Hospitalization
Admittance to a hospital as a patient.
Whether planned or on an emergency basis, hospitalization causes disruption in the life of any child. However, with the special accommodations that modern hospitals usually make for both children and their parents, a stay in the hospital need not be a traumatic event. If children receive proper support from the hospital and their families, hospitalization can even make them feel good about themselves for having successfully negotiated a challenge to their maturity, self-discipline, and courage. Because no one can predict when a child may face an emergency hospital stay, it is a good idea for all parents to spend some time talking to their children about hospitals.
Children should be carefully prepared for prearranged hospitalizations. Before they can reassure their children, parents need to deal with their own fears about the impending experience, which can be easily communicated to a child. They should describe and explain, as honestly and thoroughly as possible, what will happen to the child while she is in the hospital. A toy doctor kit can help psychologically prepare a child for the experience. There are also a number of books written especially for this purpose that parents can read to children. There are various symbolic steps parents can take to reassure young children, with their limited concept of time, that the hospital stay will be temporary. They can plan a party afterward or read a story-book part way through and mark the place where it will be resumed once the child comes home.
For preschool children, explanations should be simple and concrete. Trying to explain that the child will undergo a series of tests or that he will spend three weeks in the hospital will not ease the child's anxiety. Instead, theparent might indicate the part or parts of the body that are to be "fixed," using a doll or stuffed animal. By the ages of five or six years, children can understand hospitalization on a more sophisticated level. They will be familiar with some medical instruments and concepts and better able to grasp the time frame involved. A special concern with children this age is the possibility that they will feel like they are going to the hospital because they have done something wrong, and parents need to reassure the child that this is not true. Overall, the best reassurance parents can give children of any age is the promise that they will be there to help them through the experience, even if they cannot be physically present during the entire ordeal.
The furnishings and staff of the children's floor in most hospitals are selected to be more home-like than other areas.Many hospitals allow parents and children to tour their pediatric facilities, further reassuring the child. Children may be shown rooms similar to those in which they will stay. They may also be shown the unit's playroom, become familiar with some of the hospital equipment they will see frequently during their stay, or meet some of the nursing staff. It is best for parents to be present during these tours, so the child can see that they approve of the facilities and trust the care providers. When it comes time to help the child pack for the hospital, it is helpful to take old, familiar, comforting pajamas, toys, and other belongings.
Children's floors in many hospitals are staffed by at least some nurses who specialize in caring for infants and children and understand their special needs. In addition, it is common for the staff to include a children's activities specialist with a background in child development and therapeutic play. When a child is admitted, a nurse will probably consult with the parents to learn about any dietary restrictions or preferences. As with adult hospitalization, there will usually be daily menu choices available. Once in the hospital, a child usually shares a room with one or more other children, which is usually a positive experience. A typical feature of children's hospitals or children's areas in hospitals is a playroom where children can interact with others who are undergoing similar experiences.
Even with preparation and support, it is normal for children to experience certain fears when they are hospitalized. The most common is separation anxiety. The hospital is a frightening place full of unfamiliar sights, sounds, and people, and the child's primary source of security and reassurance is a parent. Many young children have never spent even a single night away from their parents, and if the parents leave for the night, especially at the beginning of a hospital stay, a child can easily fear that they will never return. Even a parent's short absence during the day can prove upsetting to a child. It is becoming increasingly common for parents to stay with a hospitalized child overnight, at least initially, either in a special nearby unit or on a cot or chair in the child'sroom. Once the child has become familiar with the hospital environment and personnel, the parents can encourage attachments to particular staff members or playmates to prevent the child from feeling abandoned during periods when the parents must be away.
In addition to separation anxiety, it is common for hospitalized children to fear mutilation or even death. Children may or may not verbalize these fears. Besides comforting their children simply by their presence, parents can also help them cope with the sense of helplessness that brings on such fears by trying as much as possible to help them feel they have some control over things. They may be able to decide what they will eat or wear, or what toys they will play with.
Children may cope with the emotional turmoil of hospitalization by social withdrawal, aggression, or an unnatural degree of obedience stemming from the fear that if they are "bad," even worse things will happen to them. All of these are normal and generally transient reactions that do not cause any long-lasting emotional harm. It is also common for children to experience some developmental regression in response to being hospitalized, either during the experience or after they come home. Often, they temporarily lose a recent advance, such as staying dry at night or overcoming certain fears. It can be helpful for children to cope with their feelings about hospitalization once they are home by playing with dolls and other toys. A doctor kit bought to help prepare for the hospitalization is sometimes very helpful in replaying children's reactions once they are home again.
Books and Videos for Children Ages 2 to 8
Books
DeSantis, Kenny. A Doctor's Tools. New York: Dodd, Mead, 1985.
Hautiz, Deborah. A Visit to the Sesame Street Hospital. New York: Random House, 1985.
Rey, Margaret, and H.A. Rey. Curious George Goes to the Hospital. New York: Scholastic Books Services, 1974.
Videos
The Hospital Adventures of Jimmy, Judy, and AC. (Videorecording). Fairlawn, NJ: Balducci Productions, 1993.
Steedman, Julie. Emergency Room—An ABC Tour. (Ages 2 to 10). McLean, VA: Windy Hill Press, 1974.
Stein, Sara Bonnett. A Hospital Story. (Ages 3 to 10). New York: Walker and Co., 1974.
For Further Study
Books
Azarnoff, Pat, ed. Preparation of Young Healthy Children for Possible Hospitalization: The Issues. Santa Monica: Pediatric Projects, 1983.
Organizations
Association for the Care of Children's Health
Address: 7910 Woodmont Ave., Suite 300
Bethesda,MD 20814
Telephone: (301) 654-6549
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