TENDING TO A CHILD IN THE HOSPITAL:
DURING THE HOSPITAL STAY
Meeting Your Child's Emotional Needs
During the hospital stay, your child
will turn to you for the emotional support that only a
parent can provide. All children, regardless of age, worry
about separation from their parents. Feelings of loneliness
or of being abandoned in a strange place are what distress
children the most. At these times, you should emphasize
how important it is to their health to be treated by the
doctors at the hospital.
Even though your child may not say so or act like it, he/she will need reassurance
of your presence. Young children under the age of 5 need a parent or somebody
familiar to stay with them at all times (unless they are sedated in the intensive
care unit). Your involvement in their care will help your child maintain his/her
daily schedule while retaining some degree of normalcy. Older children need
daily visits by somebody familiar to them. They also need to be encouraged
to talk about their experience and feelings. During the times you are unable
to stay with your child, give your child something to hold onto until you return.
Assure them that the separation will only be temporary and that the nurses
and doctors will take care of them while you are away.
Comforting Your Child
When your child's condition improves,
he/she will be moved from intensive care (ICU) to the pediatric
care unit where you can take a more active role in your
child's care. The nurses generally encourage parents to
bath, change and feed their child because a familiar face
makes them feel more at ease. If you are unsure of how
to do something because of bandages and tubes, ask the
nurse to show you how the first time. Find out where the
hospital supplies are so that you can help yourself to
necessary supplies when needed (blankets, sheets, bottles,
nipples, formula). Of course, you should always check with
the nurse on any major decisions related to feeding, removing
bandages, stopping medications or moving your child.
There are a several methods for keeping your child comfortable while he/she
is recovering. Some nurses will roll up a dense foam pad and insert it under
the mattress to prop the bed up to a 45 degree angle. They may insert rolled
up blankets under your child's legs to prevent him/her from sliding down or
at the sides under their bed sheet to allow your child to elevate his/her arms
slightly. For children that have been in the hospital for more than 3 days,
they may develop sore muscles from the inability to move around. Turning your
child from side to side every few hours or gently moving his/her limbs will
help with the circulation. A gentle massage after a sponge bath may also make
your child feel more comfortable. A child with congestive heart failure may
have some fluid build up around the heart and lungs that can lead to breathing
problems. The nurse can teach you how to perform chest physical therapy (using
small cups to gently pound on the chest and back) to loosen the mucous in the
lungs. Children usually find this very relaxing and may even fall asleep while
you do it.
Over time, your child will need less pain-relieving medications and the doctor
will encourage him/her to be more active. You can request sessions with a physical
or occupational therapist if your child has been in the hospital for an extended
period or if you have any concerns about his/her developmental skills. As long
as your child can tolerate it, encourage your child to engage in familiar play
and to do simple exercises in bed (i.e. throwing, kicking, rolling, reaching).
Most hospitals have an activity center where you can borrow toys and books
to play with your child. Younger children can also engage in pretend play (i.e.
taking Teddy's temperature, giving dolls an injection, playing with cars) or
work on manipulative pieces (i.e. puzzles, play-doh, blocks, activity boxes).
Older kids can work on arts and crafts projects or write/draw about their experiences
and feelings. If your child is well enough, you can take him/her for a ride
in a wheelchair or stroller to the hospital's children library or activity
center for a change of scenery. All these activities help your child make sense
of their surroundings and remind them of familiar activities from school or
Feeding Your Child
If your baby is hospitalized after breastfeeding
has been established, you will need to pump at the hospital
and at home to maintain your milk supply. You should pump
based on his/her normal feeding schedule and more often
if you need to increase your supply. Most hospitals have
breast pumps for use in the maternity ward and freezers
to store your breast milk. When your baby is well enough
to drink, you can ask the nurse to feed your baby expressed
milk by the bottle or feeding tube if he/she still cannot
For children who are eating solid food and have regained their strength, you
can check with the cardiologist and nutritionist on whether he/she needs a
special diet and inquire about when you can feed your child's favorite foods
from home. Familiar food may encourage your child to eat more and feel more
secure. If you do decide to bring prepared food from home, a refrigerator and
microwave are usually available on each floor, and dietary service can provide
extra utensils and bowls.
