Talking to Kids About Surgery
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 psychologically 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.
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The key is to provide information at your child’s level of understanding, correct misunderstandings, and get rid of fears and feelings of guilt. Help your child understand why the surgery is needed and 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 as well. It’s a good idea to educate yourself, feel comfortable with the process, and make sure all your questions are answered.
Hospitals have changed enormously and have become 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.
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 required 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, nonthreatening 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 wake up.)
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 medication 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, change of appearance, and disfigurement, 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 may also 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.
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 receive instructions for further recuperation at home and for a follow-up visit to the surgeon.
During recovery, there may be times of discomfort for your child. It can help to explain that your child may be sore or uncomfortable, but 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.