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Nobody wants to see a child sick or in the hospital or in pain. But sometimes serious things happen and medical attention is needed.
Both doctors and parents try to avoid surgery in preschool children whenever possible because hospitalization at this age can result in emotional “scars”. In an emergency situation, the child’s life and limb takes priority. In the case of an elective operation, there may be a choice. If it is medically feasible, wait until the child is 4 or 5 so that you can better explain what will happen.
The greatest fear that preschoolers have is loss of their parents or ABANDONMENT. This means that staying in a hospital would be scary even if nothing else were done. Children this age also fear BODILY DISINTEGRATION. These are the kids that scream in terror at the least scratch and may demand a bandage for a non-existent wound. Many preschoolers are also AFRAID OF DOCTORS and monsters. Because of these normal developmental fears we try to avoid hospitalization and surgery in young children.
If an elective surgery is suggested, always ask the doctor WHY the operation should be done. What will happen if the surgery is postponed for a year or two? Will any permanent damage occur? What would the doctor do if it was his or her own child? After asking these questions of Doctor Number One, get a second opinion. Also always ask for a qualified and experienced pediatric anesthesiologist.
Here are the basic principles for parents in preparing a pre-school age child for surgery:
o NO SURPRISES. PREPARE THE CHILD for what is about to happen.
Do not start preparing the child too early. Preschoolers should not be told they are going to the hospital sooner than, say, two days. It’s a good idea to “pre-prepare” the child by reading one of the many books designed to help children learn what to expect in the hospital.
Most children have never been to a hospital or ambulatory surgery setting. Try to take children two and older to visit before the procedure is scheduled. Most hospitals today encourage such a visit for young children.
o NO LIES. Don’t tell the child it isn’t going to hurt if it is.
Nearly every child will ask: “Will you be there with me?” and “Will it hurt?” Tell the child you will be there right up until the time he goes into the room where the operation will be done. While the operation is being done you will stay right in the hospital waiting room, waiting for the operation to be over.
Tell your child what to expect: “We will go to the hospital at six in the morning. You can’t eat breakfast or drink anything before the operation because that is the hospital rule. You will be put in a bed with rails but it’s not a baby crib; even grown-ups have to stay in this kind of bed when they have an operation. You can take Teddy Bear and your Curious George book with you.”
Say, “You won’t feel anything during the operation because you will breathe into a magic mask and fall asleep. You will be sore after the operation. But I will be right there when you wake up out of your special sleep.”
o STAY WITH YOUR CHILD. Only take your child to a hospital where you are allowed to stay.
o EMPOWER YOUR CHILD TO MASTER FEAR.
Use dolls and doctor kits. Invent little hospital games so the child can play out what will happen. Ask the child if he or she has any questions. Ask the child to tell you a story about going to the hospital. This tells you about any misunderstandings.
Children think, somewhat correctly, that surgery is premeditated trauma arranged by their parents and doctor. Tell your child that he or she is big enough to understand that the operation isn’t a punishment. “You were not bad. The operation has to be done because something isn’t working right and must be fixed.”
o EMPOWER YOURSELF with knowledge about what is going to happen so you can best deal with your own fears. Act calm so your child will feel as calm as possible.
o REWARD THE CHILD. After it’s all over reward the child with a little present or favorite food. Be sure to praise the child’s bravery.
o ENCOURAGE HOSPITAL “GAMES.” After the child goes home encourage talking about what happened. Play little “surgery” games. This is one way children cope with a painful or difficult experience. Do not be upset if the child is clingy and tearful for a while after surgery. This is normal.
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