My Operation
A Message for Parents & Carers This book has been compiled by the Hospital Play Coordinators and Theatre Staff to help explain admission and surgery to parents and their patients. Every year approximately 6,000 children are admitted to Princess Margaret Hospital for elective surgery. This simple photo book follows Belle through her hospital experience and explains some things that happen before and after surgery. Each page has large written text for parents and children to read together. More detailed information for parents and older children is included underneath this text. Research shows that age appropriate information can help the child and family prepare for surgery minimising stress and anxiety which is often associated through a fear of the unknown. Jane Shaw and Wendy Fincher wish to acknowledge all contributions to electronic and hard copy publications. 2011
Hello, my name is Belle. This book is about my visit to hospital for an operation. Mum and I arrive at the hospital.
We go to the Ward. There are other children on the ward. Some are babies and some are older children. There are lots of nurses and some of them will help look after me while I am in hospital.
A plastic band around my wrist and ankle has my name on it. Your child s identification band has their name, date of birth and hospital number on it and the nurses will check it regularly throughout their stay. Younger children may need reassurance with having the band attached to their wrist and ankle. You can ask the nurse to put on you first, or on your child s teddy or soft toy.
Next the Nurse weighs me. I sit on a special chair that tells how much I weigh. Your child s body weight will be used to calculate the correct amount of medicine and intravenous fluid they will need to be given while in hospital. Although harmless, being weighed can sometimes be distressing to a younger child who may be feeling anxious and unsure of their surroundings. You may like to sit on the chair first to reassure them it s okay or you can be weighed together an the nurse will adjust the calculations accordingly.
Now I have my temperature taken. A thermometer tells the Nurse how warm my body is. It doesn t hurt. A tympanic thermometer will record your child s temperature digitally and beeps once it has been recorded. The nurse will take your child s temperature regularly throughout their stay. If your child is anxious or distressed the nurse can show them how the thermometer works by taking your temperature first.
Special cream makes my skin numb so I won t feel when the Doctor puts the drip in. The cream is covered with sticky clear plastic. Emla cream will numb the skin it covers so the anaesthetist can insert the drip in theatre. It is usually applied to the top of both hands and on the inside of each arm near the elbow crease. It will be put on at least one hour before surgery while your child is still on the ward and is effective for up to four hours. Tegaderm is a clear plastic dressing used to keep the cream in place. Toddlers and young children may find having Emla cream put on upsetting. It doesn t hurt but is an unfamiliar experience. They may also have a bandage put over the dressing to stop them touching it before surgery. Reassurance and distraction through play may help divert their attention away from the cream.
The Fasting sign means I m not allowed to eat or drink before my operation. The Doctor wants my tummy to be empty. I feel a bit hungry and thirsty. Your child needs to fast so that when they are anaesthetised (asleep for surgery) food or fluid will not come up from their stomach to the mouth then back down the airway and into their lungs. A Nurse will phone two working days before surgery to give you fasting instructions for your child. Playing, reading a book or colouring in are some of the things that can help take their mind off hunger. Reassure your child that they will be allowed to eat and drink sometime after their operation when the Doctor is happy for them to do so.
I change into clean pyjamas when it s time for my operation. I ride to the Operating Theatre on a bed with wheels and a rail on each side. Sometimes children walk to theatre. One parent/carer can accompany your child to theatre and can usually stay until they are asleep. The hospital provides pyjamas or your child can wear their own but they must have an opening all the way down the front.
I wait in the Pre-Operative Bay where the Nurses check my name bands. There are toys, games and puzzles to play with and a TV to watch! There may be other patients and parents waiting in this room also. The staff will ask parents about their understanding of the child s procedure.
We meet the Anaesthetist who listens to my back and chest with his stethoscope. He is the Doctor who will give me some special medicine to make me sleep so I won t see, feel or hear anything during my operation. The Anaesthetist will examine your child and ask a number of questions to help plan appropriate and safe anaesthesia care. This is the time to mention any of your own concerns or anxieties and if your child has any specific fears such as needles or masks. The Anaesthetist will generally visit you on the ward before surgery. Occasionally it may not be until you are in the Pre- Operative Bay (as with Belle). They will also have the final say in whether you can be with your child for their anaesthesia.
Now it s nearly time for my operation. We go into another room where the Doctor puts the drip in my hand. This is a small plastic straw which gives me my sleepy medicine. Mum talks to me and helps me relax. I feel very sleepy. The Emla cream should numb the site where the drip (cannula) is inserted.
