Clinical Reference Systems: Pediatric Advisor 10.0

A trip to the hospital can be traumatic for anyone, particularly for a child. Separation from loved ones, unfamiliarity with the hospital setting, frightening hospital equipment, and unpleasant medical procedures are major sources of stress for children. In addition, because children do not understand the nature of their illness, they may believe hospitalization is their own fault. They sometimes view pain and other physical symptoms as the result of being "bad", and their hospitalization as "punishment" for their misbehavior.

Hospitalization need not be an entirely negative experience. Children and family members benefit from careful preparation for a hospital stay. Of course, sudden illnesses or accidents preclude direct preparation, but positive interventions are still helpful at the hospital and upon return.

The following suggestions have worked well for many families.

BEFORE ADMISSION --

1. If possible, time preparation activities according to the age of your child.

   For two- and three-year-olds, begin discussion about 2 or 3 days before admission. If your child is between four and five years old, 4 to 7 days is best. Children over seven have a better conception of time, and should become involved in the planning process several weeks before hospitalization.

2. Involve your child in the preparations as much as possible.

   Letting your child pack, select playthings, and plan pleasurable posthospital activities all heighten feelings of control and competence which are greatly in need of bolstering during this time.

3. Stimulate discussion about the hospital experience by reading books together.

   Talking about what happens to another child or storybook character during hospitalization is reassuring and helps correct misconceptions. Reading about the main character leaving the hospital is especially comforting.

   See Children's Literature: Hospitalization.

4. Explain the hospital experience in clear, simple terms.

   Ask your child's physician for help in explaining why certain procedures will be done and what will happen when they do occur. With a young child, demonstrate certain medical procedures such as x-rays and injections using miniature equipment on a doll, puppet, or stuffed animal. A child who is prepared for hospital procedures and temporary discomfort tends to be more cooperative and less psychologically distressed when they actually do occur.

5. Arrange a tour of the hospital for your child and other family members before admission.

   Familiarity with hospital rooms, equipment, and personnel helps alleviate some of the fear of the unknown. By learning where your child will be staying and what will be happening, trauma and apprehension are lessened.

6. Wait to talk to your child until you have some emotional control.

   Your feelings are readily communicated, so it is best to prepare your child when you feel well prepared and largely in control of your emotions.

7. Involve siblings in the preparation.

   To a significant degree, healthy siblings are affected by hospitalization as well. Siblings may experience intense feelings of guilt, jealousy, and anxiety, so involve them in hospital tours, demonstrations, and books on the experience.

AT THE HOSPITAL --

1. Stay with your child as much as possible.

   Your child's greatest fear is being separated from mother and father. Visit often, sleep in a chair, or, best of all, room-in. An older child may appear quite casual about your visits, but craves them nonetheless. Invite grandparents and siblings to visit if regulations allow.

2. When you do leave, say good-bye.

   Do not try to sneak away while your youngster is sleeping or preoccupied. Instead, make your leavetaking short and visible. Tell your child when you will return. Even though your child may cry, he or she will continue to trust you.

3. Bring a little bit of home to the hospital.

   Family photographs, tape-recorded stories or messages, cards, calls, and cuddly toys all provide comfort and security. They reassure your child that he or she is loved and not forgotten.

4. Tell pediatric nurses something about your child.

   Mention significant people and events in your child's life to help the nurses make the hospital stay more emotionally comfortable for your youngster.

5. An older child needs abundant support and reassurance too.

   An older child may put on an appearance of bravado, but do not be fooled. Children of all ages find hospitals distressing, and benefit from love and attention.

   See also:

   Keeping Your Routine When a Child Is Seriously Ill

UPON RETURN FROM THE HOSPITAL --

1. Listen to your child's repeated descriptions of the hospital stay.

   Help your child sort out feelings about the hospital visit by discussing troubling events as well as the positive features of the experience.

2. Do not be surprised if your child reverts to younger behavior.

   As your child readjusts to home surroundings, he or she may temporarily become more demanding and dependent. Provide extra hugs, kisses and words of encouragement.

3. Never use the threat of hospitalization as a way to control your youngster's behavior.

   Avoid statements like, "If you don't get enough sleep, you'll wind up in the hospital again." A statement such as this only creates undue anxiety and guilt.