Tag Archives: on call

Salads

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For medical students in basic sciences, a salad can be a great “energy” lunch that lets you stay alert in class.  For students on rotations and residents, a fresh salad is a great lunch and an even better middle of the night meal when you are on call.

The concept couldn’t be easier – put lettuce, spinach, or the greens of your choice in a big container.  Top with protein, cheese, veggies, nuts and/or fruit.  If you don’t care what it looks like, it’s also really easy to dump it all in a big zip-lock bag.  When it’s time to eat, pour the salad dressing in the bag with the salad, shake, and then serve yourself from the bag.

Protein:  Beans from a can, beans you make yourself with a crockpot or pressure cooker (which saves money and avoid excess salt and additives), canned tuna, cooked chicken from the deli, prepackaged meats (look at the labels to make sure you aren’t getting a lot of additives you don’t want), shrimp, etc.

Cheese:  Shredded cheddar, Monterey jack or Mexican cheese (reduced fat or regular), feta, goat cheese, thin slices of parmesan

Veggies:  Any leftover in your refrigerator!  Another good idea for this is to buy what you need for a mirepoix when you do your once a week shopping.  A mirepoix is the basis of  French cooking and is one part onions, one part carrots, and one part celery.  The Cajun trinity is similar but substitutes green bell pepper for the carrots.  If you buy the ingredients for a mirepox (or trinity) and chop it up on the weekend, you can use handfuls in salads, omelets, soups, etc all week.  (You can add other things, too, like mushrooms, red bell pepper, etc – anything that can be eaten raw).  If its a really busy week and you don’t have time to chop up vegetables, you can used canned green beans, corn, beets… whatever vegetables you like.

Nuts and/or fruits: Adding some dried fruits and nuts, sunflower seeds, etc, will add some extra nutrition.  Fresh fruits like blueberries, strawberries, sliced peaches are delicious in salads.  Canned fruits, especially mandarin oranges, are good, too.

Salad dressing. Don’t put the dressing on the salad until you are ready to eat.  (The French say it “cooks” the salad… but the result in any language is soggy salad.) My favorite dressing is a homemade vinaigrette.  Start with vinegar (red wine, white wine, sherry or balsalmic), a clove of diced (not crushed) garlic, a healthy teaspoon of good Dijon style mustard, salt and pepper.  Stir these all together until the salt is dissolved and the mustard is blended with the vinegar.  Add olive oil while you are stirring (or shake it up at the end.)  The classic ratio is 1 part vinegar to 2 parts oil, but you can add less oil to taste.  I usually squeeze a little lemon juice in, too.

The easiest thing by far is bottled salad dressings.  Be careful about calories (if you are watching your weight).  If you take salads to work regularly, you may want to leave the bottle there (unless the food snatchers raid your refrigerator on a regular basis).

http://allrecipes.com/Recipes/Salad/Green-Salads/Top.aspx

http://hubpages.com/hub/Favorite-Salad-Toppings-Lessons-From-Restaurant-Salad-Bars

http://www.fitsugar.com/Nutritional-Information-Salad-Toppings-7598444

Healthy Sandwiches

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Making a healthy sandwich for lunch is a great way to insure that you don’t eat the leftover pizza from last night’s call team.  A really good sandwich which balances protein and carbs is also a great way to get through a long call night.  Keeping your energy up when you are up all night on call is difficult but there are tricks to maintain energy for call. The most important way to have good energy on call is to eat good quality food every 3-4 hours. Sandwiches are great for call because they are so easy to make, easy to store and easy to put in a pocket to eat on the go.

Pick good ingredients whenever you can.  It’s worth paying a little more to have food that is just food (and not a lot of fillers, corn syrup, transfats, etc).  Make sure you get high quality bread – 100% whole wheat is best, but if you really don’t like whole wheat, at least try to get as much whole grain in the bread as you can. Whenever possible, add veggies to add nutritional value.

Peanut butter sandwiches have the advantage of not needing refrigeration.  You can keep them in your white coat pocket if you want to (an advantage on a busy day).  You can stay traditional (i.e. peanut butter and jelly), or up the nutritional content by adding banana (or other fruit) or with other unusual combinations.

Egg salad sandwiches are great in the middle of the night when you are on call.  101cookbooks.com egg salad recipe is a pretty classic recipe which is really wonderful.  If you want to up the protein and decrease the fat leave out some or al of the egg yolks and use lowfat mayonnaise.  There are other options for traditional egg salad recipes, too

Tuna or chicken salad sandwiches can be made with classic recipes, or less traditional ingredients that up the nutritional content such as spicy tuna salad, or other unique tuna salad recipes.

Lean meat (chicken, ham, pork, beef) makes a great, high protein sandwich.  Add cheese, tomatoes, spinach, shredded carrots or other veggies to increase the nutritional value.  If you are watching your weight use low-fat cheese and avoid mayonnaise.  If you use hummus or avocado instead of mayonnaise or other spreads you’ll also make the sandwich more nutritious.

