Hospital trauma
A visit to the hospital, for whatever reason, can be traumatic for your child. Here’s how to get her ready for it, says Dr Annemarie Oberholzer
THE LAST THING that you as a parent want to consider is the possibility that your child has to go to hospital. We are concerned that a healthcare experience can be traumatic for a child, and this might be true in some instances. Children don’t even understand their own bodies, let alone the strange hospital environment with all its unfamiliar sights, sounds and smells. They often hear adult conversations or they might pick up words or part of a sentence that they don’t understand and ascribe their own meaning to it. They will try to make sense of a current situation according to previous experiences in their lives, which is very limited.
Children usually regard pain and suffering as punishment for something they did wrong, and when parents threaten their child with a visit to the doctor for an injection if they are naughty, they just strengthen the child’s belief that he is being punished for some wrongdoing when he has to go to hospital.
FEAR OF THE UNKNOWN Because they don’t have a lot of life experience, children will resort to whatever they know about a situation in order to make sense of what is happening to them. A boy whose grandfather died in hospital a few months ago might expect to die too, or a little girl whose mother previously went into hospital to have a new baby might be excited about the idea of getting a real life doll to play with when she leaves the hospital. Abstract concepts are difficult for children to understand and they tend to form pictures in their mind about life experiences.
So when we explain to a child that the X- ray machine will take pictures of the inside of her body, she might be concerned about something she did that was naughty but that she thought will forever be hidden inside her body. And now the doctor wants to put this picture up on the wall for everybody to see? As absurd as this might seem to us as adults, these are real- life examples of children facing real fears and fantasies.
However, it is possible to create a positive experience for a child in hospital and to assist her in developing coping strategies to deal better with difficult situations in future. And, as a bonus, if a child was able to cope well with a difficult situation, she can also gain a sense of achievement and pride and develop a better self- esteem.
LET’S TALK ABOUT IT As soon as you know your child has to go to hospital, talk about the possibility with her. Remember that she was also in the doctor’s room when he discussed hospitalisation with you, and although it may have seemed as if she was busy playing with the toys and not paying attention to your conversation, chances are she heard every word said. Make sure to discuss the conversation you had with the doctor with her afterwards and ask her what she thinks is going to happen in hospital. Explain to her what is going to happen, why and when.
Speak to your doctor or phone the nursing staff in the ward to make sure you understand exactly what is going to happen so that you can give your child the correct information. If there is time, phone the hospital and make an appointment so that your child can visit a day or two before she’s admitted to see what it looks like and where her bed will be. Children don’t have a concept of time, so it might be a good idea to have a calendar in the home to tick off the days as they pass before the hospital visit so that it won’t come as a shock to your child when you suddenly have to leave for the hospital.
KEEP THINGS STEADY Now is not the time to take away comfort items such as a dummy or blanket. Although you might be tempted to buy her a lot of new toys, remember that she will also need familiar and trusted toys for security in this new and strange hospital environment. Children need to play in order to handle stress, so be prepared to enable your child to play as much as possible. Consider getting her a medical play set so that she can rehearse her experiences in order to come to terms with what happened to her and what she experienced in hospital.
Assure your child that she will be able to go home soon and talk a lot about the people at home. You might consider bringing some photos of them and the pets with you so she can be surrounded by good memories. Humour can be a great tool to relieve the stress for both of you. Keep your conversation with her light and refrain from criticising the environment or people working there as this will scare her and make her feel insecure.
DO IT YOURSELF Children automatically turn towards an adult they can trust when they are scared. In the hospital, children need their parents more in order to cope. Try to be there for your child day and night if possible or arrange with someone she is familiar with to stay with her. If it is doable, take care of her basic needs yourself, such as bathing, nappy change and feeding. If your child knows that you are still available to take care of her basic needs, it will make her feel more secure.
GOING HOME Expect behaviour changes after discharge. Children need confirmation that you still love them and they usually communicate this through their behaviour. Be patient and give your child lots of attention and she might be her old self soon. If, however, you are the least bit concerned, seek help from a professional specialising in children so that your child can be enabled to grow through the experience rather than suffer due to it.
WHAT ABOUT ME? Remember that children take cues from the adults around them to evaluate how serious a situation is. If you are anxious, crying and not coping well, chances are your child will also find it hard to cope. It is quite normal to experience feelings of guilt and self- blame when your child ends up in hospital. You might feel frustrated that you are unable to protect her and the feeling that all control has been taken away from you might be overwhelming. However, if you feel that you are not able to cope with the situation at all, don’t hesitate to seek professional help so you can be equipped to support your child in the best way possible. YB