By Camryn Bell, Dietetic Intern

Going to the hospital seems like an inevitable event for most people, whether it’s for pregnancy, elective or minor surgery, or maybe for a more serious ailment. Just because a trip to the hospital may seem stressful does not mean you can’t help alleviate that stress by having a plan in place for when you do go. Being vegan and put into a new situation or place, like the hospital, can come with its obstacles, but I am here to help guide you around those challenges. Let’s all be honest, being vegan is tough for some individuals at times and voicing an opinion can be hard, but being vegan is rewarding and empowering so that is why we do it. When it comes to the hospital setting, it is no different; the most important tool we have is our voice. Communication is crucial to getting what you want and understanding your options, but it is important to remember to treat the staff with respect and empathy, and to also understand the limitations the hospital staff may be working under.

What to Know Before You Go

Stating as early as possible that you are vegan, either by writing down on your admission paperwork or by simply telling the staff, can give you and the staff more time to smooth out the wrinkles and make sure everyone is on the same page. They may even be able to add into your medical record that you would like to avoid the food items you tell them, like dairy, meat, and eggs. If you have a pre-op appointment before coming into the hospital, you could discuss with the staff then about being vegan and how they can best serve you during your hospital stay.

     Hospitals have different menus and ordering systems. In some, you can order through a written form; in others, you must call the diet office to order your meals. If you have the option to call the diet staff, this would be a good time to ask the questions you have regarding ingredients and vegan options. If you are using the written form, you may be able to write on it the food items you wish to avoid. In this case you would still have to call the food staff or dietitians if you have any questions. Some hospitals have a system where you are given a menu and you can pick the items you want from the menu; this is a good situation to be in. When in doubt, stick to simple items like rice, fruit, salads, or beans that are less likely to have any hidden ingredients.

     These are just some starting examples; you will obviously need to try to get a well-balanced meal. If you have any questions or want to know the ingredients in the menu items, for example, if you are unsure if there are hidden animal products in items, calling the food service staff or the dietitians can help provide you with information and guidance. The food service staff’s number may be on the menu so look there, or ask your nurse to speak with them or the dietitian. Stating that you would like to speak to the diet staff or dietitians may help you not only get their contact information, but you may also get to speak with them in person, and that would be beneficial to really work through your options.

Who’s Who

Registered dietitians (RDs) are health professionals who have specialized in foods, diets, and nutrition. They are a great resource for support and help throughout your hospital stay. They have a lot of knowledge they would like to share with patients, and they want to help their patients enjoy their food while eating something that will help them get better. The dietitians’ specialty is more about the knowledge and implementation of food, whereas the diet staff is more about the hands-on application of food.

     The food service staff can have multiple jobs including preparation of food, serving meals, stocking, and cleaning. When it comes to the food staff, I would not assume that every member knows what veganism means, so it would be a good idea to specifically tell them the foods you avoid. You may even be able to write down these foods, and have it sent to the food staff if they are unable to put it in your chart.

     There are also DTRs (dietetic technician, registered) or dietitian assistants who could be working in the hospital. They have similar roles as the RDs but usually work under them because they have not completed the same qualifications. It can sometimes be difficult to distinguish between these different staff members. Looking at their name tags can give you insight into their job titles. The food staff will most likely be those delivering the food and taking meal orders. The dietitians are those who come in asking or giving nutrition information. They should also tell you what their job title is, but if not, just ask. 

Hospital Vegetarian Menu

Some hospitals may have a vegetarian menu, so starting with that and making adjustments to make it vegan may be easier than starting with a regular (non-vegetarian) menu. The vegetarian menu may not be attached to the regular menu, so ask the nutrition or nursing staff if there is one available.

Talking with Your Doctor

Some hospitals will only provide a standard meal to every patient unless they have a special order from the physician. In this case, speaking with your doctor would be helpful in getting a change to your diet order to meet your preference. If a meeting with your doctor to discuss your diet is not possible, ask your nurse or dietitian to be your advocate. You can also have an opportunity to bring up the topic up with the doctor the next time they come to your room to speak with you.

     Before you are able to meet with the dietitian or your doctor, see if the food service staff can add additional items onto your standard tray that you can eat. Some of these items could include additional servings of fresh, cooked, or canned fruits and vegetables, grains like rice or bread, different types of beans, non-dairy milk, or any meat alternatives they have on hand.

Bringing in Your Own Food

If the staff cannot accommodate your preferences, you may be able to bring in your own food if it is cleared by the hospital. If your diet includes other restrictions like low carbohydrate, low sodium, or texture modified, then the hospital staff would be more likely to object and not allow outside food to be brought in because it would likely not follow the stricter diet they set for you. If this is the case, try to eat what vegan food is available to you. As discussed above, the tips to help you with doing this is communicating with the food staff or dietitians about questions and support and pick simple food items from the menus provided.

     If you are cleared to bring in your own food, you can bring snacks with you when you are admitted. Healthy filling snack ideas don’t have to be complicated. Bringing staple items that can be incorporated into different snacks will give you variety without having to bring your whole pantry. Some good snack ideas could include apples and peanut butter, trail mix, vegan cheese and crackers, veggies and hummus, granola/protein bars.

     Some hospital rooms have their own mini fridges in them where you can store your food, but if this is not an option it is appropriate to ask the staff to store your refrigerated items in a fridge somewhere. There are usually refrigerators on each floor either in the staff eating areas or in the nutrition rooms.

     The food staff may also be able to store your food somewhere where it would be unlikely to contaminate other foods. You may also ask to have your food heated up if needed. The staff is there to serve you so asking for these accommodations is not far-fetched.

