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Taking fear out of hospital stays
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For parents, children hospitalization doesn’t have to be scary
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| "Always remain honest with your child, and never tell them that you are going on vacation. The hospital is not a vacation." — Suzanne Bert (Clipart.com) |
Going to the hospital is not usually an experience that’s awash with good feelings. When it is your child to be admitted, whether it’s for a mundane procedure or for an emergency, it can be especially worrisome. Parents will tell you that having to admit their child to the hospital can be one of the most traumatic events they will ever face.
How can you feel calmer and more in control if your child is one of the 3 million hospitalized in the United States every year?
The major source for this anxiety is fear. Parents are afraid of the disease or the accident that brought them there and whether or not their child will recover. Children, depending on their level of development, have more concrete fears. They are simply afraid of things and people that will cause pain.
Before your child goes to the hospital for a procedure, get an in-depth understanding of what is being done. Ask questions about tests, treatments, surgical intervention, anesthesia and follow-up care. While the majority of hospital stays go smoothly, it is essential for parents to be acquainted with the risks, procedures, reasons for the hospitalization and then pass that knowledge on to their children, according to Aurora St. Luke’s child life specialist Suzanne Berg.
Parents must be comfortable
“Parents should know that there is a tour available of the hospitals and while there, they can ask questions about their child’s care, so parents and their children know what is going on,” said Berg, who also works as a child life specialist at Children’s Hospital of Wisconsin.
“Parents’ education is important so they are comfortable with the hospitalization, which will make the child more comfortable. For example, if you are on a horse, and you are nervous about it, the horse knows if you don’t want to be on there; similarly, the child feels that anxiety.”
While the child is often the most fearful, desperate, and, at times, at risk, the parent is asked to give him or her to the hospital without always understanding fully what is happening. Instinctually, parents want to protect the child during those times of danger, and the reality of hospitalization brings out parental fears of losing control, denying their instincts, and remaining passive while their child’s ultimate care is in the hands of someone else.
Honesty is best policy
Making the transition to the hospital depends greatly upon education for the parents as well as the child, and not sugarcoating the hospitalization or procedures for the child.
“Always remain honest with your child, and never tell them that you are going on vacation. The hospital is not a vacation,” emphasized Berg. “Even if an adult has cancer, don’t tell the child that the adult has a cold, because if they die, the child will associate death with having a cold.”
While the hospital experience is frightening, the more parents understand what is going on, the less scary it will be for them and the child. Berg recommends preparing children for hospitalization according to their developmental ages.
“For little ones, such as age 2 or 3, don’t build up any anxiety,” she said. “Letting them know a day or two before is fine. Teens can handle the news sooner, but gauge that by their age and their developmental understanding. There are wonderful books to help a child to deal with the fears. One book by Fred Rogers, called ‘Going To The Hospital’ is still a great book. Parents can also take a cruise through their library or go to Barnes & Noble.”
Use descriptive explanations
Validating the child’s concerns is important in letting them know that you care about their fears. Even showing the IV process or suture equipment is helpful. Using descriptive explanations such as intravenous instead of IV, which children may mistake for an ivy (plant) is better, according to Berg, who suggests that speaking softly and remaining calm will go a long way to make the process easier.
“Tell them that an injection might sting for a minute, or explain to the child about going to radiology and what an X-ray is. Calling a gurney a ‘bed on wheels’ instead of a ‘stretcher’ is better because some kids think it means stretch-her, and explain that the railings are there due to the medications that will make them sleepy,” she said. “If a child has to get a cast removed, the cast cutter can seem very scary; it is loud, and the friction of the machine gets warm. But if the adult turns it on and uses it on their hand so the child sees it won’t cut them, the child won’t be as frightened.”
If other children are at home, Berg recommends preparing them as well. “At Children’s we offer tours on Saturdays that the whole family can attend,” she said. “The brothers and sisters should know what is going on — and we give them masks, booties and gloves so they can role play at home, whether it is practicing on each other or with their dolls or stuffed bears.”
Picture books alleviate fear
Additionally, most hospitals offer surgical pre-op teaching books that outline the child’s visit from admitting to leaving the hospital in a car. Sharing aspects of the surgery with a picture book helps to alleviate the fear of the unknown for children, and allows them to realize that there is an end to the hospitalization.
“It is important to explain that no matter where the child is, they are still with a nurse and there is always someone with them — they are never alone,” Berg said. “It helps to have parents stay overnight if possible; it’s pretty standard now for parents to room in with the child. Of course, sometimes parents can’t stay due to having other kids at home, but explain to the child that there are nurses here 24 hours a day. They need to know that they always have a call light and if they wake up in the night, they can call the nurse.”
For procedures that might be painful or scary, distraction or physical contact is often helpful in getting the child to calm down and cooperate.
“Physically touching the child can help them to relax; and you can tell your child to squeeze your hand as much as it hurts, or use stress balls, or looking at wands with stars and moons in them. This distracts the child and helps to get their mind off the shots that are coming and looking away,” she said, adding. “But, there are some kids who love to watch and anytime you can give a child a choice, it is better. Ask them if they want to watch, or talk to you, lay down or sit down; and if they won’t cooperate have them take deep breaths or grasp their face and have them watch you.”
Don’t bribe your children
Whatever parents do, Berg asks that parents not bribe their children with toys, or other activities when faced with a procedure.
“I just cringe with that,” she said. “Let them know what is going to happen and when they are through, the hospital may reward the child with a sticker, or a prize from a hospital treasure chest — if they have them.”
Maintaining as much comfort as possible, even if it means bringing a stuffed animal or a special blanket from home, will make the hospitalization a bit easier for the child.
“It is especially important if the child is staying overnight or having day surgery,” Berg said. “It adds to their sense of security. Even if the child is going to the emergency room, if you have time to grab their special lovey or bear, that will help. If not, ask the hospital if they have a stuffed animal or anything for the child to hold.”
Whether it is a routine trip to the doctor, or a visit to the hospital, allowing children to have choices, as well as answering questions posed to them by professionals, is key to an easier transition in an otherwise difficult situation.
“For the health care professionals, I ask that they try to direct some of their questions directly to the child, and for parents, I ask that they refrain from answering for their kids,” said Berg. “This gives them some control — and always praise the child during their procedures; just let them know how great they are doing.”
It is important to remember that children are not miniature adults, reminded Berg.
“Crying is a very natural way for them to cope and telling them that they should not cry will only increase the distress of everyone involved,” she said. “Preparation may take a little more time and effort, but in the long run it makes things go a little easier and faster.”
How to prepare
Infants: speak softly, hold them, comfort them and allow the use of a pacifier
Toddlers: speak softly, clear explanations, keep equipment hidden, keep toy nearby when parent isn’t present, positive verbal responses, let parent cuddle child as soon as possible.
Preschoolers: simple explanations of procedure, explain expected behavior from child during procedure, such as “you may cry but not move,” never threaten or bribe, offer praise
School age: allow child to make choices, simple explanations, allow child to touch and handle equipment, ask for cooperation, praise the child.
Adolescents: provide privacy during procedure, expose only one part of body at a time, allow for decision making, as appropriate, provide adult like explanations about all aspects of therapy, including adverse effects.
Parents: provide explanations on reasons for therapy, never have parents restrain child, parental presence and participation during procedure should be decision of parent. |
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