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We need to take stock of vending machines in A&E departments

Over my career I have spent many thousands of hours in A&E departments working on shift to care for sick or hurt children. I, along with the medical team, do my best to care for the physical wellbeing of each and every patient that comes through the door. I find it hard to believe, therefore, that the powers that be think it is a good thing to pack the A&E waiting rooms with vending machines full of sugar loaded fizzy drinks, chocolate and confectionary.

While we heal, the vending machines are stoking the consumption of foods that harm. We know that high sugar diets are implicated in obesity, Type II diabetes and a host of other health problems, and a high salt diet contributes to high blood pressure, but the vending machines right in the heart of our hospitals are sending out the message that it’s fine to eat sweet and salty snacks.

In a study of hospital trusts in England carried out  in 2015, a national newspaper found that all of the 76 which responded had vending machines in their departments, selling a range of sweets, chocolates and crisps. Yes, some did restock their vending machines to include healthier dried or fresh fruit, and two only offered diet versions of fizzy drinks, but the overwhelming majority stuck to the worst possible options when it comes to unhealthy eating.

These vending machines, which take up valuable space and add to overcrowding in cramped waiting rooms,  have a captive audience, both the staff and the patients. I have to admit that when I was working nightshifts, with no time to take even the shortest break, I would put in some coins and boost my energy levels with a quick chocolate bar. Many of the night staff have no other option but to use the vending machines – the main hospital cafeterias are closed and there is no time to pop out. Our staff room had a kettle and a fridge but no microwave to reheat home-made meals.

The patients and their relatives and carers are in an even worse predicament. They are in pain, anxious and often forced to wait for many hours. Boredom sets in and, not surprisingly, they graze on comfort food. At least, they are usually only there for a 24 hour period of less. The nurses and doctors are there day in, day out.

Our working environment in most A&E departments are pretty unhealthy in many ways, not just the kind of food we are forced to eat and the shift work patterns which rob of us of healthy sleep. There is rarely any natural daylight in the emergency rooms, which are often on the basements levels of concrete buildings to allow easy access by ambulances. Space is so limited that in one A&E department I worked in, the baby room was a concerted stock cupboard. No natural light also means poor ventilation and little fresh air. So, we work many hours without seeing the daylight or breathing fresh air. We eat junk food and then wonder why we feel so terrible at the end of our shift. It’s not just exhaustion.

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Lara Speir: Lara Speir is an emergency paediatric staff nurse who has worked in A&E.
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