Your child needs elective surgery and a date has been scheduled. Unlike emergency
surgery, an elective procedure
isn't done as an immediate matter of life and death. Having an elective procedure
gives you the time to prepare your child for the hospital and the surgery.
Good preparation can help kids feel less anxious about the anesthesia and surgery
and get through the recovery period faster. But, like parents everywhere, you're probably
uncertain about the best way to prepare your child.
The key is to provide information at your child's level of understanding,
correct any misunderstandings, and get rid of fears and feelings of guilt. Help
your child understand why the surgery is needed and to become familiar with the hospital
and some of the procedures he or she will undergo.
Kids of all ages cope much better if they have an idea of what's going to happen
and why it's necessary. To do that, prepare yourself first and correct any misconceptions
of your own. If a parent is anxious and nervous, a child will often reflect these
feelings and behaviors. So educate yourself, feel comfortable with the process, and
make sure all your questions are answered.
You might have heard horror stories in the past about traumatic parent/child separations
and very limited hospital visiting hours, but those days are over. Hospitals have
changed greatly and are more family-friendly and patient-centered. For example, many
surgeries are now "same-day" procedures requiring no overnight or prolonged stays;
most kids are back home, in their own beds, the same night. And most U.S. hospitals
permit at least one parent to stay with the child at all times except during the operation.
After the surgery, you may return to your child in the recovery room. As your child
awakens, he or she will not even realize you left.
Ask the doctors, nurses, or staff for the information you need about what will
take place so that you can prepare your child and deal with your own fears or concerns.
To parents, one of the most fearful aspects of surgery is anesthesia.
Anesthesia is much safer today than in the past, but still carries some risk. You
should discuss any concerns you have in advance with the anesthesiologist.
When hospitalization is needed overnight or longer, most hospitals avoid separation
anxiety by permitting at least one parent to stay with the child day and night. Check
with the hospital about its rules regarding parents staying over and when other
close family members can visit.
As soon as your child is able, he or she may be playing with other children, toys,
and games in a children's recreation room — even if that involves taking along
an intravenous (IV) bag on a rolling support.
Explain the Problem
Now that you're more at ease, start preparing your child. Begin by explaining the
reason for the surgery in simple, calming words. Explain — at your child's level
of understanding — about the medical problem and why surgery is necessary. Don't
use alarming language like "the doctor will cut you," "open you up," or "sew you with
a needle." Say that the doctor will fix the problem, and explain that many kids
have this problem and must get it fixed at the hospital.
Although they seldom express it, kids may fear that their parents aren't telling
them everything — that their health problem is worse than they've been led to
believe. To build trust, don't mislead your child — tell as much of the truth
as your child can understand.
Many kids fear that an operation will be painful. It can help to explain that
a special doctor, called an anesthesiologist, gives medicine to make patients sleep
very deeply so they won't feel anything during the operation and once it's finished,
they'll wake up. (Older kids, in particular, need special assurances that they will
Again, avoid frightening language — don't say, "You'll be given gas" or "You'll
be put to sleep." Young kids may confuse "gas" with the fuel that can poison
or kill and "put to sleep" with what can happen to sick pets.
Explain that you'll be there when your child wakes up — and a favorite toy
can come along, too. Tell your child that if anything feels sore right after
the operation, a doctor or nurse can give medicine that will make it feel better.
Common surgery-related fears of young children are the possibility of separation
from (or abandonment by) parents and the possibility of pain. School-age kids also
fear needles, knives, and damage to their bodies. Give a child this age clear, rational
information as well as assurances that the surgery is to fix an existing problem,
not create a new one.
The fears of teens go well beyond those of younger kids. Besides pain or change
of appearance, a teen might be afraid of losing control, missing out on events,
being embarrassed or humiliated in public, and sounding childish by expressing fear,
anxiety, or pain. A teen also may be afraid of waking up during the operation
— or not waking up afterward.
Anticipate these fears, then emphasize that expressing fear, anxiety, and response
to pain is quite normal (and OK) at any age, even adulthood. Correct any misconceptions
about disfigurement or injury. And explain that anesthesia is very safe today
and that patients do not wake up during operations but will
certainly wake up afterward.
Encourage your teen to read up on the medical condition and share the
information with the family. Reading and sharing information is an excellent coping
One further fear that affects kids of all ages is being seen naked and having their
"private parts" touched. If the operation involves the genital or anal area, your
child will cope better if you explain in advance that although it might be embarrassing,
doctors and nurses will need to examine these private areas, especially to check if
they're healing after the operation. Explain that doctors, nurses, and parents are
the only exceptions to the rules about privacy.
Encourage your child's questions about the health problem and hospital experience,
so that other fears and anxieties can be expressed. Take all questions seriously and
answer them to the best of your ability. If you don't know an answer, tell your child
that you'll find it out, and explain that the doctors and nurses are happy to answer
Children often believe that their medical problem and operation are really punishments
for "being bad." They might not say so, but they may feel guilty and believe that
they've brought events on themselves.
Explain that the medical problem is not the result of anything
your child may have done or failed to do, and that the operation is not
a punishment, but simply the way to "fix" the problem.
On the other hand, if the medical problem was caused by an accident that could
have been avoided by obeying safety rules, make sure your child understands the reason
for the rules and will follow them in the future.
Explaining What Will Happen
Find books, appropriate to your child's level of understanding, about what to expect
at the hospital. Reading together and discussing the surgery will make the hospital
seem less threatening. Discuss each idea and encourage your child's questions.
Young kids also will benefit from practicing on a doll or stuffed teddy bear
with toy doctor-kit "instruments." Your child can take the toy's "temperature" and
"pulse" and listen to its "heartbeat" and "breathing."
Ask your doctor for suggested videos or multimedia tools for parents or kids that can
help explain the procedure.
As you discuss the hospital and surgery, remember that in addition to your words,
your nonverbal cues convey assurance: your tone of voice, facial expressions, gestures,
and body language send powerful messages. If you appear fearful, your child is likely
to feel fearful regardless of the words you use.
Pre-Operative Orientation and Tour
Many hospitals offer special pre-operative children's programs, family orientations,
and hospital tours, led by specially trained nurses or licensed child-life specialists.
Child-life specialists are a valuable resource for parents and children. They are
professionals trained to talk to kids and teens about medical procedures, comfort
them if they're upset or need extra support, and organize "play time" for hospitalized
kids and teens to get together and hang out.
Call the hospital to schedule a pre-operative tour, program, or orientation
as soon as possible, even from the doctor's office when the appointment for the surgery
is made. It's best to schedule the appointment for a few days before the surgery.
An orientation program can remove the mystery of the surgery for kids and their families
by making the hospital familiar and friendly and the experience predictable.
On the Day of Surgery
When you arrive on the day of surgery, your young child can play with toys and
books you bring from home or sit on your lap and be cuddled during the waiting time.
You won't be allowed to stay in the operating room during the surgery, but afterward,
you'll be escorted to the recovery room to be with your child as he or she awakens.
Upon discharge, you'll be given instructions for further care at home and for
a follow-up visit to the surgeon.
During recovery, there may be times of discomfort for your child. So explain that
even if this happens, your child will get better.
Distracting your child, whether with a new book or a visit from a relative or friend,
also can make recovery more pleasant. Just make sure your child gets plenty of time
to rest and recuperate.