Preparing for Hospital Visits

New experiences bring a certain amount of fear and uncertainty. When a child has heart disease, many new and different things occur: office visits, examinations, diagnostic testing and hospitalizations. Each of us, whether child or adult, is able to cope better when we are told what a new experience will be like, how we can handle it and who can help. It is important to prepare both yourself and your child for what may happen. Preparation for new experiences is different for parents and children.

Parents

For parents, preparation begins with the cardiologist who makes the diagnosis and outlines the treatment plan. Other professionals in the office such as nurses and social workers can give you additional information and support.

If your child is scheduled for heart catheterization or surgery, you will be given the opportunity to come to the hospital for a tour. During the tour, you will learn what will happen in the hospital and have a chance to ask questions and meet other parents. It is an important source of information and support. Preparation will influence how both you and your child feel and act when he comes to the hospital. If you feel informed and comfortable, your child will feel more secure.

Children

Parents are the most important people in helping prepare children for a new experience. When your child has to come to the hospital, it is important to help him begin to understand what will happen and why. Encourage him to ask questions. When you are preparing your child for the hospital, be guided by his age and the types of questions he asks.

Infants and Young Children

Infants and young children are most upset when they must be separated from their home and parents. They do not trust strangers. Very young children are not able to understand why unpleasant things are happening. Shots are especially difficult for them. In helping children of this age with trips to the hospital, special attention should be given to making arrangements for parents to stay with them, maintaining usual schedules, bringing favorite toys, etc. These efforts will give your child feelings of security and safety by making the hospital more familiar.

Who Parents/Family Medical Staff Other Special People
What Brief, simple explanation

Honestly explain to your child when you will be with him		 Brief, simple explanation of the procedure they are about to perform Coloring/story books about hospital experience

Gifts of toys for hospital
When Admission to hospital
  • 1 or 2 days before office visit
  • 1 or 2 days before shots
  • Immediately before other hospital procedures
 At time of procedure
How Medical play

Set aside time for simple, brief explanations

Tour of hospital		 Brief, simple explanation with support of parents
Where Home

Medical office		 At site of medical procedure
  • Stay with your child in the hospital as much as possible; young children especially are comforted when you stay overnight
  • Ask staff if you can stay with your child during stressful events or treatments
  • Ask staff for “time out” when either you or your child feel overwhelmed
  • Describe your child’s routine to the nurses; ask that it remain the same as much as possible

School-Age Children

While school-age children have a better understanding of why they must come to the hospital, they still feel sad and worried. In addition, they are very involved in school, routines and friendships. School-age children are often upset by changes that may happen because of hospitalization. They fear they will be different than their peers and excluded from the gang and its activities. They hate shots and carry this concern home as an important memory. Hospital preparation for the school-age child is best when he has the opportunity to actively explore the new hospital environment and plan for admission.

Who Parents/Family Medical Staff Other Special People
What Describe all planned procedures

Explain reasons for doing them

Encourage questions

Share your own feelings		 Give simple description and reasons for procedure

Encourage and answer questions		 Gifts of books about hospital/illness

Discussion with people who have had similar experiences - limit to things that are important to child
When Allow enough time for child to find ways to cope with upcoming stress, usually several weeks before the event

Allow opportunity to tell friends, rearrange school/social schedule
 At time procedure is planned

Available for questions anytime prior to procedure

Tailor plans to school-age child’s needs/wishes when possible

During procedure		 Arrange above, especially if parent or professionals feel it would be helpful to the child
How Simple, verbal explanations and reading material

Tour of the hospital		 Simple language

Avoid complex details or possible frightening complications		 Avoid emphasizing experiences that are frightening
Where Medical office during initial planning with doctor

Home

Hospital		 Medical office

Phone		 Any appropriate place

Hospital
  • Maintain child’s routine both in and out of hospital
  • Set aside time to talk, listen or simply be with the child when he seems to need additional attention
  • Be available during special times when child may be likely to worry (i.e. before bedtime or early morning)
  • Give extra praise and support
  • Admit your own sadness about illness in simple, undetailed way
  • Encourage and answer questions simply and honestly; avoid overwhelming detail
  • Unless asked, omit concerns about possible complications
  • Give assistance in helping your child tell friends and other special people
  • Stay with your child in the hospital as much as possible

Adolescents

While having feelings similar to those of school-age children, adolescents have additional concerns. They worry about body scars from procedures, the impact of heart disease on their future and dying. Adolescents who have had many treatments may need special help in preparing to come to the hospital. In talking with your adolescent, encourage expression of his thoughts and concerns. Sharing your feelings about upcoming hospital experiences may help begin this conversation and show it is all right to talk about feelings.

Who Parents/Family Medical Staff Other Special People
What All procedures planned

Encourage questions

Help adolescent find resources for answers		 Explain diagnosis

Encourage questions about procedure and why it is needed

Discuss future course of heart disease		 Reading and other information sources

Discussions with people who have had similar experiences - limit to things that are important to adolescent
When As soon as treatment is recommended; adolescent needs to be part of the decision
 As soon as treatment recommendations are made Arrange above, especially when adolescent asks or if parents or professionals feel it would be helpful
How Honestly, giving as much information as requested Tailor plans to adolescent’s needs/wishes when possible

Give honest information		 Honestly

Parents/professionals should be included in discussion if needed
Where Medical office or where treatment decision is made

Home		 Medical office

Phone

Hospital		 Any appropriate place
  • Allow time for talking things over with adolescent
  • Share your feelings, concerns and hopes
  • Give adolescent praise and support with frequent reassurances of his strengths in dealing with this stressful situation
  • Check frequently with adolescent about what you can do to help him
  • Allow adolescent to be alone or seek private time with friends/trusted medical staff
  • Help adolescent realize feelings of dependency due to hospitalization/procedures are temporary
  • Encourage adolescent to maintain contact with friends through visits and phone calls
  • Arrange to be with adolescent in the hospital when he needs you

Sources of Help in Preparing Your Child

Sometimes it is difficult for parents to talk with their children about issues they feel are sad and frightening, like coming to the hospital. However, health care professionals know children who have been properly prepared for hospitalization adjust much easier to the experience. Because hospital admissions usually occur on the day of the procedure, preparation must begin in the home.

We want to help you prepare your child for hospitalization. These are ways we offer assistance:

  • Hospital pre-admission tours are held weekly for children 3-12 years of age. Reservations for these tours may be made by contacting the Admissions Department. You may arrange private hospital tours if your child falls outside these age ranges, if the group tour is not convenient or if you feel your child could benefit from individual attention. Contact one of the nurses or social workers in the Heart Institute to arrange a private tour.
  • Booklets have been written by the Heart Institute clinical nurse specialist and the social worker to help you talk with your child about coming to the hospital. These materials are available free of charge in the Heart Institute office.
  • Doctors, nurses and social workers are always available to talk with you about ways to prepare your child for upcoming hospital visits; such discussions can take place by telephone or by arranging for an office visit.

While personalities differ, there are basic guidelines to refer to when you and others talk with your child about coming to the hospital. These are listed in the following tables. The tables are organized according to the age of the child: young children, school-age children and adolescents. Across the top, columns identify important people-parents, medical staff and others-who may be talking with your child. Under each column, there is a description of what, how, when and where it might be best to talk about treatment and/or hospital experiences.