Transcription:
Making Pediatric Patients and Parents Comfortable Before Surgery

Melanie Cole (Host): When your child needs surgery, it’s bound to cause some anxiety for both of you. Your job as a parent is to help make the process as easy as possible for your child, but that can be hard to do when you're experiencing your own worries and concerns. Research shows that kids feel better faster and heal more quickly when they're prepared for their surgery. Here to speak with us today about steps the hospital takes to the children and their parents comfortable for an upcoming pediatric surgery is Marie Frazier. She’s the clinic manager at Hibbeln Surgery Center and Hendricks Regional Health. Welcome to the show. What's the first thing you want parents to know or to do when they find out their child needs surgery?

Marie Frazier (Guest): I think the biggest thing that they need to know is to be prepared and being prepared would be getting as much information about the surgery and what to expect, and then being able to prepare their child for that procedure at a level that they would understand.

Melanie: Preparing your child at a level that they would understand – that’s the big question. You certainly would have to know your own child, but how do you tell your child? Children’s imaginations can run away with them.

Marie: One of the most important things is often smaller children will think if you take them in to see a doctor and they got a shot, sometimes that is a form of punishment. It's really important to let them know that they need their surgery because they need to have something fixed and that that's the reason the doctor is going to fix something for them.  

Melanie: You start that conversation with your child. What do you want the parents to do to prepare their child in advance? Is it something you bring up every day? Do you bring it up once a week in advance and then not bring it up again? How does that work pre-surgical procedure?

Marie: When you first find out your child is having surgery, you definitely want to talk to the doctor or the nurse to find out what to expect and then that will help prepare you to speak with your child. You always want to speak at their level. Everybody’s children are different. You know what would scare your child and what might not, but one of the best things that Hendricks Regional Health offers in order to prepare your child is what we call a teddy bear tour where you can come in and bring your child into the facility. We can offer it later in the afternoon where we are still taking care of patients or we can do them in the evening where there are no patients there at all in the facility – it’s empty so it’s not quite so scary for some of the children.

Melanie: They can go through the teddy bear tour with their parents and everybody can get a feel of what to expect.

Marie: Absolutely. We spend as much time as you need. I've had some people come in and do a tour in 30 minutes and I've had a couple children that they had so much fun, they didn't want to leave, and at two hours, mom said that we have to go. It's very informative. You can just see each of the areas that the child will experience all the way from registration into the pre-op area where you get prepared for surgery, and they get a glimpse of the operating room, and then onto recovery and then they're discharged home. We have placed large teddy bears in each of those areas so that the child gets to see who’s in the bed, and with the teddy bears, it’s not quite so scary.

Melanie: It’s so important to prepare your child, but what about preparing the parents? That anxiety can translate to the child – they can feel when their parents are nervous about things. What do you want the parents to know or to do about preparing themselves for that anxiety in concerning surgery?

Marie: That is very important as well because the children do feed off the parent's anxiety, so getting as much information, and the teddy bear tours are even very helpful for parents. I've not had one family come in and tour and say that they didn't find it beneficial – all of them have found it beneficial not only for the children but also for the parents. When you know what to expect, you tend to remain calm. Children will come into the surgery center, if they've never been there before, it's scary for them, so if they can come in ahead of time and see the facility – it doesn’t matter which hospital you're having your procedure at – that preparation ahead of time is so important.

Melanie: On the day of the procedure, what would you like the children to bring with them to make them more comfortable?

