10 tips for preparing your child for hospitalization

By Meaghan O’Keeffe, RN, BSN, CCRN, nurse in Children’s Hospital Boston’s Preoperative Clinic. See more of her writing at Healthy Offspring.

Visiting a hospital can be overwhelming for anyone, but for kids it can be downright scary. The range of fears will vary from child to child depending on their age, development, personality and prior hospital experience. As parents it’s our goal to help calm our children and prepare them for experiences that might be frightening, but when it comes to preparing your little one for a hospital stay that may seem easier said than done.

Fortunately the staff at Children’s Hospital Boston has seen it all and is here to help children (and their parents) know just what to expect if they’re coming to Children’s. Mary O’Malley, NP, MSN, and Certified Child Life Specialist Hayley Sorensen, MS, CCLS, have extensive experience working with children in the hospital’s Preoperative Clinic, and offer these tips for families who may be preparing a child for a hospital stay.

1. Be honest

According Sorensen, most children will be looking for answers to three W questions when they find out they’re going to a hospital for an extended visit. “The concern for children being hospitalized are usually, ‘Who is going to be with me, what will the doctors do and will it hurt?'” she says.

The single most important thing parents can do to help alleviate any fears is to have an open and honest dialogue with their children. Kids are observant and intuitive and they know when information is being kept from them, which can cause anxiety.

By discussing the upcoming hospitalization in age appropriate ways, you can quiet a lot of the fears your child may be worried about. “Children need to be prepared,” O’Malley says.  “Nothing in real-life is as scary as their imagination is and they need to be reassured of that.”

2. Observe your child’s cues

Every child is different.  Some can handle more information than others.  Does your child have trouble dealing with stressful situations?  Do they handle information better in small amounts? Watch their facial expressions and body language during your discussions about the hospital. If they start to show signs of stress, it may be time to pull back a little. But plan to revisit the topic another time.

3. Keep timing in mind

Younger children benefit from shorter notice about an upcoming hospital trip, usually about three to four days in advance. Older kids should be told further ahead. “Telling a school–age child about a week in advance would be appropriate,” says Sorensen. “That way they have time to process the information and ask questions. Adolescents should be involved in the process from the beginning stages.”

4. Revisit the conversation

One discussion is usually not enough. After a talk, your child may spend some time thinking and developing questions. Their feelings may change. Opening up the discussion more than once gives your child a chance to think things through. It also gives you a chance to prepare a different explanation or come up with new ways to provide comfort.

5. Get creative

Encourage your child to express his or her feelings about the upcoming hospitalization or surgery.  Artwork can be a significant means of non-verbal expression. “Drawing allows kids to make a personal statement about their feelings,” says O’Malley. Using dolls or puppets to act out some simple scenes related to hospitalization can also be therapeutic. “Medical play is so important,” she adds. “I also always tell kids to bring a camera, to take pictures, and make a picture book to show to friends and family to help work through the experience.”

Teenagers can be encouraged to journal their feelings, enabling them to work through them privately, which can very important at that age.

6. Practice relaxation techniques as a family

In the days and weeks before surgery, become familiar with some simple breathing and relaxation exercises. Practicing some tools for minimizing stress can come in handy for both you and your child during the hospital stay. Relaxation techniques are typically more effective when parents participate alongside their kids.

7. Involve your child

Whenever possible, give your child choices during their hospital stay. Let them choose activities (watch a movie or play Chutes and Ladders?) or pick their own a snack (cherry ice or grape popsicle?). Involve them in deciding what to bring to the hospital and pack the overnight bag together. When it comes to teens, ask them what they need to make their hospitalization easier. By including your children in as many hospital related choices as possible, they are likely to feel more in control of their situation, which can alleviate stress.

8. Set limits

Most children are naturally afraid of medical procedures and personnel. It’s important for parents to acknowledge and validate those fears, but also to reinforce the idea that mom and dad are on the same team as the nurse or doctor. Staying firm often helps the visit run quicker so the child can move on to more positive activities.

9. Bring “home” to the hospital

When packing for your trip, grab pillows, stuffed animals, cozy slippers and special blankets. Bring anything that makes the hospital seem warmer and more comfortable or could remind the child of home. If you’re unsure if a certain item would be allowed, simply call and ask.

10. Find out what your hospital offers

With an ever-increasing emphasis on family care, many hospitals offer a wide array of resources and information for patients and families. Search your hospital’s website for information and links to see what’s available. For instance, Children’s has videos and pictures that detail the hospital experience so kids can get a realistic idea of what their stay might look like. If appropriate, older patients may get the opportunity to take a brief tour of the hospital unit where they will be staying. At Children’s we have an Office of Child Life Services, staffed with trained professionals who can help provide age appropriate coping, distraction and play during hospitalization. A few of the services they provide include:

  • Help patients develop ways to cope with fear, anxiety, separation and adjustment to the hospital experience.
  • Provide individualized support before and after medical procedures.
  • Facilitate developmentally appropriate play, including medical play, at the bedside, in activity rooms and in clinic areas.
  • Tutoring services
  • Back-to-school” programs, on referral, following a patient’s extended hospital stay

To read more by O’Keefe, visit her blog, Healthy Offspring.