First rule in preparing kids for surgery: don't lie

A month after having his tonsils and adenoids removed, 7-year-old Eden Gonzales stood before a wall-sized photograph of an operating room.

A Child Life specialist at University Hospital used the photo before his procedure to familiarize Eden with the operating table; the large, overhead disk-shaped lights; the carts with equipment, and locations where doctors and nurses would be standing.

“That’s the bed where I went to sleep,” said Eden, pointing at the table.

Bianca Gonzales, Eden’s mother, said the preparation helped her son overcome some of the fear he had about surgery.

“He was curious about what was going to happen. Are there shots? Do I have to take medicine? Where are my mom and dad going to be?” Gonzales recalled. “If we hadn’t gone through that it would have been way more of a traumatic experience, not just for him but for me. I would have been there the whole time trying to keep him calm and console him.”

Monica Gibson, University Hospital’s Child Life team leader, says that prior to an operation her staff works to minimize a child’s anxiety by demystifying the health care setting and explaining why the procedure is important.

Gibson’s team members are all certified Child Life Specialists. Their training includes academic and clinical experience in child development, understanding family systems and using play therapy.

The specialists choose techniques for reassuring a child based on the child’s age, maturity, personality and previous healthcare experiences. Elementary-aged children like Eden are inquisitive, so knowing what will happen helps them cope.

“It puts the child in control and gets him used to the idea something is happening with his body,” Gibson said.

Role-playing promotes a child’s feeling of control

Therapeutic play is an important tool. In a room known as the “medical play zone” Gibson demonstrates some of the games and activities that allow children to rehearse the rolls of their doctors and medical team.

Child Life specialist stands in front of a picture talking to a mother and son about his upcoming surgery

At a table filled with plastic, snap-together toys, Eden positions a miniature hospital bed with its patient next to a stand holding a replica of an intravenous fluid pouch. Having an IV needle inserted into his arm was something that frightened Eden.

Gibson uses a cloth doll to demonstrate how the IV needle was used during Eden’s surgery. Eden refers to the needle and IV tube as “the straw.”

“Do you remember how it felt to have the straw?” Gibson asks.

“It tingled,” Eden said.

“Did you feel better after surgery? Gibson asks.

“Yes,” said Eden, crediting the medicine in the IV bag with helping him recover.

Tips for parents

Gibson says the biggest mistake parents make in preparing their children for surgery is lying to them. Parents may insist the medicine is going to taste good when it’s bitter. They may claim a shot won’t hurt when it will clearly sting.

Lying erodes trust and heightens a child’s fear. So, while the exercises to prepare for surgery may be different depending on a child’s development, Gibson says the first rule for all parents is to provide honest information.

Other recommendations:
  • Use age-appropriate language and simple explanations
  • Answer a child’s questions. If you don’t know the answer, tell them you will talk to the doctor or medical team and find the answer.
  • If a child has a favorite doll, blanket or comfort-item, allow them to bring it to the hospital.
  • Parents should appear confident the procedure will make the child feel better. Studies show that when a parent is anxious, the child becomes more anxious.

Eden clearly feels some pride in having coped with his anxieties about surgery, and he knows he feels better after having his infected tonsils removed.

Eden’s 6-year-old sister is also expected to have her tonsils out sometime soon, and Eden is ready with some big-brother advice.

It’s OK to cry if you want to go home, says Eden.

The IV “straws” will only be there a while. They come out.

And sometimes the medicine tastes “gross,” but Eden promises it will make you feel better.

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