333 E Second St., Richland Center WI, 53581
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Surgery and Your Child

Surgery and Your Child

The staff at the Richland Hospital are dedicated to the care of you and your child. We understand that surgery can be an emotional time, especially when it is to be performed on your child. Children who are less anxious and less fearful have an easier time before and after surgery. There are things you can do to decrease the chance that your fears and anxieties will be transferred to your child.

Display a Calming and Soothing Manner

  • Try to avoid crying in front of your child. If needed, take a few minutes out of sight of your child to express your emotions, then focus on what your child needs from you – support.
  • Allow your child to share fears and concerns with you. Let your child know that it is okay to feel afraid. Your child may bring an item or two from home (blanket, book, stuffed animals…) to keep at their side.

Be Honest

  • Give facts without being too graphic or detailed about what your child will experience. If you don’t know the answer, find out by calling your doctor, surgeon or nurse.
  • Telling your child that they are going to take a ‘nap’ may raise fears in the future when the word nap is mentioned to your child. Instead, say “You will be given medicine to make you sleep so it won’t hurt when the doctor fixes your _____. The doctor or nurse will wake you when they are done.”
  • Let your child know to expect some pain after surgery.

The Day before Surgery

Surgery arrival time

We will call you with an arrival time and instructions the day before surgery. If surgery is scheduled on Monday, you will receive a call on Friday.

A tour of the Surgery Department

You will be given the option of allowing your child to see the surgery department prior to their surgery.

Make sure your child is healthy for surgery

If your child becomes ill, has been exposed to infectious diseases such as chickenpox, measles or mumps, please call your doctor’s office.

Make arrangements ahead of time

A parent or legal guardian needs to stay with your child on the day of surgery.
We recommend that two adults accompany your child home. This will allow one of you to drive while the other is available for your child.

What to bring

To make your child more comfortable, they may bring a favorite item such as a toy, blanket or game. We will let you know if you need to bring any specific items.

Caring for your child after surgery

Depending on the surgery, your child may only be able to have specific foods or drinks after surgery. If so, have those items (soup, popsicles and clear liquids like apple juice) in your home prior to your child’s surgery.

Follow preoperative instructions

  • Be sure your child does not have anything to eat or drink after the designated time. If they do, their surgery could be delayed or even cancelled.
  • If your child wears glasses or contacts, bring their case with them.
  • Do not let them wear jewelry, make up or nail polish.

The Day of Surgery

  • On the day of surgery, don’t mislead your child into thinking they are going somewhere other than the hospital.
  • Your child will be taken to surgery on a gurney or carried there by a surgery staff member.
  • You will remain in the child’s room or waiting area during the surgery.
  • When your child’s surgery is complete, the surgeon will speak to you. During this time, your child will be taken to the PACU (Post Anesthesia Care Unit).

PACU (Post Anesthesia Care Unit)

  • PACU is a specialized area where your child will be monitored while recovering from anesthesia. A nurse will remain at your child’s side during the entire recovery phase. When possible, you will be allowed to visit your child in the PACU. We will let you know when the time is right for you to join your child.
  • Before you enter PACU, be sure that you are comfortable in a medical setting. You must be willing to follow directions from the PACU staff. This may include being asked to return to the family waiting area or preoperative room.

PACU Points to Remember

  • PACU is a restricted area, so you will enter and leave PACU with a staff member.
  • When you enter PACU, there may be other patients present. We ask that you respect their privacy and confidentiality by remaining at your child’s side.
  • No cell phones or cameras are permitted in the PACU.
  • One adult will be allowed to be with the child and should plan on remaining at their side until the child is moved.
  • If you have other children with you, it will be your responsibility to have another adult available to supervise your children at all times.

In the PACU
, How Will My Child Look?

  • Your child may be awake and smiling, may appear sleepy or disoriented, or may even be upset and crying. Each child wakes in his or her own way from anesthesia. Their face may be pale, red or puffy. They may feel dizzy, blurry eyed, nauseated, or be shivering even if they are not cold. All of this is normal.
  • Your child will most likely have an I.V., be receiving oxygen, and be connected to a monitor that will allow the nurse to measure specific vital signs.

What Can I Do For My Child?

  • If your child is sleeping, do not wake them. They are calmer when they wake up naturally after anesthesia.
  • 
If your child is fussy, holding them may or may not be calming. The nurse will help you with this. This fussy state may last the entire time you are in PACU. If it is due to pain, the nurse will give pain medication as appropriate. The nurse will decide when your child is ready to leave the PACU.
  • For safety reasons, your child will be taken to their room on a gurney or be carried by a staff member.

