Preparing the Preschool-aged Child for Surgery

Preschool-aged children are learning and absorbing new information and details about the world with every interaction that takes place. Caregivers should begin preparing preschoolers for surgery several days before the procedure. As caregivers prepare their children for surgery, it is important that they know what may be stressful for the child while at the hospital. 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 or she is in the hospital because he or 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

Preparing for Surgery

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. Our pre-surgery tour offers patients the opportunity to tour the hospital with an associate from our Child Life staff who will explain the rooms, procedures and machines the child will encounter in terms they will understand.

As caregivers prepare their children for surgery, we encourage them to always tell the truth in simple terms and answer all of the child’s questions. We encourage families to explain surgery in a way that is meaningful for preschool-aged children by:

  • Explaining why the child is having surgery. It is not uncommon for children in this age group to think they have done something wrong or that needles are given to kids who are “bad.”
  • Engaging in dramatic play. Using pictures, stuffed animals or toys to help the child understand is better than simply telling him or her what will happen.
  • Providing very simple explanations and carefully selected words. 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 or 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 will wake you up after it is over.”
  • Reading books about the hospital with the family.
  • Allowing the patient to help pack his or her own suitcase. Bringing a favorite security item, pictures of family and pets and a special toy can be very comforting. Please be certain to limit the number of security items, as space can be tight in the preoperative unit.
  • Explaining the benefits of the surgery in terms the child can understand. For example, “After the doctor fixes your arm, you can play ___ .”
  • Making sure a family member is with the patient as much as possible to provide comfort.

Preparation is Key

Caregivers can prepare themselves and the rest of the family by knowing:

  • 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.
  • It is normal for a child to require more attention before and after surgery. The child may have temper tantrums or be uncooperative. It is not unusual for a child to return to bedwetting, 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.