Here are a few other sites to help you be creative with your sandwich ideas:

Healthy Sandwich Recipes & Tips

Love Your Lunch: 10 Healthy Sandwich Recipes

Good Nutrition is in the Bag: Healthy Sandwich Alternatives

How to Eat Well On Call

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It’s Saturday and I’m on call – and it’s going to be a busy day!  We have about 75 patients on the service, we already have 4 cases done and another 4 posted, and it’s still early (~4pm)   I have a fantastic resident with me today.  We just were chatting about what we are going to do for meals today.  He didn’t have breakfast and has only had a Coke and a “borrowed” bowel of Kix cereal from the recovery room so far.  I had whole wheat toast with some goat cheese before I left my house this morning, and I here’s what I have to eat today:

  • Strawberries
  • A handful of frozen cooked shrimp with cocktail sauce (they’ll thaw by the time I want to eat them)
  • Frozen peas (I put them in the microwave for a minute but, like the shrimp, frozen would be fine because they’ll thaw) + goat cheese, olive oil, vinegar, salt and pepper
  • Leftover whole wheat orzo, artichoke hearts, tuna and lemon pasta from last night
  • An apple
  • Lemon wedges for water

My resident’s Coke is probably more than I used to have as an intern… which is STUPID.   Eating well is important to feel well, perform well and do the right thing for your patients. There is one word that explains the difference between my resident (and what I used to do) and what I do now… planning.   “I’ll just get something from the restaurant across the street later…”, “There will probably be food leftover from the GI conference…” .. “I can always eat a bagel from the lounge..” … NOT.   When you finally have a minute to grab something to eat, you won’t usually have time to go look for the food.  It’s a lot easier if its’ there and ready to eat.

Here’s how to do this right:

1. Buy a good “lunch box” .

I like the hard plastic ones that fit in an outside, insulated carrying case.  It’s a lot easier to clean up if something spills than the usual “lunch box”.

You can use plastic (disposable) containers to carry your meals with you.  I’ve switched to glass containers because some of the data about heating the plastic containers in the microwave started sounding convincing.  It does mean you have to keep track of them and bring them home, but I suspect in the long run (if I don’t lose them) it will be cheaper than the plastic containers.   I particularly like the ones I bought because the seal is so tight that they don’t ever leak  (even for things like soup).

2. PLAN.

The night before call, figure out what you are going to take. Make it good stuff, too!  Call nights are not the “what I know I should eat” nights.  You need to have real food (i.e. not processed) but don’t skimp.  When you get to the “I really deserve those french fries” time of your call (which we all do) you will have really delicious and balanced food  in the refrigerator.

3. Pack your meals for the next day the night before (no matter how late it is or how tired you are).

It’s the only way you’ll actually do this.   None of us when we work this hard have the energy to put together meals for the day at 5am.  This takes a little effort but the payoff is real.  You will absolutely eat better, have more energy, maintain your weight and do a better job.  Don’t forget to throw some fruit in – and to make sure it’s washed so you can just pull it out of the refrigerator for a snack.

Recipes for Medical Students and Residents

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I’m going to periodically add some recipes to the blog that meet my “pizza rule” i.e. if it takes longer to cook than it does to order a pizza it’s not going to work… http://wellnessrounds.org/cooking-for-yourself-in-medical-school-and-residency/

WHOLE WHEAT SHELLS WITH ASPARAGUS, PEAS, FETA AND MINT

This is a great vegetarian dish and would make enough for a lot of call nights!.  The recipe calls for garlic oil (which I’ve never heard of).  I’d skip it or, if you really want to add a little garlic taste, mash up a couple of cloves in some olive oil (like 2 tblsp) before you start and let it sit while everything else is cooking.  You can drizzle the olive oil over the pasta at the end.

http://www.vegetariantimes.com/recipes/10964?utm_source=Vegetarian&utm_medium=newsletter&utm_campaign=vege174

GRILLED FISH WITH FRESH PEA SAUCE AND PEA AND TOMATO RELISH

Here’s the original url for this recipe which is delicious (but a little fussy and violates the pizza rule)

http://www.foodista.com/recipe/4V8PPYZF/grilled-fish-with-fresh-pea-sauce-and-pea-and-tomato-relish

Here’s the resident friendly version:

GRILLED FISH WITH FRESH PEA SAUCE AND PEA AND TOMATO RELISH  (PIZZA RULE VERSION)

2 servings

  • 2 filets of the freshest white fish in the store (Tilapia, snapper, etc)
  • 2 tablespoons olive oil  (cut to 1 tablespoon or use Pam to save calories)
  • 1 package frozen peas
  • 1 cup chicken stock  (buy the 4 packs of one cup each)
  • 1 shallot (if you can’t find one, use part of the red onion)
  • 2 cloves of garlic (don’t cheat on fresh garlic)
  • Salt and pepper
  • 2  Italian Roma tomatoes
  • ½  minced red onions
  • 1/4 cup chopped black olives  (buy in bulk at Whole Foods – use Nicoise or herbed olives of Provence – can buy small jar, too)
  • 2 tablespoons chiffonade of basil  (chiffonade = finely sliced.  Don’t cheat on the fresh basil, either)
  • 3 tablespoons extra-virgin olive oil  (cut to one table spoon if you are watching calories)
  • 2 Yukon gold potatoes cut into 6ths or 8ths

