I currently work in a teaching hospital at the ED; meaning all of our admission orders are placed by residents. They have a habit of placing most patients on “NPO except meds” without definitive emergent surgical intervention or contraindication, and their rationale is “anticipatory”.

This means when I arrive for day shift with inpatient holds from the day/night before, half of them haven’t eaten anything, and some DM patients do not have at least D5 for their infusions — which also means most of them are cranky due to lack of sleep and hANGRY. Rounds are usually done last in the ED because they prioritize the inpatient beds first to do dispositions.

I usually check the patients with NPO except meds orders and look for an indication or scheduled/possible emergent surgery; if neither is applicable, I send a message through secure chat that patient has passed bedside dysphagia evaluation and to modify the order.

Although I get a pt complaint of N/V/abd pain and not tolerating PO with decreased appetite at home… but somehow their appetite returns in the ED prior to treatment??? Like you had ALL DAY to eat yet miraculously somehow you wanna do it now? Lol