I think you need to trust your assessment skills- keeping in mind the above posts and taking into consideration the age of the patient, in particular, and, of course, the total physical and mental status of the patient. Is this a geriatric patient who may feel that pain isn't "real pain" until it is excruciating, or does he have fears about addiction, appearing to be"weak" or suffering from altered alertness with pain medications? Maybe he is "used to" a certain level of pain? Are there mental health illnesses or issues, or perfusion issues? I have worked with elderly people for eleven years, and have found that depending upon the patient, sometimes a lower dose of pain medication is needed regularly to help him/her remain constantly pain free or to keep pain at a level acceptable to the patient and family. I agree with Nurse T about the hallucinations, but if you do feel they are actual hallucinations, review all of the meds, because, as I'm sure you know, pain medications and anti-anxiety (or other psychotropic) meds are not always to blame although they are frequently blamed. If used correctly, pain and psychotropic medications can make a person's life, or the end of their life, much more fulfilling for the patient and his/her family. If the patient is feeling nausea, are adjustments needed in the meds?
Also, good for you for being willing to listen to your peers, despite the method of presentation, about what the patient needs rather than getting defensive!! That is one of the many traits that is the mark of a good nurse!! Good Luck!!!!!!!