Start with the base of the sauce

  • Saute the shallot (or onion) in the olive oil
  • Add the garlic until you smell it (more and it will burn = bitter)
  • Pour in the chicken stock
  • Bring to a boil
  • Add the potatoes – drop the heat to a simmer and cook until just fork tender (~8-10 min)
  • Pour in the frozen peas – cook for 3 minutes
  • Take the potatoes out and save

Take out a third of the peas with a slotted spoon and put in a bowl to use later

  • Put everything else (minus the peas and potatoes you took out) into a blender until smooth.  (If you don’t own a blender, this is a critical tool for residents so go out and get one!  Smoothies are a key food item for medical students and residents and blenders are cheap!)

Make the relish

  • Cut up the tomatoes, olives, basil, red onion
  • Add to the peas you saved from above
  • Add the olive oil

“Grill” the fish

  • Use a grill pan or non-stick sauté pan (another important piece of resident equipment)
  • Put olive oil in the pan (Pam if you are watching calories)
  • Cook 3-4 minutes per side

Assemble the dish

  • Pour the sauce into a bowl
  • Put the fish on top
  • Arrange the pieces of potato around the edges
  • Put the relish on the fish

A variation (if you like Mexican flavors)

  • Use tomatoes, corn, cilantro, jalepeno and onion for the relish
  • Use frozen corn instead of peas

MLB’S EASY MEXICAN SOUP

8 servings

  • 1 tsp olive oil
  • 1 onion, diced
  • 1 red bell pepper, diced
  • 4 carrots, diced
  • 4 stalks celery, diced
  • 8 cups (two containers) chicken broth
  • 1 roasted chicken (bought already cooked), skin removed and meat broken up into small pieces
  • 10 oz frozen corn
  • 1 can pinto beans
  • chopped cilantro
  • 2 avocados
  • pico de gallo (buy at the store)*

Saute vegetables in olive oil until they are soft

Add chicken broth, bring to a boil

Lower heat to simmer and cook 10-15 min (until vegetables are mostly cooked)

Add chicken, corn and pinto beans

Cook another 5 minutes on simmer

Garnish bowls with chopped avocado (1/4th per serving), cilantro and pico de gallo

Optional:  Add cooked rice and/or shredded cheese

* to make pico de gallo (if you can’t find it ready made)  combine 3 diced tomatoes, 1 diced onion, chopped cilantro, one diced (fine) jalapeno, salt and lime juice.  This is a great dip for chips or to put on grilled fish or chicken, too.

You Can Exercise Even if You are on Call

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One of the great fallacies about working out is that you need to “go somewhere” to work out.  This idea that working out is separate from the rest of your life is the main reason people don’t work out.  Be creative – there are lots of ways to work out that don’t require much and can be done in the hospital.  There are days on call and then there are days on call (everyone who has done it knows what I am talking about).  On the days that have a little “breathing room” here are some ways to work out while you are at work.

Cardio options

  1. Take the stairs instead of the elevator.  There are good data that 3 sessions of 10 minutes of cardio has the same result as a 30 minute cardio session.  Those 2-3 minute “sessions” of going from floor to floor will add up to 20-30 minutes easily by the end of the day.  Or, if you want to push it a bit, add a few flights (or minutes) here and there.  You can always find 10 minutes (or 20, if the day permits) and really climb the stairs.
  2. Take a jump rope to the hospital and keep it in the call room
  3. Find out if there is a stress test lab or PT area in the hospital that has stationary bikes or treadmills that you can use.
  4. Go for a walk.  If it’s safe, and your beeper and cell phone permit, walk outside the hospital.  If not, do “power rounds” on the floors for exercise (do the circuit of each floor, climb the stairs to the next floor and continue).
  5. Talk your program into paying for a used bike or treadmill.
  6. Commute to work on your feet or on a bicycle (more on that later…)

Strength training options

  1. Buy a set of stretch bands or inflatable (with water) dumbbells and throw them into your on-call bag.  You can get a good strength training workout with these.
  2. Cheap dumbbells are easy to find.  For $20-30, you can put a pair or two  in the call room or resident lounge.  See if there are other residents that want to go in with you to buy a complete set.  Of course, you will have to find a way to lock them up if, like most hospitals, things have a habit of walking away.
  3. Old fashion calesthenics (push-ups, squats, etc) will provide a good strength workout , too. You might consider one of the many popular DVD based programs that are making the rounds (no pun intended) at the moment.

Flexibility training

Stretching can be done anywhere, anytime.  Like weight training, there are some good tips that can be taught by a pro.  Make sure if you hire a personal trainer that you ask them to give you some tips about stretching, too.  There are also excellent books on stretching.  You might think about web based or DVD yoga sessions as another alternative.

The key concept here is that working out during call is doable – and will often help with fatigue, stress and the feeling of being overworked.  These “workouts” don’t have to be long – even 10 minutes will help.