Transcription:
Preparing Your Child for Surgery

Melanie Cole (Host):  Surgery or any other medical procedure can be so scary for both children and their parents. What can you do to ease your child's concerns? My guest today is Christina Berg. She's a child life specialist in pediatric hematology/oncology at UVA Children's Hospital. Welcome to the show, Christina. So, as a child life specialist what do you do to help children at UVA get ready for surgery or procedures?

Christina Berg (Guest):  That's a great question. After assessing, the situation I always ask the child first to tell me in their own words what they know about their upcoming surgery.  I then ask if they would like to learn more about it. If they do, I explain what the surgery is for and how it's going to help them. I discuss the sequence of events and sensory experiences including things they might see, smell, taste and feel. Throughout preparation, I use visual teaching aids including pictures of what they'll see and actual medical equipment such as an anesthesia mask. I utilize medical play during preparation which allows additional insight into a child's understanding and fears of the procedure. This is a really great opportunity to address fears and their misconceptions. Finally, as a child life specialist, I plan and rehearse coping strategies with the child in order to give them a sense of mastery and control over their situation. These things include things like deep breathing, guided imagery, muscle relaxation or choice of their distraction.

Melanie:  So, when a child asks you these questions and you say you give them sensory input on what they can expect to see and hear and smell. Do they express their concerns to you? Are you able to, Christina, help them with those fears as far as, “What if my parents aren't right there next to me?” How do you allay those fears?

Christina:  That's a really great question. As a child life specialist, we always advocate for a parental present, and we get permission from the anesthesiologist. If not, we are actually able to go back into the OR with children and to provide that continued support and utilize those coping strategies that we planned. A really big question children ask is, “How is anesthesia going to make me feel? How do I fall asleep?” So, this is a great opportunity to utilize medical play with the anesthesia mask. We practice breathing through the anesthesia mask. We let them decorate their mask. We really kind of try to make it fun and relaxing for them during this kind of stressful time.

Melanie:  That's so important and I would think one of the biggest questions children have is, "Will it hurt?" What do you say when they say that?

Christina:  Well, as a child life specialist it's our job to be as honest as possible with them. So, if something is going to hurt we do say in a simple, friendly way, “It might feel uncomfortable. It might burn your skin, it might feel like your skin is tingly, you might feel sleepy.” We do let them know if something is going to be slightly painful, we do let them know. We never say, “No, it won't be painful if it could be.”

Melanie:  So, that speaks to the trust issue with children where they're looking at you as a child life specialist and trusting you that the information you're giving them is really what's going to happen and their parents as well. Is there any feeling of mistrust where the kids really think that you guys are just telling them things to get them where they need to be?

Christina:  With their goal for them not to feel that way and we always do relay the message to parents as well to try to keep them as honest as possible with their children. We explain the importance of this so that they do continue to build trust with their children and so, if they do have future procedures, the child knows that they can ask questions to their parents and they'll know that their parents are going to tell them the truth and they'll know what to expect.

Melanie:  Now, for the parents:  what tips do you--when you're working with the parents on this too--what do you tell them about getting their children ready to even go to the hospital that day or the night before?

Christina:  I always encourage parents to be as honest as possible with their children about what they are going to experience and use age appropriate language in their explanations and preparation. I encourage them to encourage their children to ask questions and make sure to keep the lines of communication open. Let them know that it's okay to ask questions. I remind them to try to remain calm. This is important because children really feed off of their parents' reactions and they can sense when their parent is anxious or stressed. It really does help when parents remain calm. I continue to encourage them to stay positive and provide reassurance that whatever feeling their child has, that those feelings are okay and give them opportunity to express those feelings.

Melanie:  That's a huge point, Christina that children feed off their parents. And how can a parent not be nervous when they know that their child is going in for surgery? You work in pediatric hematology and oncology so you must see children with cancer and things. How do the parents maintain that sense of calm on the outside when inside they are really terrified?

Christina:  You now, it is a very interesting topic because on one side, you want the parents to remain calm during stressful times, during procedures, but at the same time you're encouraging your child--you're trying to let your child know that, “If you feel scared, if you feel worried, that's okay, too.” So, there are times when parents say, "Well, I don't want to breakdown in front of my child. I don't want to cry around them." And sometimes you have to say, "Well you know, it's okay. That will let them know that it is okay to cry and it is okay to be upset if you're scared." But during really stressful times and procedures, I try to prepare parents as well. I let them know what their role is during that time for their child so they can be there to support them as best as they can.

Melanie:  And in just the last few minutes, what's your best advice for parents who are considering having surgery or procedure for their child and why should families come to UVA Children's Hospital for their care?

Christina:  I think my best advice would be to provide preparation for your child in advance and let them know what to expect and talk about some of those things, use those tips that I provided. I think families should come to UVA for their care for the great comfort and care that they receive throughout their stay.  Staff members as a whole really goes extra mile here to make sure children and their families are as comfortable as possible. 

Melanie:  Thank you so much and I certainly applaud all the great work you do at UVA Children's. You're listening to UVA Health Systems Radio. For more information you can go to uvahealth.com. That's uvahealth.com. This is Melanie Cole. Thanks so much for listening.