"There we were . . ."

[Old_School]

There we were . . . everything was going great and then . . . the dieticians showed up.

To listen to the dieticians, its a wonder any of our poor starving patients survived their stay in ICU. Every day is like the spanish inquisition. "Why isn't the patient in Bed 3 on feedings? He's been NPO for 3 days." Could it be that the patient has an ICB and the neurosurgeon wants him NPO and with minimal protein load. To add insult to injury, when we do feed our patients we are doing it wrong according to them. Granted, I do like the convienence of continuous feeding. However, there are circumstances where bolus feeding is appropriate.

My theory is that if dieticians had to be actively involved with the subsequent copious code brown they would be less inclined to indiscriminately recommend tube feeding for all.