What is helpful for families coping with hospitalizations?
It’s really important for them to have a relationship with the surgeon, to feel comfortable with the communication. That’s a problem when they’re getting a lot of their care sometimes through trainees, through residents who may rotate, so the attending really has to have a presence. The nursing staff is also crucial in these clinics in terms of being a person who often the families will share more with than with the doctor.
With children and families, you help them by trying to set out a time frame for the surgeries and the length of hospitalization. You don’t want there to be fantasies about the surgical process that may impede psychological wellbeing. You encourage the child and family to inform the surgical team about an important family event so that the surgery will not be more disruptive than it needs to be and lessens the perception of the child as a burden. The same is true in regard to school attendance. You try to schedule surgery during vacations so the child doesn’t have to experience going back to school with lots of bandages or taking time off from school. While the child is in the hospital it is important for them to keep up with school work and maintain some contact with trusted friends.
Myron L. Belfer, MD
How do you help families cope with hospitalizations?
Try to get the child to verbalize some of their concerns, and by implication to get the family also to know it’s okay to listen to what their child has to say, “I hate the hospital. I hate the doctor.” To express those feelings is important. Any of us would say that, and there’s no reason to expect them to be “good” … that’s a burden for them. If you have just one hospitalization, okay, you go in, get it done, and you’re out. But the children then with multiple hospitalizations often worry about when is this going to end? There seems to be no endpoint, and so that’s why it’s important to be concrete about procedures and timeframes. As the child gets older, concerns may shift to worries about future social prospects and the child now young adult ask, “Will I be able to have children?” It may be totally unrelated to any underlying pathology, but they’ll have a host of anxieties as they get older.
Myron L. Belfer, MD