Preparing Your Other Children

If you have other children at home, it is important that they understand what is happening regarding their brother or sister’s surgery.

They may be feeling

  • Fear that their sibling won’t come home or that they may have to have surgery also.
  • Jealousy because of the attention being given to the other child.
  • Anger that their parents did not keep the child from needing to have surgery.
  • Guilt because they don’t need to have surgery themselves.
  • Lonely if they don’t have their sibling to play with for a while.
  • Confused if they don’t know what is happening.

How they may show what they’re feeling

  • Change in their behavior. They may become withdrawn or cling to parents.
  • Pretend to be sick
  • Act out
  • Change their eating or sleeping habits.
  • Helping your other children

    • Talk to them about what is going on.
    • Have them talk to you about their feelings. Encourage them to ask questions. Use answers appropriate to their age.
    • Reassure them that you, or someone else, will be there to care for them.
    • Make special one on one time for you and your child.
    • Visit their brother or sister in the hospital if appropriate. If not, let them call, Skype or make a get well card.

    Understanding and Helping Your Child as Surgery Approaches

    The information that follows lists characteristics children tend to have in common. The list does not cover all tendencies and does not apply to every child. We hope the information will increase your understanding of what you may observe in your child, what you can expect from us as caregivers, and assist you in preparing your child for their surgery.

    View the Children’s Surgical Procedures page of our site.

    View information by your child’s age in the chart below





     INFANTS (0-12 MONTHS)
    Factors that Increase Stress
    • Separation from family
    • Strangers
    Approach to Use
    
What you can do as a parent:
    • Provide comfort measures (pacifier, toy or blanket, swaddling, holding)
    • Be present whenever possible
    
 What you can expect from your child’s caregivers:
    • Use a slow approach
    • Allow time for familiarity
    • Provide consistent caregivers
    • Minimize separation from parents
    • Assist in decreasing parent’s anxiety
    • Facilitate parent or caregiver presence
    
 Preparation and Care of an Infant
    • Short attention span (1-2 minutes)
    • Prepare the infant just before performing care by telling them what you are about to do (check their temperature, change their diaper…)
     TODDLERS (1-3 YEARS OF AGE)
    Thinking Characteristics
    • Egocentric (self-centered – don’t understand other’s views)
    • Magical thinking (for example, may believe they will slip down the drain)
    Factors That Increase Stress
    • Separation from family or caregivers
    • Pain
    Approach and Education Methods Parents and Staff May Use
    • Minimize separation from parent
    • Use picture books
    • Use play to demonstrate
    • Let play with equipment (mask, teddy bear…)
    • Provide comfort measures (own toy or blanket, holding, singing)
    Preparation by Parents and Staff
    • Should occur immediately before event  – too far in advance increases anxiety
    • Keep explanations simple
    
The following is normal for this age group:
    • Any actions by healthcare providers (taking a temperature, checking a blood pressure) may cause your child to become upset.
     
     PRESCHOOL CHILDREN (3-6 YEARS OF AGE)
    Thinking Characteristics
    • Egocentric (self-centered – don’t understand other’s view)
    • Magical thinking (that thinking something may cause it to happen)
    • Highly literal with words (saying ‘you have a stomach bug’ will make the child believe they have a bug in their stomach)
    • Basic ideas about their bodies
    • Difficulty in differentiating “good” hurt (will make you feel better) with “bad” hurt (illness or injury)
    Factors That Increase Stress
    • Separation from family
    • Loss of control
    • Fear of bleeding and punctures (fear their insides will “leak out”)
    • Emotional reaction of others can increase their anxiety
    • Lack of preparation for procedure
    Approach and Education Methods 
Parents and Staff May Use
    • Minimize separation from parent
    • Use play to explain procedures and activities – encourage verbalization
    • Use pictures, story books and puppets
    • Use models and actual equipment – hands on practice with equipment
    • Describe what child may feel, hear and taste
    • Give choices whenever possible
    • Allow child to bring a favorite item (toy, book, blanket)
    Preparation by Parents and Staff
    • Acknowledge and accept fears and anxieties
    • Be concise, simple and concrete. Short attention span. Limit length of explanation to 5 minutes.
    • Prepare 1 to 3 hours before minor event (Dr. visit) and days in advance for major event (surgery).
    • Repeat explanations every time something is being done. Do not assume the child will remember.
    • Do NOT tie evaluations of the child’s behavior with the procedure (do not say he is a “good boy” for holding still but rather, “That was helpful to hold still.”).
    • Do not tell the child they will feel better after surgery. They will likely feel worse in the postoperative period.
    • Emphasize child will wake up after surgery.
    • Repeat often that the child has done nothing wrong and is not being punished.
    