Marie: We like our children to bring something from home, something that’s a comfort item. They can take their stuffed animal, a blanket, whatever they would like. We do let them take it into the operating room and then keep it with them so when they wake up in recovery, that item is also with them. With parents, we don’t want our parents to leave – that’s probably the single most important thing for a parent – because children sometimes will wake up and if there isn't a parent there, then they really get scared, so we always want our parents to stay present. Prepare the child ahead of time – let them know that they will be separate for the surgery, but that the parent is not going to leave, that they will be waiting right there in the room. When the nurses come to get the patient to take them to surgery, mom or dad is going to follow them all the way up to the doors that lead into the operating room. At that point in time, it’s important for the parent to help support the nursing staff when they take their child to reassure the child that everything is going to be okay. It’s very difficult if the child is really clingy and holding on real tight, and if you don’t have that parent support, it makes it harder on the parent as well as the child. The teddy bear tours, talking about those types of things, seeing everything ahead of time – it really helps that parent do that separation. If the parent doesn’t have somebody with them, you need to bring a support person because it is hard, especially a first-time surgery. When you're separating from that child and you don't have a support person yourself as an adult, sometimes it is scary. If they can bring somebody, that's also helpful for the parents.  

Melanie: What about in recovery? Can the parents visit the child in recovery, and what do you want them to know about what the child can expect and what the parent can expect as the child wakes up from a procedure?

Marie: That is a very good question. As soon as our children wake up in recovery and they're awake and have to know what's going on, we bring a parent to the bedside, and they can have two parents at the bedside just as they're waking up. Once they're out of phase one, they're allowed more at the bedside. In the very beginning, it can be very scary when your child is waking up – sometimes their eyes might roll back or they might do some thrashing in the bed that they normally don’t do. Sometimes as children wake up, they may say something or do something they normally don’t do and that does scary our parents, so that’s why we do wait until the child is awake. Once they're awake enough and know what's going on, we definitely know they want their mom and dad, so we will definitely bring the parents in. As far as what to expect when we do the teddy tour, we also talk about that, but ahead of time, we try and do the pre-op teaching. The worst part about doing everything on the day of surgery is everybody is nervous – the patient is nervous, the parents are nervous, and they don’t retain a lot of the information. It’s kind of scary, but if you come in, we recommend the tour usually within four to five days before their surgery because then we do give them quite a bit of information. It gives them a chance to digest that information, and if they come up with questions, they can bring those in or even call us ahead of time. We encourage questions – that’s the best thing to do – ask questions. The other important thing is never ever telling your child that if they don’t do something that you're going to give them a shot. So often we will hear a parent say ‘if you don’t stop doing that, the nurse is going to give you a shot,’ and then it makes the nurse a scary person to that patient. We definitely want to do some education with the parent as well as the children.

Melanie: That’s such a good point. To wrap it up about surgical procedures and making the child and the parent comfortable, what's the best bit of information that you would like the listeners to know about this, and also what they can expect when they take that child home with some sort of a bandage or gauze of there and what you would them to know?

Marie: Understand the instructions before you leave. If there is something you have a question about, don't feel like you don't want to bother the nurse; definitely, ask those questions and get the answers. We want you to know what to expect. The next thing is you should want to follow the doctor's orders. I think the hardest part after some of our pediatric surgeries if you're a family member of a patient that is hurting, and so everybody seems to want to baby that person, but sometimes if they have their tonsils out, that child might say ‘no, I don't want a popsicle,' mom may not push them to drink because they don't want to. That's where you're doing more harm to your child than good; you want to make sure you follow the orders and do exactly what they say. If you have any questions or the child is not doing what you think they should be doing, don't wait until the morning. There's always a doctor on call 24 hours a day. If it's later in the evening, definitely call and find out if this is normal for my children to be doing this or not. Don't wait until the middle of the night, don't wait until first thing in the morning when the doctor's office opens; we would much rather you call and get that problem taken care of or resolved ahead of time than have something bad happen if the child is getting worse in their condition and you need to bring them to the hospital. We want them to call no matter what time of day or night it is.

Melanie: Thank you so much. It’s such great information. For more information on preparing your child for surgery and the teddy bear tours, please visit hendricks.org. That’s hendricks.org. This is Health Talks with HRH – Hendricks Regional Health. I'm Melanie Cole. Thanks so much for listening.