School-aged children can benefit from planning and learning about surgery and the hospital experience one to two weeks before their procedure. Knowing what is stressful for children can be helpful as parents prepare children for the hospital experience. Common stressors and fears in the hospital may include the following:
- being away from school and friends
- thinking he or she is in the hospital because he or 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
- Making sure the child knows why he or she is having surgery. 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.
- Having the child explain back what is going to happen in the hospital. School-aged children sometimes will listen carefully, but not understand all that was said.
- Encouraging the child to teach their stuffed animals, pet or other family members about the surgery and hospital. The child will not only learn from the experience but will feel more confident as an “expert.”
- Reading books about the hospital or surgery with the entire family.
- Giving the child as many choices as possible. This can include allowing the patient to pack his or her own suitcase and select the clothes worn to the hospital. Allowing the child the ability to make choices provides a sense of control of the situation.
- Emphasizing that the child has not done anything wrong and that surgery is not a punishment.
- Explaining the benefits of the surgery in terms the child can understand. For example, “After your knee has healed, you will be able to play soccer again.”
- As much as possible about the surgery. Children can tell when adults are worried. The more the adults in the family know, the better they will feel. They will also be better able to help explain what is happening to the patient and other children in the family.
- Being patient with your child. It is normal for him or her to require more attention before and after surgery. The child may have emotionally outbursts or be uncooperative. It is not unusual for a child to return to being afraid of the dark, thumb-sucking or other behaviors they have long since outgrown. These types of behaviors will usually improve after the stress of the procedure has passed.
- The importance of simplifying. The patient’s immediate family should try to simplify life during this time and shouldn’t be afraid to ask for help from friends and extended family members. Remaining positive and unstressed can help reduce the child’s anxiety.
- A family member should stay with the child as much as possible in the preoperative unit.
- Letting the child know that it is acceptable to be afraid and to cry. Encourage the child to ask questions of the physicians, nurses, or child life specialist.
- The child’s school can be a great resource during stressful times. Teachers can be on the look out for changes in mood or behavior and offer encouragement and support to students who are under a great deal of stress. Teachers can also modify work assignments—in-class work and homework—so as to make school a little less difficult. Caregivers can also work with teachers and administrators to make special arrangements to get students back on track after surgery.