I have a patient that has been NPO for a week. She is confused and has failed two swallow studies. The family refused for her to have a peg tube placed but agreed to a PICC for TPN. However, when the PICC nurse came, she refused. There was a big debate over whether or not she was competent to refuse, but she hadn't had anything to eat for a week. Tonight she wanted a banana, which I could not give her, of course, but I did give her thickened liquids. She did okay with them but is still complaining she is hungry. It's a thin line we walk in comforting our patients and doing what is best for them (I.e., being NPO).