Did you revise your care plan?

Suggestions please!!!! How do you revise your plan of care when your known-frequent-flyer reports a pain level of 10 from before admission, clear up to the trip to the elevator at discharge? After all, he/she is still our patient until the car drives off.

***Note*** The patient states, "I told them when I left the last time, that I was still hurting."

Did you revise your care plan prior to the patient being wheeled out; do you just make reference to the prescription for pain meds IF they doctor will provide one on this visit; or do you just click the x in the upper right corner and forget about it since the patient is discharged and 'everybody knows his/her routine' and "oh,he/she's always in pain?"
pain management is so tricky. For one thing, spiritual and emotional pain can actually HURT, and frequent flyers probably do have pain of some sort. I would create my plan so that the outcome would be reported by patient as "tolerable". If that is not possible we need to be thinking of what this patient needs after discharge - psych consult? pain management consult? Both??? Something is going on and the nurse does not have time or scope of practice to do behavioral management. Something has to break the cycle.

Quote from classicdamepain management is so tricky. For one thing, spiritual and emotional pain can actually HURT, and frequent flyers probably do have pain of some sort. I would create my plan so that the outcome would be reported by patient as "tolerable". If that is not possible we need to be thinking of what this patient needs after discharge - psych consult? pain management consult? Both??? Something is going on and the nurse does not have time or scope of practice to do behavioral management. Something has to break the cycle.