After leaving work this morning I left with my mind totally blown and I need advice. I had a patient who is s/p placement of a jp drain in an intraabdominal abscess after a bout of diverticulitis with subsequent perforation. The patient has an order for dilaudid 1 mg IV q 4 hours prn for pain and percocet 5/325mg 1-2 tabs PO q 6 hours prn for pain. When I arrived on the floor the pt was crying and rated their pain as 10 plus saying that they had been for hours and was livid that the prior nurse had obtained a new order for percocet and let the pt believe they could no longer have dilaudid. By the end of the shift the pt was sitting in a chair brushing their teeth with managed pain. I had given a dose of dilaudid at 1930, 2 percocet at 2100, another dose of dilaudid at 0100, 2 more percocet at 0330, and one more dose of dilaudid at 0530 with a consistent pain rating through the night of 4-5 out of 10 and the low of 2/10 at 0630. When I gave report the oncoming nurse told me that you cannot give 2 different pain medications during either of the pain medications duration for example when I gave the 1930 dose of dilaudid I should not have given another dose of pain medication until 2330 and then I could have either given the dilaudid or the percocet but if I gave the percocet then I could not have given another dose of pain medication until the 6 hours between doses was up. The pt's VS remained stable if not elevated throughout the night, they had continuous tele monintoring (in fact HR never went below 90) and 15 and 60 minute follow up after IV dosing and 30 and 60 minute follow up after PO dosing. I used my nursing judgement to manage pain without going overboard and I gave the medications that were ordered in order to control breakthrough pain. The oncoming nurse said "it's not our call, that is why the doctors write the orders so you could give one or the other but not both." That statement left me absolutely dazed and confused. Please help.