Comfort Contract

• Patient Name:
• Date:
• Surgeon:
• Nurse:

Expected Level of Postsurgical Comfort

I expect to be comfortable after my surgery. I understand that there will be some discomfort, but I expect to be able to manage it with the help of my nurses and doctors.

Chronic Discomforts

I have the following chronic discomforts:

• Pain
• Nausea
• Vomiting
• Constipation
• Diarrhea
• Other:

Interventions I Use at Home for Relief

I use the following interventions at home to relieve my chronic discomforts:

• Pain medication
• Antiemetics
• Laxatives
• Other:

Nursing Care Expectations

I expect my nurses to:

• Provide me with pain medication as needed.
• Help me to manage my nausea and vomiting.
• Help me to stay regular.
• Provide me with other interventions as needed.

Signature

• Patient or Surrogate Signature:
• Date:

Nurse Signature:

• Date:

This comfort contract is a way for patients or their surrogates to communicate their expectations about postsurgical comfort to their nurses and doctors. It is important to discuss these expectations before surgery so that everyone is on the same page. This will help to ensure that the patient’s comfort needs are met and that they have a positive experience after surgery.

Here are some additional tips for writing a comfort contract:

• Be specific about your expectations. What does “comfortable” mean to you?
• Be realistic about your expectations. There will be some discomfort after surgery, but it should be manageable.
• Discuss your chronic discomforts and how you manage them at home. This will help your nurses and doctors to tailor their care to your individual needs.
• Be open to feedback. Your nurses and doctors may have suggestions for how to improve your comfort. Be willing to listen to their suggestions and try new things.

By following these tips, you can write a comfort contract that will help to ensure that you are comfortable after your surgery.