A child’s admission to hospital is usually a difficult and stressful situation both for the child and for the child’s family. The hospital is an unfamiliar and largely unpredictable environment for the child. The necessity to stay in hospital may lead to serious stress, which complicates cooperation during the treatment and recovery process. The children are afraid of unknown persons, places, procedures, equipment, pain, but above all of loneliness, abandonment and a loss of control of the situation in which they have found themselves.
The parent / carer provides basic support for the child and constitutes the main source of essential information. Children carefully observe persons who are dear and important to them. Therefore it is essential to keep your own emotions under control, stay calm and display a positive attitude, as it affects the child’s feelings and behaviour. We should talk to the child in a simple way, accurately and truthfully (e.g. don’t make the children believe that taking blood sample or injection is painless – it is true that everyone feels pain during that procedure, however when we cooperate more peacefully, the pain may last for a shorter period of time and it may be weaker).
We shouldn’t promise the child a quick return home. Even the shortest stay in hospital usually takes several days, which may appear too long for the child. We should explain to the child that coming home will be possible as soon as all examinations necessary to continue further treatment at home have been performed (in the case of stay for diagnostic purpose) or when as a result of the hospital treatment (or procedure) the attending physician has confirmed that the child’s condition does not require any longer hospital stay.
When talking about the hospital, we should emphasise all positive information, i.e. the purpose of the stay, which is the improvement of health condition, frequent visits of the family and friends, company of other children, opportunity to play together with them, possibility to attend the hospital kindergarten or school or to use the day room. When dealing with an infant, you can not talk about hospital. The best for the baby would be hospitalization together with the parent / carer. The same should be applied to mentally retarded and disabled children, who are highly dependent on their parent’s permanent assistance. However, if it is impossible to stay with such a child, the child should be visited as often as possible.
Children at the age of two or three may be familiarized with medical examinations, treatment or hospital stay by playing. We can organize a hospital for the child’s favourite teddy bear or doll while playing with the child at home. Tell the child that the cuddly toy needs to be examined and treated, because we love it and want it to feel better. Show the child how the toy travels to hospital (by car or train), where it has its own bed, how the doctor or the nurse takes care of it and attends to it, even during the night, how pleasant the visits may be, etc. Playing hospital, drawing and reading about the hospital stay would also be an ideal complement to conversation with the pre-schooler and a way of releasing the stress. Teenagers, similarly to younger children, fear what is new, painful and difficult during the hospital stay. To accustom themselves to this situation, they need to be provided with as much specific information on the hospital stay as possible. We should be prepared to this. We can review the hospital guide or browse the website together with the child. We need to bear in mind that despite keeping up the appearances of maturity, the teenager may be fretful like a child, may oppose or even cry. When faced with an illness and a prospect of being separated from their own environment, the teenager may feel lost or even terrified. Let the children express their emotions and opinions, still explain to them the necessity of hospitalization in a firm and calm way.
Show your support. To deal with stress more effectively we should suggest the teenager using relaxation techniques, such as deep and calm breathing, thinking about pleasant things or listening to music. Young people are afraid of losing their independence and control over their own life when faced with a possible hospitalization. We should assure our children that they can decide about themselves to a large extent, however they need to take into consideration our opinion and arguments put forward by the doctor. We should note that in the case of invasive examinations or procedures planned at patients aged 16 and over, a consent of the patient is required to perform such an examination or procedure.
Teenagers may worry that the hospital stay will affect their school situation (falling behind at school, no grades obtained). We need to explain to them that the pediatric hospital has a school where classes for primary and junior high school pupils are conducted. High school pupils are provided with individual assistance of teachers. The classes are conducted in a pleasant atmosphere. Participation in the classes is recommended, but voluntary. The children are not forced to learn, particularly when they don’t feel well. The attendance and grades are entered into the class register and after the hospital discharge they are accepted by the pupil’s school based on the certificates issued by the hospital. The pupil should take to the hospital their own textbooks, notebooks and school equipment.
Justyna Dubi Ph.D. in Humanities