So your child is going into hospital

 

A hospital admission is always a bit stressful.
Even if its for something exciting like the arrival of a new baby, there is so much to think about, organise and prepare (and worry about!). When a child  is involved the stress levels tend to escalate. Our emotional involvement and our desire to protect and care for our little ones together with the need to organise and prepare for the event can be rather overwhelming.

I am writing this as during the week our youngest child was admitted to hospital. This is the first time I have had to deal with this and therefore I basically had no idea what to expect or what would happen. There were a few things that, had I have been pre-warned, would have made life a little easier so I will share them with you!
Some of these things will help you if you are booking in for a procedure, some may help to prepare you if in the future you are faced with a sudden admission/emergency situation.

This article is long- because I wanted to provide as much detail as possible. The important points are

• Make sure you are familiar with all hospital procedures including admission
• Familiarise yourself with the ward and hospital layout
• Play act hospital procedures (listen to heart, take temperature etc)before admission
• Leave a teddy with child
• Let them know what to expect
• Educate yourself about reactions to anaesthetic
• Be gentle and reassuring 'naughty' behaviour is a result of fear/ pain / anger - find out what's wrong. Comfort the child.
• Debrief afterwards- you AND your child.

First of all let me admit that I underprepared my child, this was due to my lack of knowledge and I didn't think to ask the right questions to find out more.

I gave him the basic information and that was it . Along the lines of " You will go into hospital, there will be nice people there to look after you, they will give you some magic medicine so you have a little sleep so they can fix you up. Then you will wake up and when you feel ok we will go home."

As a result both he and I were nervous and stressed, we didn't really know what to expect and it was a struggle to get anything done ( heart rate temperature etc) and he woke from the anaesthetic very distressed.

Get the details
If possible when you book into the hospital ask if there is someone who can explain DETAILED admission procedures.
 
I didn't have a clue what would happen, but didn't even think about it until we got there and were left alone with no idea what was going to happen or when.
When we booked in we were given an information sheet. Although important it was not enough.
It told us to fast from the night before and to be at the hospital at 7am, what to bring and what not to bring, that was about all.

Familiarize yourselves.
Also ask if you can go and have a look at the children's ward - have a play with the toys and say "Hi" to a few nurses. We didn't do this and that was very foolish because when I arrived on the morning of the admission I didn't really know where to go and we were walking into a totally unfamiliar environment.

Act it out with your child
Once you know what to expect you can play doctors and nurses with teddy. Teddy is going into hospital- here is his paperwork, here is the ward, the nurse, the play room etc. Now teddy we need to take your temperature and weigh you, listen to your heart and pop this pulse rate indicator on your finger/paw. Its alright teddy we are here to help you...and so on. Siblings can play this game too ( Your big brother is in hospital- you be the nurse and look after him...)

Our experience; do's and don'ts
Please check with your hospital and have a look around- but this is what happened with us.

Arrival- where to go- what to do?
We were told to arrive at 7am.  We had to come in the casualty/emergency entrance because the main reception was still closed (although it turned out the doors were open.) Our booking sheet told us to go to the Booking office to show our receipt (for bed fees) but it turned out that was closed too and all we actually had to do was go to the Emergency reception booth.
Don't waste your time by being unsure or going to the wrong office- ask questions when you book in ( which entrance will be open, where do I go, do I have to go anywhere else) and make sure you are clear about where you must go and why. When you have your information- go and have a look at were you will have to go- check where the entrances and reception areas are.

Don't get lost!
Then we had to go up a few floors to the children's ward. We came out of the lift and found ourselves in an empty fire escape area. There were several doors none of which looked like they led to a ward. Again this was unnecessary stress as we stood in confusion.
Fortunately for us a nurse arrived in another lift and she escorted us into the ward and to the nurses station.
Again - don't let yourself be left lost and confused - when you book in (or on a day before you arrive for the admission) ask if you can go and have a look so you know where the ward is- where the lift is located , which doorway to use and where the nurses station is. Let the staff know your child is coming in and you want to be familiar with the area and make it as stress free as possible (they will appreciate this as happy relaxed kids are easier for them too!).

