You could always just have one short-acting dose in a pill container with instructions to take it after a certain time (ie 3pm), with a flowsheet for them to rate their pain prior to taking the pill and to write down the time they took the med. It'll give the nurse a good 3-4 hours to reassess their pain and VS, stock the next dose, and hopefully it will let the patient feel that their pain control needs are being met. You'd probably need to have a 12-hr basal dose given by an RN (such as oxycontin), with short-acting meds that are patient administered (such as oxycodone). The patient must be cognitively aware of what is going on and able to understand the instructions though.
Like I said, what's one dose of pain meds vs. 60 pills sent home? If they're gonna divert their narcs in the hospital or abuse them, then they'll divert and abuse at home too.
Sorry, this is way off your original post. I just know that I would go crazy if I was a patient waiting for pain meds (granted, not all patients are nurses).
I'm in the ED and we've been asked to round every half hour! There's no standard as far as VS assessment goes (although its a given that if you give an IV med, that a patient should be revitaled). Also, if you're giving a med that has serious side effects (ie nitro drip -> hypotension), then its a given that you're going to be on their VS very often. I try to chart every half hour on my patients, but its pretty hard at times! However, there are some patients that I'm charting every 5 minutes on...everyone is different, and each patient needs to have a care plan individualized to their own needs. Setting an arbitrary time (such as 2 hrs) is unreasonable - some people need more coaching, some less.
I would try to find out what upsets patients the most (such as not knowing what is going on, not getting good pain control, not getting enough rest, and so forth). Then, figure out how to best meet these needs - such as oral PCA, patient-chosen "quiet time", a notepad for the patient to write down questions so they remember what they wanted to ask, or a whiteboard with "pending" written on it, followed by the care plan for the day (such as blood work to be drawn at 8am - results after 12pm, PT at 1pm-130pm, quiet-time at 3pm, etc).