The following are normal for this age group:
    • You may see regression, detachment, avoidance or despair in your child.
    • You may see verbal uncooperativeness, physical aggression or tantrums. 
You may even see this with experiences like taking a temperature.
     
     SCHOOL-AGE CHILDREN (6-12 YEARS OF AGE)
    Thinking Characteristics
    • Still tend to be literal with words but beginning to think logically (knows that a ‘stomach bug’ is not an actual bug in their stomach)
    • Better ability to understand relationship between illness and treatment
    • Can listen attentively to everything being said without always understanding
    • Reluctance to ask questions or admit they don’t know something
    Factors That Increase Stress
    • Fear failure to live up to expectations of others
    • Fear loss of control, bodily injury, mutilation, procedures involving genitals, and death.
    Approach and Education Methods Parents and Staff May Use
    • Minimize separation from parent
    • Respect increasing need for privacy
    • Establish limits (example: will be allowed to go home but have to eat and drink first)
    • Stress peer group (friends, people their age) can be maintained
    • Encourage verbalization and questions
    • Acknowledge fears
    • Reassure they have done nothing wrong
    • Offer choices to provide measure of control (flavor of anesthesia gas, which book to read while waiting…)
    • Hands-on practice with equipment
    • Use photographs, books, diagrams, charts, or videos to explain
    • Standardized multimedia education may be helpful
    • Likes learning scientific terminology
    • They may want to have a familiar, comforting item with them. Encourage them to bring the item(s). This might include a stuffed animal, toy, game, or music…
    Preparation by Parents and Staff
    • Introduce days ahead for minor events (such as a Dr. visit) to weeks ahead for major events (such as surgery)
    • Respond honestly to request for factual information
    • Ask them what they understand
    
• They want to know what a procedure is for, if it will hurt, how it will make them well and what injury or harm could result.
    
The following are normal for this age group:
    • Your child may show disinterest or withdrawal
     
     ADOLESCENTS (TEENAGERS)
    Thinking Characteristics
    • Beginning to think beyond basic meaning of words
    
• Able to think logically
    • Still some magical thinking (thinking something can make it real – feel guilty for illness)
    • Has some understanding of structure and workings of the human body
    • Loss of control
    • Altered body image
    • Separation from peer group
    • Strong need for privacy
    • Information sensitivity – adolescents react not only to what they are told but also to the manner in which they are told
    • Tactfully explore what they know
    • Allow as many choices and control as possible
    
• Allow to bring favorite item (music, book, tablet…)
    • Use photographs, books, diagrams, charts, and videos
    • Provide tours and equipment and models to examine.
    • Audio video and multimedia computer-based programs may be helpful
    • Attention span up to 60 minutes
    
• Introduce preparatory materials up to 1 week in advance for minor events and weeks for major events. This is vital for adolescent’s ability to cope, cooperate and comply.
    • Use collaborative approach – support independence and decision making
    • Stress how much they can do and how important their compliance is to their recovery. Be honest about consequences.
    
• Assure ability to maintain contact with peer group.
    • Teach relaxation methods: deep breathing, self-comforting talk or use of imagery.
    • Privacy: Inform them that certain procedures will be conducted only after start of anesthesia (hair removal, skin preparation…); they will be allowed to leave undergarments on when appropriate; and only surgical area is exposed.
    
• Reassure that they do not need to worry about talking or doing anything embarrassing under anesthesia.
    • Discuss approximate time they will be in each area of the building (Admission, PreOp, Surgery, PACU, and PostOp).
    • Tendency toward hyper-responsiveness (may seem extreme in relation to what they are reacting to) to pain.
    • May alternate between dependence and exerting independence.
    • Pain is perceived on three levels: physical, emotional and mental.
    • Not unusual for teens to deal with pain through regressive behavior as seen with: increased dependence on parent; expectation that nurses should know they are in pain; belief that they should not have to ask for pain medication.