In the ward
Next we were standing uncomfortably at the nurses station until someone came to rescue us! They took our paperwork and took us to the toy room which was in darkness. They put the TV on and left telling us someone would be with us shortly. We stood there in the darkened room feeling a bit lost and confused, we had no idea who would be coming, when or what they would do. My little one assumed that when someone arrived he would magically be put to sleep on the spot so he was wary of everyone!
We put the lights on when we found the switches and had a look at the toys, we were there for quite a while before someone appeared and when they did we didn't know what to expect. As a result my son got very shy and curled in a ball on the sofa refusing to look at anyone or cooperate. What this meant was that we were left alone again...until another nurse came to have a go (using the right lets get this down now attitude' which just reduced him to tears. Still with no explanation we were left alone again for quite some time. Eventually a sweet gentle young nurse appeared , she chatted and talked to the teddy and took its temperature and listened to its heart.
In minutes my son was giggling happily and he let her do the 'obs' on him too (just listen to his heart, take temperature). At this point it turns out we were assigned a bed.

With hindsight this is what happened- we arrived at the end of the night shift- they wanted to go home and didn't want to waste time with a frightened uncooperative child. So we waited until the next shift started.

By this time it was about an hour and a half since we had first arrived at the hospital we were hungry , tired and scared and had no idea when we would have to go to theatre.
Find out before hand what will happen. Ask to view the ward- Ask what will happen when you arrive. Ask how long you will wait and where. Ask when the operation/procedure will take place.

WHAT happens up until now (this was our experience - so it may help as a guideline)

• Arrival at hospital - go to the reception desk- this may be the emergency/casualty one if it is very early morning (check paperwork, verify identify and next of kin)
• Go to ward.
• Report to nurses station- give them any relevant paperwork
  
• Go to the play area, lounge etc to wait for someone to come and do paperwork and observations. ( relax- put on the TV and the lights, play or read!)
• A nurse arrives- takes obs (may listen to heart with a stethoscope- take temperature with an ear thermometer- pulse rate with a machine which has a little gentle clip which goes over a finger.and weight - they had a plastic chair to sit on which was also scales...very clever)                                                                                      AGAIN-PLEASE ask when you pre-visit the ward what will be done- ask to see the things which will be used if at all possible - even have a demonstration on a teddy if you are lucky!
• Fill in some more paperwork
• May meet the surgeon and anaesthetist
• Be assigned a bed

Then to theatre.
All this and we had still not got to theatre- we were both feeling very nervous and very unsure as to what would happen.

At this point they explained they would administer pre-op medication (to calm the child and make the transition smoother) Thank goodness- I could have used some too by that stage!
For us this bit was easy - I just told my son he had to have some medicine that was like Panadol (which he takes readily) so that he wouldn't be too sore when he woke up.
Now I know we were lucky- some kids will not take medicine!
So- this is what can happen;

• pre-op medication is offered- if this is not able to be administered-
• they will try for a drip (hmmm good luck with that one) - a needle is inserted under the skin of hand/arm to allow the fluids to enter the body and the drug to be administered -if this is impossible as well
• they are left with trying to get the 'gas' mask over their mouth and nose in theatre
  
• last resort- the mask will have to be held onto the child's face by force.

Fortunately we had that bit very easy as the medication was no problem

• we then walked to the lift and down to theatre with a nurse escort. Child was increasingly woozy and happy
• On the theatre floor we were met and popped on a trolley.
• I was given theatre gowns to cover my clothes, shoes and hair. (please note- you can choose NOT to go into theatre - I was asked if I wanted to continue and I felt it was better for my child to stay with him and keep him calm.....you only stay until they are 'under' the anaesthetic by the way!)
• we were taken into the operating theatre.
• I was asked to sit down and my child was put on my lap
• the mask was put near his mouth and nose until he was relaxed and then he was told to 'watch the balloon- and see if he could blow it up by taking deep breaths'
• the anaesthetic is administered slowly until the child is 'under'
• at this point his breathing was suddenly much louder and he was taken from my lap and laid on t he table (yes this is stressful)
• I was escorted out.

At this point I was told to return to the ward and I assumed he would be brought up there- I envisaged a sleepy child sitting in the semi darkness with me holding his hand while he woke fully. I made the mistake therefore of taking his teddy with me
LEAVE THE TEDDY WITH THE CHILD!

