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Children in hospital

hospital; separation; doctor; nurse; anaesthetic; operation; illness ;

Spending time in hospital can be very stressful for children and their parents, and distress can affect how children recover from their illness. Most hospitals are aware of this and will help you to support your child in hospital.

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Children and illness

Young children have different ways of thinking from adults and less experience of the world, so what seems ordinary to an adult (eg a visitor leaving) can be very frightening to a child (will mummy ever come back?)

Babies

  • Because babies are just learning to make sense of the world they can become very unsettled if different people are caring for them and doing things differently from what they are used to.
  • They cannot understand that things which hurt them may be needed to make them well.
  • As they get to about six months old and older they can be very afraid if their main carers leave them. See the topic 'Separation anxiety'.

Toddlers

  • Toddlers are likely to be afraid if separated from their main caregivers, especially in a strange situation. Being separated, rather than being ill, can be the major stress for them if they have to stay in hospital without their parent or caregiver.
  • Toddlers also don't understand what is happening when they are ill and they don't understand time and space so all this can be very frightening for them.

School age children

  • These children are learning to understand about what can cause an illness and how the illness affects their bodies.
  • Almost all school age children will have seen and heard a lot about illness and hospitals on TV. They may often have seen people 'die' in hospital, and know about cancer and other illnesses that can cause children to die.
  • Like babies, they cannot understand that things that hurt them may be needed to make them well.
  • They need to know what will happen to them, and that they will not die (they might be too frightened to ask this themselves).
  • Children often misunderstand what they over-hear, so it is important to give them opportunities to ask questions.

Preparing children to go to hospital

  • Many hospitals allow visits by parents and children before the children go into hospital, so they can see where they will be and what will happen.
  • Many also have printed material (such as pictures of children in hospital to colour in) or information on the Internet to go through with children (see Resources below).
  • Find out what will happen yourself and play some hospital games with your child.
  • Read or tell your child stories about a child who goes to hospital, gets better and comes home. Check your local library or the school library. Teachers may talk about hospitals with the whole class.
  • Be honest with your child about what is going to happen, so she does not lose her trust in you. She needs to be able to trust you.

Note: for toddlers and young children it is important not to tell them too far in advance because they don't need too long to worry about something they don't understand - a few days is usually long enough.

Children in hospital

Children in hospital need the support of a parent or a very close family member. The younger the child is, the more important it is for you to stay with her if you can. This can sometimes be difficult if there are other young children at home. If it is possible, arrange for someone else to care for the other children. But make sure your other children understand what is happening, and that they see you or at least talk to you on the phone as often as possible.

About two generations ago little was done to support children or parents when children were in hospital, and much harm was done to children. Visiting was sometimes only for an hour twice a week ('justified' by a child becoming very upset after a parent visited), and for parents only (no brothers or sisters, no friends, no 'germs'). Now hospitals and hospital staff have much greater awareness of the needs of children and their parents and mostly have very different policies.

Admission

  • Most hospitals have 'day' wards so that few children have to stay overnight or more than one day.
  • For some illnesses and injuries children still have to stay for more than one day, but many more children stay only for a short time compared even to 10 years ago.

Parents

  • Mothers or fathers should be able to be admitted with children, especially if the child is under five, and should be near the child at night. Research shows that this helps children to get better more quickly.
  • Hospitals should make provisions so that parents can stay (such as comfortable chairs, and somewhere to get meals), and encourage them to stay.
  • Parents should be able to help as much as they are able with the care of the child. (However parents need to be supported and not left to provide all the care).

Visitors

  • If children are to be in hospital for more than a couple of days, they will usually want to have visitors unless they are very unwell.
  • Being visited by other family members will be important to them, especially brothers and sisters. But the rights of other children and their families have to be considered; they may need quiet time.
  • Children who are unwell should not come into the hospital. If a visitor has a cold or gastro this can be spread to the other children in the ward.
  • While friends and others may visit, you and the staff need to limit the time and number of visitors so that your child is not overwhelmed.

Activities

  • Many hospitals expect children to be out of bed and playing much of the time unless the child 'has' to stay in bed. Having a 'drip' in does not mean a child has to stay in bed. (Take some normal clothes, not just pyjamas.)
  • Play coordinators work in many children's wards, and they can play with little children, and with children who do have to stay in bed, as well as children who can be out of bed.
  • Having play coordinators seems to help children get better more quickly, and they seem to need less pain relief.
  • School aged children who are in hospital for a length of time are usually expected to have to do school work. The child's usual teacher may set some work or a few children may have contact with a teacher based in the hospital.

