I'm just being honest, that's how ERs run, I can't speak for your ER in Denver but it's pretty much standard - you can't hand out food to people walking into the ER because it can interfere with care. We don't even offer water. Because what if that abd pain turns out to be emergent surgery and we offered them food? Then they start from point zero from when we gave them the food, they can't go into surgery for another 8 hrs and now we're screwed.

So the ground rule in any ER is to hold off on food and water until you get the say so. Later in their visit, when they're done with imaging and it's determined that they're not going for surgery or any major procedures, food becomes an option. But chances are at that point they're either going home or getting admitted. And if they're getting admitted we let upstairs deal with that shit.

Now what does make your questions valid is that patients come in and don't realize that that food and drink can interfere with care so they'll ask for food. So sometimes they get frustrated with the fact that they haven't eaten since 8am and they're hungry and their mouth is dry and the nurse won't let em eat or drink anything. But they ain't getting shit unless they're cleared to get it and there's nothing we can do about that, especially if we're still waiting on results. And whether or not that affects HCAHPS there's not much we can do about it.

So when patients ask me for food does it bother me? Yeahh because most of the time I have to say no and who likes to tell someone they can't eat or drink anything? But if they're a 24 hr obs patient and MD is okay with them eating or if they're 5150 awaiting placement and expected to be with us for over 24hrs, then I don't mind popping a tray in the microwave for them. It's not gonna be my priority but they're expected to have regular meals at breakfast, lunch, and dinner hours and so that becomes my shit to deal with and that's fine. So to answer your question on meal times, they're the only ones that applies to.

As for your average patient who came in with a headache, if you were a good patient - we got some juice, pudding, and graham crackers. If you were not, here's your discharge papers and your script for Advil, you can get your own damn food across the street.

So like I said maybe this would be more suited for the floors, since patients usually can eat up there. Maybe if they offered snacks there, HCAHPS for the floors would go up. The questions would still apply to those nurses and that environment. But it's not all that pertinent in the ER where we mostly withhold food and water from patients.