1. Fill out the comfort plan:
• Encourage the client to contribute as many ideas as possible and to do the writing, if they are able, to better gain a sense that the comfort plan is their own
• Ideas from community teams/families are welcome at client’s consent
• For page 1: “when a challenge happens…what it looks like/feels like” discuss how emotions are on a spectrum. A crisis/trauma happens when emotions are so strong that the emotion goes outside the window of tolerance and may feel unmanageable
• For page 2 “when a challenge happens…what to do/how others can help” use the Comfort Plan Guide on page 3 for ideas
o Discuss how the more we learn what “level” our emotions are at, the more control we gain in making them more manageable
o Discuss how there are things we can do and others can help with to manage emotions and how these strategies may be different depending on how intense the emotions are
o Strategies may change over time and the comfort plan can be revised
3. Discuss use of the comfort plan:
• Client can hang page 2 on their wall or keep it in an accessible place to remind them of all the things they can do when a challenge arises
• Staff will:
o Keep comfort plan in Kardex next to care plan
o Use it to help client deal with challenging emotions
o Review it during morning huddle if the client is having difficulties
o Review/update it during icare with team
o Review/update it with client during IDrounds
o Review/update it with client after a crisis or code white as part of the debrief
4. Wrap up:
• Thank you for filling out your comfort plan. Remember this is for you to help you feel more comfortable and safe. If it isn’t working, just let us know so that we can find strategies that do work
Example procedure for an acute inpatient psychiatric setting: The Two-Step Comfort Toolkit is part of the primary nurse admission checklist, to be initiated during orientation to the unit if the client is settled. If the client is not able to participate at admission (e.g., admitted into seclusion, or sedated from medications), initiation of the Two-Step Comfort Toolkit is postponed until next earliest opportunity. Although primary nursing initiates the Comfort Toolkit, all disciplines are encouraged to contribute, including Psychology, Social Work, Occupational Therapy, and Psychiatry. Throughout a client’s stay, the Comfort Plan is updated, and the Comfort Kit is reviewed and utilized. Sample Comfort Kits are kept on each unit, and clients may use them with a clinician or on their own (after instruction has been provided). Following discharge, the Community Team takes over in maintaining the Comfort Plan and encouraging the client to create his/her own individualized Comfort Kit.