The Child Having Surgery
Preparing the Preschooler for Surgery
Preschool-aged children can certainly benefit from preoperative planning, education, and explanations. This preparation should take place several days before the procedure, to give your preschool child an adequate amount of time to prepare. Recognizing what is stressful to your preschool 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:
- fear of being away from family and home, or of being left alone
- thinking he/she is in the hospital because he/she is in trouble or being punished
- fear of having a part of the body damaged
- fear of needles and shots
- fear of waking up during surgery
- fear of pain (or the possibility of pain)
- fear of the dark
- One of the major fears preschoolers have is fear of the unknown. Your child should be told of surgery several days before the procedure and perhaps even visit the hospital for a tour. Many hospitals will allow you and your child to visit. 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 he/she may have. Contact the hospital's child life department for this service.
- Tell the truth in simple terms and answer all of your child's questions, for example, "Yes, it will hurt, but it will not last long."
- Make sure your child knows why he/she is going to have surgery. It is not uncommon for this age group to have misconceptions regarding hospitalization. Often, children think they have done something wrong or that needles are given to kids who are "bad."
- Dramatic play is a big part of a preschooler's life. Using pictures, stuffed animals, or toys to help your child understand is better than simply telling him/her what will happen. Illustrate the situation clearly for your child. Ask a child life specialist to help explain what will happen, and why, in terms your child can understand. Also discuss therapeutic play activities such as playing "hospital" with your child at home before he/she is admitted for the procedure.
- Give very simple explanations and be careful of the words that you use. For example, say, "The doctor is going to fix your arm." Do not say, "The doctor is going to make a cut on your arm." If you describe anesthesia as "being put to sleep," your preschooler may think of a family pet that died and wonder if he/she will die, too. A better way to phrase it might be: "A doctor will help you sleep (a different kind of sleep than how you sleep at night) during the operation, and he/she will wake you up after it is over."
- Your child may enjoy reading books about the hospital with the family.
- Allow your child to help pack his/her own suitcase. Bringing a favorite security item, pictures of family and pets, and a special toy can be very comforting.
- Explain the benefits of the surgery in terms your child can understand. For example, "After the doctor fixes your arm, you can play ___ ."
- 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 feel and the more you can help explain things to your child.
- Make sure to stay with your child as much as possible - to provide comfort and security.
- Be patient with your child. It is normal for him/her to require more attention. Your child may have temper tantrums or be uncooperative. It is not unusual for your child to return to bedwetting or thumb-sucking. The regressive behavior will usually improve after the stress of the procedure has passed.
- Remember, too, to take care of yourself. Simplify your life during this time and do not be afraid to ask for help from family and friends. Remaining positive and non-stressed can help reduce your child's anxiety.
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.
- 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 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.
Anne Civardi and Stephen Cartwright. 1993. Going to the Hospital. EDC Publishing. (ages 3 to 6)
Fred Rogers. 1997. Going to the Hospital. The Putnam Publishing Group. (ages 5 to 6)
Deborah Hautzig. 1985. A Visit to the Sesame Street Hospital. Random House/Children's Television Workshop. (ages 4 to 7)
Richard Scarry. 1995. Big Operation: The Busy World of Richard Scarry. Aladdin Paperback.
Debbie Duncan, Nina Ollikainen (Illustrator). September 1995. When Molly Was In The Hospital: A Book for Brothers and Sisters of Hospitalized Children. Rayve Productions, Incorporated. (ages 4 to 7)
Paulette Bourgeois, Brenda Clark (Illustrator). 2000. Franklin Goes to the Hospital (volume 25). Scholastic, Inc. (ages 5 to 7)
Virginia Dooley and Miriam Katin. 1996. Tubes in My Ears: My Trip to the Hospital. Mondo Publishing. (ages 5 to 7)
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. (age 6 to 9)
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