Working With Health Professionals
While your child is in the hospital,
you will meet many different health professionals. At times,
it may seem like an endless round of visits from cardiologists
and possibly electrophysiologists, geneticists, nutritionist
and occupational, physical and feeding therapists. If your
child is in intensive care, there may also be ventilator
technicians and other pediatric specialists (surgeons,
neurologists, gastroenterologist) visiting. In addition,
there are daily rounds with attending unit doctors, fellows
and residents to discuss your child's case.
The hospital staff is there to help your child get well but at the same time
you should be aware that they handle many patients. You will therefore need
to be an effective advocate for your child's medical care. You are the best
person to interpret his/her needs and wants, and determine whether something
seems out of the ordinary. This is one reason why you should be available during
the day when the doctors make their patient rounds. It is the best time to
update doctors on your child's condition and bring up any concerns you may
have. There are some basic tips to keep in mind when dealing with various health
- Be clear and to the point when asking
questions. Think ahead and make a list of questions
and concerns and have them in front of you when you
speak to doctors.
- Write down the answers and keep
them in a folder or notebook for easy reference. Writing
things down, especially in stressful times, make it
easier to remember later.
- If there is some aspect of your
child's treatment that bothers you, discuss it with
your doctor or get the nurse to leave a note for the
doctor in the patient care book. Don't be afraid to
speak up when you feel you are not getting the attention
or help that your child needs. The best approach is
to be firm and straightforward while remaining calm
and pleasant in your requests.
- Get to know the nursing staff by
name and agree on the sharing of your child's care
on a daily basis. Inform them of what comforts and
upsets your child in case you need to be away.
- Report your observations or recap
the major day's issues with each new nurse that comes
on shift. Although each nurse will brief the next nurse
on shift, it's always good to reemphasize what you
feel are the key issues to be addressed for your child.
- If you leave for any length of time,
tell the shift nurse where you be and when you plan
to return. If you cannot make it back in time, phone
the ward and let them know of your new arrangement.
Getting Necessary Support
When your child is in the hospital,
it is a stressful and emotional time for everyone. If your
child is chronically ill and has been in the hospital frequently
or for an extended period, it can become especially physically
and emotionally draining for you and the whole family.
It is important to remain calm and ask for the support
that you need before stress begins to wear you down. Here
are some practical tips on getting the necessary support
while your child is recovering.
TOP OF PAGE
- Space visits from relations or friends
so that they can provide relief or companionship for
you. Arranging "shifts" with your child will allow
you to go home to rest or take care of household issues.
Although you may fell guilty leaving your child, remember
that everyone needs a break at some point. You will
probably have more energy once you have a change of
scenery even if it is merely a walk outside the hospital
or taking a break in the cafeteria.
- Ask for specific help from friends
and relatives such as watching your other children
during the day, bringing over a home-cooked meal on
a specific day or running errands on certain days of
the week. In many cases, people want to help but need
to be told exactly how.
- Take some time out each day to talk
with your spouse and occasionally do something for
yourself whether it's reading the newspaper, taking
a long bath or getting a massage. During stressful
times, it is easy to forget to take care of your own
needs and feelings.
- If your child has a scheduled hospital
visit, try to make all necessary domestic arrangements
ahead of time so that you can completely focus on tending
to your child at the hospital. Work out a plan with
your spouse as to who will be responsible for various
care and home duties. Hire outside help if you can.
- If you have other children at home,
enlist the help of relatives (grandparents, aunts,
uncles) to provide the extra attention and emotional
support that siblings may need at this vulnerable time.
You should also reserve a certain amount of time each
day with them so that they do not feel neglected.
- If the situation gets overwhelming,
get input from others (families, nurses, therapists,
a chaplain, a social worker, support groups) on how
to deal with your child during this stressful period.
All hospitals have chaplain services and a social worker
available to work with families. It may be comforting
if there is someone to share your feelings with on
a regular basis.