The Child Having Surgery
Preparing the School-Aged Child for Surgery
School-aged children can benefit from preoperative planning, education, and explanations. This preparation should take place a week or two before surgery since preparation too far in advance can produce more anxiety. Recognizing what is stressful to your school-aged child while in the hospital can guide you in preparing him/her for the surgical experience. Common stressors and fears in the hospital may include the following:
- being away from school and friends
- thinking he/she is in the hospital because he/she is bad or is being punished
- having a part of the body destroyed or injured
- loss of control
- pain (or the possibility of pain)
- needles and shots
- dying during surgery
- Tour the facility with your child prior to surgery. Touring the hospital before surgery can help your child see the sights, sounds, and events he/she will experience the day of surgery. It can help your child learn about the hospital, and gives him/her time to talk about concerns and questions. Ask a child life specialist to explain what will happen, and why, in terms your child can understand.
- Make sure your child knows why he/she is having surgery in words he/she can understand. School-aged children may not ask questions about something they think they are supposed to know about, leading a parent to think the child understands what surgery and hospitalization involve.
- Have your child explain back to you what is going to happen in the hospital. School-aged children sometimes will listen carefully, but not understand all that was said. This can help you to learn whether or not your child has a clear understanding of what lies ahead.
- Read books about the hospital or surgery with your entire family.
- Give as many choices as possible - to increase your child's sense of control.
- Emphasize that your child has not done anything wrong and that surgery is not a punishment.
- Explain the benefits of the surgery in terms your child can understand. For example, "After your knee has healed, you will be able to play soccer again."
- Encourage your child's friends to visit the hospital, or to keep in touch with your child by telephone or with letters and cards.
- Learn as much as you can about your child's surgery. Children can tell when their parents are worried. The more you know, the better you will be able to help explain things to your child.
- A family member should stay with your child as much as possible. Always tell your child when you are leaving, why, and when you will be back. If your child will remain in the hospital for several days, ask family and friends to call and visit often.
- Let your child know that it is acceptable to be afraid and to cry. Encourage him/her to ask questions of the physicians and nurses.
- When your child is stressed, they may start regressing and/or displaying new fears, such as being afraid of the dark. Give many compliments and hugs. Parents should always hold their child's hand (not restrain) during tests or procedures.
It is extremely important that you have followed all of the instructions that were given to you by
your child's surgeon during the preoperative visit. The day before surgery, someone will call you
from the hospital to tell you the exact time to bring your child to the hospital. You will be
instructed where to go and when to stop giving your child food and drink. It is very important to
follow these rules. Arriving at the wrong time or allowing your child to eat and drink after the
prescribed times can cause delays in your child's surgery, or perhaps even postpone or cancel it.
It is recommended that you make arrangements for other siblings to be cared for at home. Your
attention needs to be focused on your child having surgery.
Before coming to the hospital, remove any jewelry (i.e., watches, necklaces, or earrings) that
your child wears and leave them at home so they are not misplaced. Also, have your child
remove nail polish so that the color of the nail beds can be observed during surgery and
afterwards.
- Before surgery, you and your child will be taken to the surgical holding room.
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- Your child will change into hospital pajamas and the nursing staff will get your child ready for the operation.
- Your child will be given an identification bracelet to wear and the nurse will check your child's temperature, blood
pressure and oxygen level. None of this should be uncomfortable for your child.
- You and your child will meet with several people from the surgical team. This includes the
anesthesiologists and operating room nurses. They will ask you many of the same questions
about allergies, medications and your child's medical history. They will also tell you more
information about the operating room procedures.
- Waiting for surgery can be a stressful time for your child. There are a variety of toys and
activities for all age children and teens to use. Playing with toys, reading a story with you,
watching a movie or playing a video game are all good ways to help your child relax and refocus.
- Most often, children are given relaxing medicine to drink (or through an IV for older
children) before they go to the operating room. This helps your child to calmly separate from
you.
- Before your child leaves for the operating room, reassure your child that you will be waiting
close by. If you brought your child’s favorite stuffed animal or comfort item from home, this
can go with your child to the operating room. Members of the anesthesia team will take your
child to the operating room. The nurse will show you where to wait while your child is in
surgery.
- When the surgery is over, the surgeon will speak with you and let you know how the operation went.
After the operation your child will be taken to the recovery room (called the PACU or Post
Anesthesia Care Unit). Once your child is settled in the recovery room you will be able to join
him/her there. Your child will stay here while the anesthesia wears off. Your child's vital signs
will be monitored and your child may be connected to several machines, including an IV
(intravenous) pump. Ask the nurse about any equipment you do not understand. Depending on
the type of surgery, your child may be sent home or will go to:
- The children's unit to recover for 24 hours or less
- The children's unit to recover for several days
- An intensive care unit to recover, then to the regular children's unit until time for discharge.
Claire Ciliotta and Carole Livingston. 1992. Why Am I Going to the Hospital? Lyle Stuart. (ages 5 to 12)
James Howe. 1994. The Hospital Book. Morrow Junior Books. S. B. Stein. 1985. A Hospital Story. New York: Walter and Co.
Lisa Ann Marsoli. 1984. Things To Know Before You Go To The Hospital. Silver Burdett Co.
Debbie Duncan, Nina Ollikainen (Illustrator). 1995. When Molly Was In The Hospital: A Book for Brothers and Sisters of Hospitalized Children. Rayve Productions, Incorporated. (ages 4 to 7)
Virginia Dooley and Miriam Katin. 1996. Tubes in My Ears: My Trip to the Hospital. Mondo Publishing. ages 5 to 7)
Paulette Bourgeois, Brenda Clark (Illustrator). 2000. Franklin Goes to the Hospital (volume 25). Scholastic, Inc. (ages 5 to 7)
Deborah Hautzig. 1985. A Visit to the Sesame Street Hospital. Random House/Children's Television Workshop.(ages 4 to 7)
Marianne Johnston and Erin Mckenna. August, 1997. Let's Talk About Going To The Hospital. The Rosen Publishing Group, Incorporated. (ages 8 to 9)
Francine Paschal. 1991. Twins Go To The Hospital: Sweet Valley Kids Series #20. Bantam Books. (ages 6 to 8)
Juliana Lee Hatkoff, Craig Hatkoff, Marilyn Mets (Illustrator). 2001. Good-Bye Tonsils!. Penguin Putnam Books for Young Readers. (ages 4-8)
Norman Bridwell. 2000. Clifford Visits the Hospital. (Clifford the Big Red Dog ). Scholastic Inc. (ages 4-8)
H.A. Ray. 1999. Curious George Goes to the Hospital. Rebound my Sagebrush. (ages 4-8)
Barbara Taylor Cork. 2002. Katie Goes to the Hospital. Peter Bedrick; 1 edition. (ages 4-8)
Joanna Cole and Bruce Degar. 1989. The Magic School Bus: Inside the Human Body. Scholastic, Incorporated. (ages 6 to 9)
Anne Civardi and Michelle Bates. 2002. Going to the Hospital. Sagebrush Education Resource. (ages 4 to 8)
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