This is what the drip looks like. The drip is inserted for ongoing medication and fluid during and after your child s surgery. There will be a small board taped under the drip site with a bandage wrapped around it to help keep it in place. The drip may remain in until your child goes home.
Another way I can have my sleepy medicine is through a mask. It smells a bit sweet and makes a soft whistling noise. It doesn t hurt. For the purpose of this book we have shown Belle receiving anaesthesia through the drip and the mask. Normally it would be one way or the other. The Doctor will decide which method is best for your child. If your child has their anaesthesia through a mask they will still have a drip inserted once they re asleep.
I am in a very deep sleep and will not see, hear or feel anything until the Anaesthetist wakes me up after my operation. Watching your child go to sleep can be difficult. They may roll their eyes, twitch, snore, and go limp very quickly. This is perfectly normal. Remember your child is in the hands of highly qualified experts who have had many years of training and experience. You must leave the room as soon as your child is asleep.
Now it s time for my operation. A lady shows Mum where to wait. A volunteer will escort you to the Friendship Room where they provide free tea/coffee and biscuits while you wait. You may prefer to have a meal in the canteen, make some phone calls or go outside for some fresh air to re-charge your batteries. It is important to give your mobile phone number to the volunteer if you leave the Friendship Room so they can contact you when surgery is finished. They will then take you to see your child in the recovery room, also known as P.A.C.U. (Post Anaesthetic Care Unit).
My operation is finished and I am in the wake up room. A Nurse looks after me. A soft peg on my finger tells the Nurse how much oxygen is in my body and how fast my heart is beating. The machine beeps sometimes. A specially trained nurse will continually monitor your child while they wake up. They may have an oxygen mask to help them wake. There may also be other patients in the recovery room.
I am glad to see Mum. The Nurse gives me an icy-pole to suck on. Sometimes children can t have an icy-pole until later. Some children wake up distressed or upset. Giving gentle reassurance that you are there may help them to settle. Other children may be drowsy and it s best to let them sleep. The Nurse will decide whether your child is able to have an icy-pole. The icy-pole will help moisten your child s mouth and soothe their throat which can sometimes be sore after an anaesthetic.
Now I am back on the Ward. I still feel sleepy. I have a drip in my hand and the soft peg is still on my finger to help check my oxygen levels and heartbeat on the oximeter machine. The nurse checks my pulse and temperature and looks after me while I rest in bed.
At night Mum sleeps in a big chair beside my bed. A large recliner chair is available if your child needs to stay overnight. There is also a ward kitchen where you can make toast and tea/coffee for your breakfast. You can also bring your own food and use our microwave oven. The Nurse will observe your child regularly throughout the night, checking their pulse, oxygen levels and drip. This may seem disruptive but is an important part of your child s recovery.
The Nurse gives me my medicine. It s really important to take my medicine because it helps me feel better. Some children find taking medicine difficult. It s important to stress the medicine helps you feel better and makes you well so that you can eventually go home.
Sometimes you can have medicine in a syringe.
I get medicine and fluid from my drip too. The bag of fluid (like water) is hung up on the drip pole. It drips down a long thin tube of plastic and then through the small straw the doctor put into my hand. It gives my body a drink and helps my body get better. I have a board taped to my hand to stop the drip falling out. When I go home the Nurse will take the drip out.
Now it s time to eat. I m hungry! I have some toast and a drink. Your child may receive food and drink depending on the type of surgery they have had. If they have had a tonsillectomy they will be encouraged to eat and drink straight away. Normal food (not icecream and jelly) is provided and they will not be discharged until they are eating and drinking normally. Other types of surgery may require food and drink to be withheld for a longer period of time. You can ask your nurse and explain to your child accordingly. Reassure them the Doctors and Nurses are doing everything to help make them well and they will be allowed to eat when the Doctor says so.
The Doctor has been to visit me and tells Mum that I can go home. The Nurse takes the drip out of my hand and puts on some cotton wool and tape. Sometimes they put on a round bandaid. Removal of the drip shouldn t hurt apart from the tape pulling on the child s skin. Sometimes the nurse can apply a solution to help loosen the tape. Reassurance and distraction may help your child to cope. You can explain the drip has done a great job in helping make you well and now it s time to take it out.
I have fun in the playroom while Mum packs my things and talks to the Nurses. Play can help relieve stress and anxiety and be an important part of your child s recovery. The Play Coordinator can provide a wide range of toys, games and activities for children of all ages and capabilities.
I change into my clothes then Mum and I say goodbye to the Nurses and other people we have met. Hospital was the best place to be for my operation, but now I m glad to be going home!