Operations

  • If a child is going to have an operation, parents are usually expected to go with their child to the anaesthetic room, and often to stay until the child is asleep. Some parents find this scary; maybe a nurse who the child has gotten to know might go instead.
  • Usually parents will not be allowed into the 'recovery' room, which is the place where children are taken immediately after the operation until they start to wake up. The child will still be drowsy when taken back to the ward and will be unaware that you were not there in recovery. The child will become alert in the ward and parents will usually be able to be with their child when he fully wakes up.

If you are unable to stay with your child

Some parents are unable to stay with their children in hospital. If you are in this situation here are some suggestions that will help your child.

  • Try to visit as much as possible. If this is difficult, try to find other people who your child knows well, to visit.
  • Always let your child know when you are leaving and when you are coming back. For young children who don't understand time, it can be after sleep or after breakfast etc. Make sure you come when you say you will.
  • Talk with the nurses about when things such as dressing changes, or doctor visits are going to happen. The time they are done may be able to be altered so that you can be with your child when they are done.
  • Try to show your child that you feel confident about the people who are looking after her, and that you understand her fears.
  • Let her know that you wish you could stay and explain why you can't. Even very young children can get reassurance from the sound of the words, while they can't understand all that you are saying. Eg "You are sad because mummy has to go and you wish I could stay. I wish I could stay too, but I have to go because..." "The nurse will look after you and I will be back when..."
  • Always let the nurses know where you will be and when you will be back so they can answer your child's questions. Your child will trust the nurses more if the nurses know what is happening. Let them know whether your child can ring you.
  • If your child is upset when you leave, ask a staff member to be with her to comfort her. Children cry when they are left in a strange place, especially if they don't feel well. They cry because they are scared, because they are angry that you have gone, and maybe because they are unwell or in pain. This is understood by hospital staff, who will do their best to help your child become calm.
  • Don't let anyone tell you that your child being upset when you leave is a reason not to visit. It is much better for children to have you come for a while and then be sad when you go but know that you will be coming back, than not to have you come. This helps your child trust you.

If you have worries about what is happening for your child in hospital or any health care service you have the right to put those concerns to the health care providers. You know your child best and you have the right to speak up for your child. If this does not work find out the Client's Rights or complaints process for the hospital and follow it through.

Brothers and sisters

While one child in the family is in hospital, other children in the family can have very complex reactions. They might feel:

  • responsible for the illness (did it happen because I said I hated her?)
  • sadness (for the crying child)
  • anger (for mummy to be at the hospital)
  • anxiety (what if she dies?)
  • loneliness and fear (if sent to stay with someone else, will mummy or daddy ever come back?)
  • worry (when left out of the grown-up discussions).

They will need you also. They may: 

  • 'play' up when you are there
  • want more of your attention than usual
  • go backwards with some of their skills (wet the bed again)
  • fight with other siblings more.

They may manage best if they continue their usual activities, go to school, to child care and play with friends. (While it is not exactly related to having a child in hospital, the topic 'Disability - brothers and sisters'  has information about the complexity of this experience.)

It is normal for children to want more of you. They will not recognise that you need time out. You need to let some other things go to be there for your children at this time and accept any help that is offered, or ask for help.

When your child comes home

Most children are unsettled and demanding for a while after they come home from hospital. This is not because they have been 'spoilt' in hospital, but because going to hospital and being ill is very stressful, and also because they are usually not fully well.

  • Often children will be very quiet while in hospital because they don't feel safe, but they will show their distress when they feel safe at home.
  • They may go backwards in behaviour for a while, eg have nightmares, wet the bed or forget their toilet training.
  • They may cling, and get really upset if you go out of sight.

This is normal and it will pass as your child becomes more secure again. Try not to expect too much, but help your child to get back into doing what he used to do when he is ready.

Older children need someone they can talk to about what has happened. Younger children may be able to work through their feelings in play.

  • Use a doll, or puppets, to play about what has happened to her. Let your child lead the play.
  • Give her paints or pencils to draw with.
  • Tell or read stories about her experience (the same books that you used before she went into hospital may be helpful).
  • If your child is very young and afraid of being separated from you (eg going to child care), don't force the issue until she becomes more secure again. This can become a problem because your child may actually be calm and happy when with trusted care givers, but get very distressed when you leave, and again when you come back. The care givers will probably have worked through these reactions with other children and may have some ideas which can help you manage. (See 'Separation anxiety' for more ideas.)

Resources

Internet sites

Books for children

  • Check you local library, school or preschool library - they are likely to have books about going to hospital. Many bookshops will also have books about being ill or going into hospital. It can be good to own the book, because your child may want to have it read many times.
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The information on this site should not be used as an alternative to professional care. If you have a particular problem, see a doctor, or ring the Parent Helpline on 1300 364 100 (local call cost from anywhere in South Australia).

This topic may use 'he' and 'she' in turn - please change to suit your child's sex.

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