Promoting a positive first hospital experience for children.

Visits to the emergency department for illness or injury, or even planned surgery can be very scary for a child (and the parent).  Often the experience is filled with painful and uncomfortable, but necessary procedures required for diagnosis and treatment.

  The first hospital experience can determine how well a child copes with subsequent experiences- not only at the hospital, but with illness, visits to the GP, dentist or any other medical related appointments; not only as a child, but as an adult too.  It is therefore important that we, as parents, can assist with promoting a positive first hospital experience for children.

Being a paediartic nurse, it is in my job description to minimize distress and discomfort with any medical or nursing procedures being performed on my patients.  Hopefully the staff treating your child will also do the best they can to avoid unnecessary distress.  There are ways that parents can actively participate to assist the staff to do their job and help the child to cope.

Confidence- Just imagine for a moment that you are a child, in a foreign environment with strangers invading your personal space and hurting you.  Then imagine your one reassuring comfort (parent) also looks scared, panicky or unsure.  As a parent, your body language and words say a lot to a frightened child.  If you are also frightened and lack confidence in the situation, this will perpetuate the child’s fear and lead to distress and non-compliance.  The no. 1 best thing you can do for your child is have confidence in the treating staff and be conscious of the things you say and do to your child during procedures.  I know that it is very scary to be a parent of a child that is sick or injured enough to end up in hospital, but as the experienced and knowledgeable adult, you need to push that aside to help you child cope better.  Model calmness and control.  A hysterical mother usually results in a hysterical child.

Reassurance-  Offer reassurance but don’t go over the top with it.  Acknowledge that it hurts, reassure that it will be over soon and let them know that they are OK.  Tell your child that they are brave.  Stay calm.  Try not to smile too much- a very young child (baby to young toddler) will get confused if the one who is supposed to be there to protect them is happy and smiling when the child feels he/she is being harmed.

Information- If you are unsure of what is going on, why your child is having a certain procedure or don’t know what to expect- don’t be afraid to ask questions.  The more you know about what’s going on the more confident you will feel and the more you can explain to your child.  It’s very reassuring for a child when the parent has confidence and knowledge.  Once you understand the situation, you can help the staff to provide a united front in caring for your child.

Explanation- Good doctors and nurses will explain to a child what they are doing in terms they can understand, unfortunately some not-so-good doctors and nurses do not.  This is where it is important for you use the information you seek to explain to your child what, why and how interventions are done to them.  An adult asking why or what type questions may just prompt a good explanation from staff to your child.  A child that understands why a painful or scary procedure has to happen is more likely to cope with it better and be cooperative.  Don't lie.  If a procedure is going to hurt then tell the child that it will hurt but it will be over quickly.  A child that experiences pain after being told otherwise will lose trust.

Distraction-  Using toys, songs (particularly songs with exciting actions), movies, TV, games (eye-spy is good for familiarizing the foreign hospital environment), is very effective at minimizing distress.  As a parent, you know the favourites that your child is most likely to positively respond to.  Don’t be worried that everyone will think you are a shocking singer, or laugh at you doing strange actions to songs, if it’s for the comfort of your child, its worth it.   Some hospital treatment rooms have a distraction box full of toys and activities for this very purpose.  

Position, control and comfort- A child is more likely to be less frightened if they have some control over their situation.  Control could be something as small as choosing what position they wish to be in during procedures. Ask if it is possible for your child to sit on your lap if you are in a chair, or if you can sit at the pillow end of the bed with the child lying against you.  Most of the time, this biggest distress is not the procedure itself, but the ‘being held down’ and loss of control the child feels.  Avoid a lying down position, but the staff will tell you if this is necessary or not.

Feeding- studies have shown (sorry, I can’t cite sources here because this was information I read a while ago) that breastfeeding, bottle feeding or offering a small amount of glucose during painful procedures is effective at decreasing pain and distress in infants.  As a result of these studies, there are now pain protocols where I work including these pain management techniques.  Ask the staff if you can feed your baby during blood taking or IV jelco insertion.  There will be instances where feeding is contraindicated due to the nature of the procedure, fasting or nature of the injury, so PLEASE ASK the staff before offering a feed.

No parent wants to see their child in hospital and I hope that you all can avoid this too.  But if it does happen to you, I hope this article helps to make your experience easier and more positive for both you and your child.