As someone who is a nurse, suffers from chronic pain and who worked on a surgical floor for a long time, these days there is no reason a patient should be in moderate to severe pain. It’s for break through pain, if the patient can’t wait for the pain pill to work because they are in so much pain then they need to be given the PRN breakthrough dose and the schedule for the PO med must be adjusted to properly control the patient’s pain. Why should a patient who is in horrible pain have to wait for a PO pill to work, which by the way can take up to an hour, when they have IV or IM meds available. So I guess the answer is it depends on the patient, their LOC, their pain level and how well they tolerate meds as well as their DX. Pain is subjective for a reason.