Special thanks to our Expert:
Michelle Brauntuch, M.S., CCLS.
Certified Child Life Specialist
Englewood Hospital and Medical Center, Englewood, N.J.
How to Reduce Anxiety
Everyone, even adults, experiences anxiety prior to surgery. For children especially, what they imagine is often more frightening than reality. You can, however, reduce your child’s fears and minimize your own anxiety by preparing your child for what will actually happen during the hospital experience.
You may want to call the Child Life Department or your doctor to see if it is possible to tour the Medical Center before surgery. Visiting a Medical Center for a tour and reading books about going to the hospital give you and your child a way to talk about some of the feelings you both have about the hospital and surgery. Talking together, playing “doctor” or “hospital,” drawing and writing about the upcoming hospital experience are all important ways to help make feelings more manageable. This preparation will help to increase your child’s confidence and ability to cope, as well as reduce any fears.
After the tour, you and your child can plan and rehearse effective coping strategies at home to use on the day of surgery. For example, you can plan to tell your child to hold a Teddy bear or other special toy until you can enter the recovery room.
How to Explain Surgery to a Child
It is important to be as honest as you can with your child about the upcoming surgery. Simple, accurate explanations in developmentally appropriate words are best. To communicate what an operation is, you should tell your child that it is a way for a doctor to fix something inside your body or to take something out of your body that is giving you trouble. For example, you might say: “The doctor is going to help you and take your adenoids out of your body so you don’t keep getting all those ear infections.” If the surgery is to remove something, it is important to tell your child that we are all born with parts of our body that we don’t need, so its okay for the doctor to take it out. Emphasize that life will be fine without it.
Children under age five need to know that they did not do anything wrong. The operation is not a punishment of any kind. Younger children have “magical thinking” and are developmentally egocentric. They think that they are the cause of everything that happens. It is, therefore, important for a child not to feel at fault for needing this operation. It’s just that a part of the body needs help – like people who wear glasses need help for their eyes to see clearly.
When to Tell a Child About the Surgery
When approaching young children from two to six years of age, it is a good idea to tell them about the surgery only a few days prior to the actual date. The younger the child, the less preparation time is needed because a sense of time is not as developed. However, time is needed to play or “act out” the upcoming experience, so a child should be given at least two days notice. Children seven years of age and older need time to think about questions they may have and to work through their feelings. They should be told at least a week before surgery. Always tell your child the truth about what will happen. Listen to your child’s questions and discuss any concerns.
What to Bring to the Hospital
Allow your child to pack special things to take to the hospital, such as favorite toys, books or videos that are familiar and can give comfort. Pack slippers for walking to and from the playroom on the Pediatric Unit. Another important thing to explain to your child is that everyone at the hospital wears special clothes. There are hospital clothes in all different sizes for children and special green clothes called “scrubs” that people who work in the hospital or operating room wear. All these clothes are cleaned a special way to make sure that there are no germs on them.
The Day of Surgery
Can Parents Stay With Their Child?
Parents are encouraged to participate in their child’s hospital experience. You should ask your doctor who can go into the holding room and recovery room. The recovery room is when a favorite stuffed toy or “security” item from home can be helpful for your child until you get there.
What to Say When Your Child Asks if the Operation Will Hurt
Explain to your child the special kind of “sleeping” they will be doing during the operation. An anesthesiologist has the job of giving your child medicine that will help them sleep while their doctor performs the operation. Anesthesia is either in an I.V. for older children or perhaps inhaled through a fruit-flavored mask for younger children. Your child feels no pain during this special kind of sleep.
Explain that the doctor knows just how much medicine to give and when to stop giving it, so that your child will wake up when the operation is over. Assure your child that this waking up will happen only after the operation is over and not before
The type of surgery your child is having will determine how much pain your child will experience after the operation. Most surgery causes some pain or discomfort, but most post-operative pain can be prevented or at least reduced. There are many medicines and methods which can be used to treat pain, but there are a few simple things to remember:
- Children must know that their pain will be taken seriously and they need to tell a grown up what is bothering them and where it hurts.
- Their parents, doctors and nurses will do their best to stop the pain.
- The pain will be treated.
- Medicine will be given to stop the pain quickly.
- Having a parent or another loved one present may be the best psychological treatment for the pain. Parents know more about comforting their own children than anyone else.
- Parents can help relax or distract their children.
After surgery, your child will be brought back to the room and monitored by a nurse. When determined ready, a child will be given food or drink according to a diet ordered in advance by your physician. Generally, children are encouraged to drink clear liquids (apple juice, ginger ale) and are offered jello or ices. Check to make sure that the staff at the hospital will ensure that all necessary arrangements are made for equipment and all prescriptions for medications and will be delivered to you with discharge instructions before you leave the hospital.
What to Do Once at Home
Your child may seem to need you more than usual after getting home from the hospital. Brothers and sisters may feel jealous of this extra care and attention, so it is helpful to talk about these feelings as a family. Perhaps you can make arrangements to have siblings out of the house with friends and neighbors for a couple of hours when the patient returns home so they can settle restfully and you can give them your undivided attention. Otherwise, maybe you can have a special treat such as a new video rental for them to watch to give you some room to focus on the patient’s re-entry to the home.
Let concerned friends and family help out with siblings in a routinized, non-emergency way. This gives the siblings time to be the “center of the action” in normal play situations with friends and neighbors. Playing “operation” or “hospital” at home after surgery lets your child express important feelings and feel more in control.
Encourage your child to pretend giving you or a stuffed animal an operation, or suggest building a hospital out of blocks or drawing pictures and writing stories about the experience. Children can cope with the stresses of surgery and feel proud for having managed such a difficult experience.
Praise your child who will feel good about doing well on a difficult day. This will help your child feel competent and successful and more likely to be able to incorporate this experience into a positive sense of self-esteem. Do not hesitate to call your physician if you have any questions or if your child’s condition changes in any way.