THE WAIT
I had been told it would only be half an hour and the nurses in the ward all assured me it wouldn't be long. However the anaesthetist had mentioned that it may be as long as an hour. I tried not to look at my watch too much but all up it was about 45 minutes. Many mothers I have spoke to since have confirmed that they waited longer than they had initially been told so assume it may be a longer wait than you are first told!
At this point a nurse came and told me he was out of theatre and would I like to go down to recovery. I just remembered to grab his teddy and I walked down (getting lost on the way)
When I arrived I was horrified to be able to hear my child screaming for me long before I got to the recovery area. When I did get there he was hysterical.
He calmed momentarily in my arms but was soon distressed again....screaming and yelling and babbling. I was in shock (remember I was expecting the gentle waking in the quiet darkened room) The behaviour was to me extreme and extremely distressing

However since then numerous parents who have had children in hospital and several friends who are nurses - as well as the nurses who were with me in the recovery area have all reassured me that this reaction is not uncommon and it is a normal possible way to wake up after anaesthetic.

So be prepared- ASK how your child may be when you first see them in recovery! What may they be like emotionally- and will there be bandages, tapes, tubes etc. Personally I was confronted by a delirious hysterical child with a drip bandaged to his arm who was almost impossible to calm for quite some time.

A kind nurse reassured and supported me and explained

• Although some children  wake woozy and sleepy- some awake disorientated and hysterical - some can be angry/ sad/ terrified (adults also sometimes react like this  following anaesthesia!!!)

• as the drug wears off they are often hysterical and delirious- they don't remember what has just been said to them and will repeat things over and over (just keep answering and reassuring) (my son for instance was screaming in a panic- "what happened to me Mummy" and "I feel sick/ awful/ weird/ terrible"and "it HURTS")  Keep answering, keep reassuring- as the drug wears off they will start to take it in.
• The child is not being 'naughty' they are terrified, in pain, angry and so on and the extreme seeming behaviour is result of the drugs - they will calm as it wears off.
• My child was screaming that his head hurt- which was very scary...this was a result of his constant screaming and when he calmed it was fine!
• As he still had a drip they gave him a little morphine to ease the pain and calm him.

Return to the ward
After a while -Still crying my little boy and I were popped on the trolley for the journey back to the ward. I lay on the trolley and he half sat/half lay back against me.
In the ward they quickly set up a TV by his bedside and popped on a video while he continued to whimper and ask to go home. I sat there rubbing his back and continuing to soothe him as best I could. Thankfully after about half and hour he fell asleep and slept for about an hour.

What happened next
When he woke he was completely calm and relaxed. He spoke to the nurses and co-operated with them taking obs etc. He sipped some water and placidly watched some of another video, asking politely if we were allowed to go home now?

Shortly before 12 (as he stated he was not hungry and did not want any jelly or anything else) we were allowed to go home.
He was very tired and quiet but we went to the shops and bought a little 'bravery award' for him to take home.
He slept all the way home.
At 2pm he had a little soft food and by 7 that night was gobbling pies (his choice of food and he ate two large ones ;-)

The next day he was very cheerful and only needed a dose of Panadol in the morning.

DEBRIEF
Please take care of yourself and find someone to talk to about your experience. I found I was very shaky and teary that evening (once he was ok- I could let go of all that tension I guess). The next morning I was also very 'delicate' and needed to talk. Luckily I found lots of support and was able to go over things and be reassured and comforted- by lunch time I was feeling fine!
If there is no-one for you to talk to then write it all down (blog on here if you like- then people can offer you support and caring comments if you need them!) - once you get it all 'out' you will stop it all running around in your head.

The child too!
Give your child a chance to talk about it too. A quick debriefing process is very helpful for you both.
This is what I did;  that night as he was tucked up in bed I commented what a busy day we had had and asked how he was feeling now and then what he could remember.
We went through the whole thing from the early waking ,through the admission , the journey to theatre, the waking up , the return to the ward, the video, buying the 'bravery award', the journey home, playing at home, dinnertime and now in bed.
I dint prompt him- just asked him to tell me what he remembered and asked him questions. Its important to ask how they were feeling too. The debriefing process involves

• how do you feel now
• how was the experience
• remember where you were and what you were doing - in as much detail as possible (as questions but don't 'put words in their mouth')
  
• how you were feeling - ask this often; whenever a significant point is reached.
  
• what happened
• Finish up...is there anything still bothering you- anything that made you feel sad or angry?
• Finally- very important- return to the here and now- how do you feel NOW
• Reassure, comfort and encourage. Tell them how brave they were and how well they did.

My child cant remember going into theatre and very little about recovery (although he knows he was "sad and angry')
However overall he remembers the experience as 'pretty good' and that everyone was 'nice to me and good really'.

Good Luck
I hope that some of this account or the suggestions will help you in some way if you are facing a hospital admission with your child. Our experience was quite brief and simple compared to many but it would have been even easier if I had taken steps to educate and familiarise myself and our child prior to admission.