     You may also have friends or family pick you up meals and brings these in. Preparing a list of nearby restaurants with menu items you can eat may be helpful for those bringing you food.

Special Situations

Calling ahead to hospitals to see how they can accommodate and what they can offer you is a good idea, but sometimes admission is unexpected. In this instance having a note in your wallet listing your preferences could be helpful, and even in the Emergency Medical ID section of your phone you could indicate that you are vegan. 

     When you are in the hospital, you may require nutrition supplement drinks/food or tube feeding formula. Most of these formulas are vegetarian because they are made with milk protein excluding the fact that they contain vitamin D3. Vitamin D is often sourced from sheep lanolin (the waxy substance secreted by the glands in sheep skin), so it is not vegan. If you are requiring these products, I would ask the staff if they are able to order a vegan option or if they would be willing to make blenderized meals for you. This link lists different vegan meal replacements, supplements, and feeding tube formulas, https://www.vrg.org/seniors/#meal. It is always best to consult your dietitian and doctor to confirm that these options are appropriate for your situation and medical status. If you have any questions regarding the ingredients in your supplements or tube feeds, you can look at the ingredients on the back of the container, look up the ingredients online, or call the company (their number is usually on their website). This may be a case where you have to do the best that you can, keeping in mind that it is not a vegan world. You may also ask a friend or family member to do the research if you do not feel well enough to take this task on yourself.

     After a surgery or procedure, there is usually a natural progression in your diet orders to ensure that you are tolerating food well and that your GI tract is working as it should. This progression may begin with a clear liquid diet, move to a full liquid diet, then a soft diet, and then back to a regular diet. These diets are already limiting so let me give you some ideas of what you may be able to eat from them. A clear diet is a diet that consists of (you guessed it) clear liquids. It usually includes broth, sugar-free gelatin, clear fruit juices, popsicles, tea, sports drinks without color, clear sodas, or water. Although you should stay clear of meat based broths and gelatin, all the other options should be appropriate. Consider asking for vegetable broth instead.

     A full liquid diet will include more liquid options and even some soft foods. Appropriate vegan options on a full liquid diet could include all the items from the clear liquid diet in addition to oatmeal/grits made without milk, milk alternatives, creamy peanut butter, the vegan supplement nutrition drink mentioned above, puréed fruits, or mashed potatoes. The hospital may be able to make you smoothies if you ask. If you are able to bring in food beforehand, vegan protein powder may be a great option. Protein powder can help you get protein, vitamins, and minerals if the hospital is unable to provide sufficient options. Speak with your doctor beforehand though to confirm this is an appropriate option for you. A soft diet would include all mentioned above, but it could also include refried beans, cooked vegetables, softer fruits like bananas or cooked pears, soft noodles, or soft tofu.

     Once you are back on the regular diet, you can use all the tips above for planning your vegan meals. And again, if you have questions about what ingredients are in your food, calling the dietitian or food staff is the way to go to get the information you need. Here are links for texture alterations for vegan diets: https://www.vrg.org/fsupdate/fsu981/fsu981design.htm and https://www.vrg.org/journal/vj2009issue2/texture.htm.

Corona-Upending-Everything-Virus

As I said, going to the hospital can be scary, but going during a pandemic is a completely different story. This is a new territory for the whole world. Although having your preferences during this time might seem trivial, standing strong on your beliefs does not have to feel like a nuisance to the staff. I believe that all the tips mentioned above are still appropriate but it may be harder to accommodate you during this trying time. It may be more difficult to have your own food brought in due to avoiding outside contamination; discuss that with the hospital staff.

     Some hospitals may even switch over to house or standard trays, but they still have to accommodate those with allergies, and although being vegan for most people is because of values not medical necessity, they still may be willing to alter your meals for you. When it comes to supplements and tube feeding, this may not be something they are able to change. Most nutrition departments are stocking up on commonly used formulas, and vegan formulas most likely will not make the cut, so it may not be possible for them to order a special formula for you in time, if at all. If none of these attempts work for you and you have no other choices left, just know that it is likely short-term. It may be hard to go against your beliefs, but having the mindset that you tried your hardest and once you are healthy again you can go home and resume your normal lifestyle, may help ease the weight.

     The hospital system does have room for improvement when it comes to veganism, but much like society, they have come a long way with accommodating and offering vegan options. It is a lot easier to get information on ingredients and being able to have vegan food in the hospital than it was even a few years ago. So, although it may seem frustrating while being in the hospital and having a lack of options, it’s noteworthy that progress has been happening and will continue. I would also just keep in mind that as you expect understanding and respect with your decisions and expectations, you extend the same courtesy to those staff members who are trying to help you. Although it is the healthcare staff’s job to help you, showing kindness is always an effective way to really get them on your side. Good luck with any future hospital stays.

Camryn Bell is a dietetic intern with Lenoir-Rhyne University in South Carolina. She is originally from Arkansas; go Hogs! She looks forward to becoming a dietitian and spreading accurate and positive information to help people with their nutrition needs and goals.

The contents of this article, website, and our other publications, including Vegetarian Journal, are not intended to provide personal medical advice. Medical advice should be obtained from a qualified health professional. We often depend on product and ingredient information from company statements. It is impossible to be 100% sure about a statement, info can change, people have different views, and mistakes can be made. Please use your best judgment about whether a product is suitable for you. To be sure, do further research or confirmation on your own.

The Vegetarian Resource Group 2020, www.vrg.org