Alphabetic Guide to Child Care - Hospitalization

Hospitalization

Most children at some time in their first 15 years of life require at least one hospitalization, ranging in time from a few days to many months. This can be a frightening experience and may leave permanent emotional scars on a child. Parents can do many things to make the experience less harmful.

These charts indicate the rate of growth of boys and girls from birth to 36 months in the United States. In each chart the upper gray area indicates the range of growth in height from the 5th to 95th percentile, and the lower gray area indicates a similar range in weight. (If a boy or girl is in the 95th percentile in height, 95% of all other boys and girls are not as tall as he or she. If someone is in the 50th percentile in weight, half of other children weigh more and half weigh less. If one is in the 25th percentile of weight, 75% of other children weigh more and 25% weigh less. Thus, the percentile indicates how your child compares in height or weight with other children of the same sex and age in the United States.) Height, indicated at the left-hand side of each chart, is shown in inches and in centimeters. Weight, indicated at the right-hand side of each chart, is shown in kilograms and in pounds. The bottom and top lines of each chart indicate age in months.

Preparing the child for the hospital stay may be the most important task for the parent. There are many books available for different age groups on going to the hospital. Authorities generally agree that parents should:

1. • Try to answer all the questions the child asks. If you have no answer, try to find one.
2. • Be as honest as possible. The child will want to know why he or she has to go to the hospital, what will be done there, how long it will take, and whether it will hurt.
3. • Be reassuring. The child should know that he or she will receive good care and that the hospital visit will be temporary.
4. • Explain what the hospital is and what it is like—with wheeled carts, people in uniform, and so on.
5. • Using sheets as gowns, role-play to make it clear that under the gowns will be helping people.
6. • Let the child know when they will be in the hospital and how long they will stay.

Most hospitals today try to work with parents to make the child feel at home and to allay the child's fears. Many hospitals offer rooms so that parents can “room in"—and stay near the young patient. A playroom may be available. Hospital staff members may hold parent-nurse sessions to introduce mothers and fathers to the hospital's schedule, locations of facilities, and other details. Parents of a child who has to be hospitalized can, by learning as much as possible and cooperating with the staff, help alleviate a child's natural fears of separation, of mutilation, and of the strange new situation.

Fear of Separation

Hospitalization for an operation or an illness affects different children at different stages of their development in different ways. Very young children may be particularly worried about separations from their mothers. Parents can help with this fear by assuring the child that separation will not be permanent.

If at all possible, the child's mother or another member of the family should stay with the child during much of the hospital stay. During an extended hospitalization, of course, this may become difficult or impossible. Barring accidents, children should always be forewarned of a hospitalization; if they are not, they may feel they were deceived by their parents and lose trust in them.

Fear of Mutilation

Children of about 4 to 10 or 11 may be more worried about possible damage or mutilation of their bodies than about separations from their families. They often have fears that parts of their bodies may be cut out or that in some way they may be permanently harmed. They may feel that when they come back from the hospital they will not be the same as they were when they went in. Matter-of-fact reassurance by the parents can be most helpful in alleviating these fears.

Fear of the Strange

Both younger children and older children aged 10, 11, or 12 may fear the new or strange, such as the anesthetic that goes with an operation. The child should be allowed to talk out fears. Simple explanations usually help. A child can, for example, understand that when you get sick taking medicine can sometimes make you better. At other times an operation, or surgery, is the only thing that will help. In the hospital, physicians or nurses may have to make tests to find out what is wrong. One such test is the X ray, which is simply a “picture” of a part of the child's body.

The parent can prepare the child for the operating room and for the operation. Everything in this special place, for example, must be kept perfectly clean, so nurses and physicians wear long-sleeved gowns. They also wash carefully before the operation begins. They wear sterile gloves so that they can touch patients without passing on germs. They also wear masks, shoe coverings, and caps. They may make a small opening in the patient's skin so that they can take out or get rid of whatever is making the child sick. The physicians and nurses use stitches, or sutures, to pull the skin edges together and allow healing to begin. Some stitches may be under the skin; these simply melt, or dissolve, by themselves.

A dressing may be placed over the part of the child's body that was opened up. These pieces of soft cloth protect the skin opening and keep out germs. When the dressing comes off, a white scar may remain. The scar will not open up and it will not hurt. It is a sign that the child was sick, got well, and came home.