Preparing the Preschooler for Surgery

What part about surgery is most stressful for a preschool child?

Preschool-aged children can certainly benefit from preoperative planning, education, and explanations. This preparation should take place several days before the procedure, to give your preschool child an adequate amount of time to prepare. Recognizing what is stressful to your preschool child while in the hospital can guide you in preparing him/her for the surgical experience. Common stressors and fears in the hospital may include the following:

fear of being away from family and home, or of being left alone
thinking he/she is in the hospital because he/she is in trouble or being punished
fear of having a part of the body damaged
fear of needles and shots
fear of waking up during surgery
fear of pain (or the possibility of pain)
fear of the dark

How do I prepare my preschool child for surgery?

One of the major fears preschoolers have is fear of the unknown. Your child should be told of surgery several days before the procedure and perhaps even visit the hospital for a tour. Many hospitals will allow you and your child to visit. Touring the hospital before surgery can help your child see the sights, sounds, and events he/she will experience the day of surgery. It can help your child learn about the hospital, and gives him/her time to talk about concerns and questions he/she may have. Contact the hospital's child life department for this service.
Tell the truth in simple terms and answer all of your child's questions, for example, "Yes, it will hurt, but it will not last long."
Make sure your child knows why he/she is going to have surgery. It is not uncommon for this age group to have misconceptions regarding hospitalization. Often, children think they have done something wrong or that needles are given to kids who are "bad."
Dramatic play is a big part of a preschooler's life. Using pictures, stuffed animals, or toys to help your child understand is better than simply telling him/her what will happen. Illustrate the situation clearly for your child. Ask a child life specialist to help explain what will happen, and why, in terms your child can understand. Also discuss therapeutic play activities such as playing "hospital" with your child at home before he/she is admitted for the procedure.
Give very simple explanations and be careful of the words that you use. For example, say, "The doctor is going to fix your arm." Do not say, "The doctor is going to make a cut on your arm." If you describe anesthesia as "being put to sleep," your preschooler may think of a family pet that died and wonder if he/she will die, too. A better way to phrase it might be: "A doctor will help you sleep (a different kind of sleep than how you sleep at night) during the operation, and he/she will wake you up after it is over."
Your child may enjoy reading books about the hospital with the family.
Allow your child to help pack his/her own suitcase. Bringing a favorite security item, pictures of family and pets, and a special toy can be very comforting.
Explain the benefits of the surgery in terms your child can understand. For example, "After the doctor fixes your arm, you can play ___ ."
Learn as much as you can about your child's surgery. Children can tell when their parents are worried. The more you know, the better you will feel and the more you can help explain things to your child.
Make sure to stay with your child as much as possible - to provide comfort and security.
Be patient with your child. It is normal for him/her to require more attention. Your child may have temper tantrums or be uncooperative. It is not unusual for your child to return to bedwetting or thumb-sucking. The regressive behavior will usually improve after the stress of the procedure has passed.
Remember, too, to take care of yourself. Simplify your life during this time and do not be afraid to ask for help from family and friends. Remaining positive and non-stressed can help reduce your child's anxiety.

Helpful books for you and your child:

Anne Civardi and Stephen Cartwright. 1993. Going to the Hospital. EDC Publishing. (ages 3 to 6)

Fred Rogers. 1997. Going to the Hospital. The Putnam Publishing Group. (ages 5 to 6)

Deborah Hautzig. 1985. A Visit to the Sesame Street Hospital. Random House/Children's Television Workshop. (ages 4 to 7)

Richard Scarry. 1995. Big Operation: The Busy World of Richard Scarry. Aladdin Paperback.

Debbie Duncan, Nina Ollikainen (Illustrator). September 1995. When Molly Was In The Hospital: A Book for Brothers and Sisters of Hospitalized Children. Rayve Productions, Incorporated. (ages 4 to 7)

Paulette Bourgeois, Brenda Clark (Illustrator). 2000. Franklin Goes to the Hospital (volume 25). Scholastic, Inc. (ages 5 to 7)

Virginia Dooley and Miriam Katin. 1996. Tubes in My Ears: My Trip to the Hospital. Mondo Publishing. (ages 5 to 7)

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Online Resources of The Child Having Surgery

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