ban staff from eating and drinking in those specific areas. On the flip side, OSHA does not require hospitals to create safe eating and drinking zones for staff; that decision is left to each individual hospital.
OSHA sets minimum health and safety regulations, which are then enforced by TJC. However, because they are only considered minimum requirements, hospitals are free to adopt more stringent policies if they choose. If you’re an emergency physician who is restricted from eating and drinking in your emergency department, even in areas separate from potential contamination, those policies are likely directed by your hospital, not TJC, Centers for Medicare and Medicaid Services, or OSHA.
“As we start thinking about ways to improve health systems, wellness is so critical, and eating and drinking directly pertain to that,” said Erik Blutinger, MD, an emergency medicine resident in Philadelphia and Emergency Medicine Residents’ Association representative to the ACEP Board of Directors. “I certainly know that without food and drink, I can’t function. I can’t think straight, and my thoughts are no longer rational and logical. It’s especially important in emergency medicine to be able to eat and drink, given the fact that we can’t even step away for a few minutes from the department.”
How Do You Work with Your Employer to Change Its Food and Drink Policy?
Start advocating for change by making your hospital’s policymakers understand the forces at play regarding this issue. ACEP created a fact sheet that emergency physicians can share with administrators to jump-start this conversation. It explains current OSHA regulations, the role of TJC, and how these factors affect the emergency department. It’s possible that your hospital’s policies were put into place years ago by previous administrators without full understanding of the regulations. Providing the facts, combined with your firsthand testimony reflecting how hard it is to navigate a stressful shift in the emergency department without once pausing for food or drink, creates a compelling case for change. Visit acep.org/letseat to read more.
Ms. Grantham is a communications manager at ACEP.