What can I do to help prepare my child for surgery?
The hospital and operating room environment can be stressful, and sometimes frightening, for children and families. Children may have similar fears to their parents or fears more unique to their age and/or developmental stage. It is important to talk to your child prior to their surgical experience to help identify these fears and to comfort them. Several studies have evaluated the impact of preparing children and their families for surgery. Preparing your child for surgery may be helpful, however, not all children benefit from extensive preparation; instead, they may benefit from minimal preparation. You know your child best, and you can use the suggestions below to help you and your child prepare for their surgical experience.
A child life specialist is an invaluable team member that can help children and their families cope with medical events. They are found throughout the hospital and can help parents and caregivers prepare their child prior to surgery by giving tours of the procedural area, sharing developmentally appropriate preparation materials, providing play materials to help normalize the surgical experience, and talking with families to develop an individualized coping plan for the day of surgery. These interventions can help with potential anticipatory anxiety or other stressors related to their upcoming surgery. Parents can download a free app, “Simply Sayin,” on their personal device for brief descriptions about surgery or visit, https://kidshealth.org/en/parents/anesthesia-prepare.html for more information about supporting their child before and after surgery.
Infants
For infants, it is important to maintain as much routine as possible before arriving at the hospital. They may cry or show discomfort, but this is normal. There are new sounds, sights and people interacting with them. Infants can experience stress with too much environmental stimulation, so you can ask to dim the lights in your room, talk or sing to your baby, continue to give them comfort and positive touch while waiting for surgery. Lastly, you can bring a pacifier, blanket, or other special item to the hospital with you, as this will help provide your baby with familiarity and comfort during their change of routine.
Toddlers & Preschoolers
For toddlers and preschoolers, you can talk about their surgery one to two days prior to surgery. Children this age benefit best from simple language when describing new events. For example, you can tell your child, “We are going to the hospital tomorrow to see your doctor. You will take a special nap at the hospital, and the doctor will help your body while you’re napping.” It may be helpful to provide your child with an opportunity for medical play at home prior to surgery. They can play out their perceptions if they choose to, and this will help you identify if your child has any misconceptions regarding their surgery process or reasoning for surgery. It is important to continue to promote play and normalcy in your child’s environment leading up to their surgical experience. This will provide them with an enhanced sense of control and familiarity, even though there will be a change in their routine due to their surgery. Lastly, if your child has a comfort item, such as a stuffed animal or blanket, or favorite toy, you should bring that with you to promote comfort and familiarity.
School-aged Children
School-aged children may be more curious about their surgery. This age benefits from concrete language. This means that explanations should avoid euphemisms and use simple language to describe upcoming events. For example, you can talk with your child about their upcoming surgery or procedure by saying, “You are having surgery at a hospital soon. An anesthesiologist is a special kind of doctor. They will help you stay asleep and safe during your surgery. Your surgeon will fix your body while you are sleeping. When the surgery is finished, the anesthesiologist will stop giving you sleepy medicine and help you wake up.” You can ask your child to explain to you what they know about their surgery. This may help identify misconceptions or fears related to the upcoming surgery or to falling asleep with anesthesia. Additionally, you can provide your child with comfort and reassurance for their care and safety, as well as the benefits of having their surgery. Often, children this age feel a sense of guilt or punishment about their surgery, and it is important to remind them that their surgery is not a punishment or a result of a negative action or emotion. It may be helpful to explain what they might experience before surgery, such as meeting their nurses and doctors, having their heart rate and blood pressure checked, and changing into a hospital gown. Children this age will benefit from as much opportunity for control as possible. You could encourage them to help pack a bag of familiar comfort or play items to take with them to the hospital, to help pick out their clothes for surgery day and to choose a meal or drink after their surgery. Preparation for a surgical experience may be best one week prior for school-aged children.
Teenagers
Teenagers will benefit from preparation as soon as the decision is determined for surgery. Teenagers should have the time and space they need to process the surgery, as well as ask questions or share concerns. To enhance teenagers’ control in their care, parents and caregivers should involve their teenagers in decisions and conversations prior to and on the day of surgery. You can encourage your teenager to make a list of questions for surgery day, and you can encourage your teenager to bring a comfort item to help them focus on something else while waiting for surgery. This may be their cell phone, a personal gaming device, or creative art materials. It is normal for teenagers to have changes in their emotional affect prior to surgery, and they may not want to talk about their emotions or share their thoughts. As parents and caregivers, you can encourage and model appropriate emotional sharing to help build trust and comfort with your teenager. Lastly, teenagers often fear that they will wake up and be aware during their surgery. You can provide them with reassurance that their anesthesiologist is with them in surgery to help them stay asleep and safe until the surgery is complete.
Newell, C., Leduc-Pessah, H., Bell-Graham, L., Rasic, N., & Carter, K. (2020). Evaluating and enhancing the preparation of patients and families before pediatric surgery. Children, 7(8) 90.
Perry, J., Hooper, V., & Masiongale, J. (2012). Reduction of preoperative anxiety in pediatric surgery patients using age-appropriate teaching interventions. Journal of Perianesthesia nursing, 27(2), 69-81.
