Many parents find themselves having tough conversations with their families when their child has to have a minor surgery.
Whether it is something outpatient like getting tubes put in a child’s ears, or removal of tonsils or an appendix, to larger surgeries that may keep them in the hospital for a few days, parents have to prepare their children for a pending hospital visit.
While discussing a challenging topic like pain with children is scary for most adults, University of Alabama at Birmingham experts from the schools of Medicine and Education share their tips for having open, productive and reassuring conversations about surgery with little ones.
Familiarize yourself (and your child) with the medical care team
Entrusting your child to a surgeon can be a difficult task for parents, but rest assured the doctors and nurses who care for your child understand the enormity of their responsibility.
“Operating on a child is a special privilege,” said Mike Chen, M.D., director of UAB’s Division of Pediatric Surgery and surgeon-in-chief at Children’s of Alabama. “Families are entrusting us with their loved ones and, in this case, often the most vulnerable ones because of their age and inability to really protect themselves. We treat these opportunities with gratitude and humility and care for these infants and children as our own. Letting the family know that these are our core principles can ease a lot of anxiety. By setting clear expectations and through strong communication, parents will feel more at ease, and in turn, they will make their child more comfortable and less stressed about the surgical experience.”
Often, doctors are able to establish a rapport with patients and families in clinic visits before any procedure is done. This relationship is key for building a successful and safe relationship for children.
“A pediatrician is the key ally and a parent’s best friend in explaining the surgical process and procedure with children,” said Lawrence Tyson, Ph.D., associate professor of counseling at UAB’s School of Education. “Making sure that parents help encourage children to ask questions — even if the parent feeds questions or helps the child ask them — builds trust and comfort that lets the child feel secure.”
Chen adds that, beyond just familiarizing with the surgeon, the nursing and hospital team play vital roles to keep children and parents feeling at ease.
“Our nurses are a vital part of our team,” Chen shared. “They are our ambassadors who can support the family before, during and after the procedure, and they can alleviate a lot of fear and provide comfort.”
Clear communication, cues
While parents are understandably nervous about the state of their child’s health and the pending surgery, it is important that parents remember that their child looks to them for reassurance about their health. Clear communication and body language can help make the process run smoothly.
“If a parent is acting nervous, tense or confused, their child will pick up on their tone and mood and emulate that also,” Tyson said. “The stability of the parent’s delivery about the situation is key, and they need to have their emotions, look and body language in check when explaining to the child what is happening next.”
To help with keeping the whole family informed and at ease, Chen explains that it is also key for the medical team to exercise clear communication as well.
“Every child is unique in regard to their age and understanding, and family values and norms play a role as well,” Chen said. “By being clear with parents about the journey they will be on with their child, their anxiety can be diminished, and that will in turn reduce stress for the child. Using simple language about safety and being well cared for by the medical team will assuage a lot of anxieties.”
Parents and doctors together can help alleviate anxiety of children who have to visit the hospital.Know your words
In ensuring that children understand their health and have a sense of ownership in the process, both Tyson and Chen agree that knowing how to say things and what terminology to use can minimize challenging conversations and anxiety.
“Children developmentally receive words differently and apply distinctive meaning to those words depending on what age they are,” Tyson explained. “If parents are talking to a young child, they may want to refrain from foreign and/or scary words like anesthesiologist, needles and pain. Parents need to be considerate of the age of the child and what kinds of words are being used for reassurance in conversation. That can be telling the 4-year-old that they will get ‘special juice to help them sleep’ or the 10-year-old who may respond better to knowing that they can return back to recess after the procedure is completed.”
No matter the size or scope of a surgical procedure, it is important that little people know that they are safe, be it that they are going to wake up, that they are not alone or that they will not be in pain any longer. Children may ask questions like ‘will you be here when I wake up’ and parents can engage by assuring them they will be right with them and will bring their favorite toy, that they will feel so much better and happier when they wake up from their nap.”
While parents can work to control the language and phrases they use, the medical team also tries to speak at a level that makes the most sense for that child and their age.
“When I talk to children about surgery, I explain that it’s my job to make them feel better or take care of a problem. I always reassure them that the process is quick and they won’t feel any pain,” Chen said. “I promise them that I will take very good care of them. I do this after establishing rapport with them in the clinic so that they trust me to do good by them.”
Trust your parental instincts
At the end of the day, parents know their child best. Some children have a more anxious disposition, while others can view visiting the doctor as exciting. No matter the situation, parents can read their child, know when they will respond positively or negatively, and do what they know to be best for their child.
“Parents can be more of a help than they give themselves credit for — they can really help calm their child and make them feel secure,” Tyson explained. “Children just want to know that everything will turn out OK, and the most important thing a parent can do is be just that — a supportive parent.”