The quality of patients’ pain control should be addressed when they are discharged from one clinical area to another. Many short stay units, outpatient surgery units, and PACUs establish the criterion that patients must achieve a pain rating of 4/10 or better before discharge; however, the expectation that all patients must be discharged from these areas with pain ratings below an arbitrary number is unrealistic and can lead to the unsafe administration of further opioid doses to patients who are excessively sedated, which is widely discouraged (Blumstein & Moore, 2003; Lucas, Vlahos, & Ledgerwood, 2007; Pasero, 2014; Vila et al., 2005). Instead, achieving optimal pain relief is best viewed on a continuum with the primary objective being to provide both effective and safe analgesia (Pasero, Quinn, Portenoy, McCaffery, & Rizos, 2011). Optimal pain relief is the responsibility of every member of the healthcare team and begins with analgesic titration in the PACU followed by continued prompt assessment and analgesic administration after discharge from the PACU to achieve pain ratings that allow patients to meet their functional goals with relative ease.
Although it may not always be possible to achieve a patient’s pain rating goal within the short time the patient is in an area such as the PACU, this goal provides direction for ongoing analgesic care. Important information to give to the nurse that is assuming care of the patient on the clinical unit is the patient’s pain rating goal, how close the patient is to achieving it, what has been done thus far to achieve it (analgesics and doses), and how well the patient has tolerated analgesic administration (adverse effects).