HOSPITALIZATION:
Admission to the hospital is usually required for surgery; however, some admissions are for supportive needs such as IV hydration, electrolyte correction, bowel preparation before surgery, colonic irrigation, and observation. If your child is admitted to the hospital for a planned procedure, you will be given guidelines regarding specific feeding instructions prior to surgery. It is routine for the surgery to be set up before the patient’s family leaves clinic and at that time given any steps to follow in preparation for the procedure, including a packet of information to take home and review. If it is not set up at the time of consultation, the surgeon’s secretary will contact the family regarding the surgery and any instructions necessary. Your child may need to see another specialist for consultation or testing before surgery is planned. During your child’s hospital stay, we will update your pediatrician or family physician about your child’s progress.

BEFORE SURGERY:
If your child is scheduled for surgery, the best way to prepare him/her is to prepare yourself first. Your child will look to you to provide direction and response; a calm, informed demeanor from you might not alleviate all of your child’s concerns, but will certainly help deflect some fear or apprehension that is common for new patients.

As far as discussing the visit, your timeline will vary with age, attention span, and maturity of your child. Generally, younger children can be told a day ahead of time. School-age children and teens may need more time to think about things and may be told several days to a week before the visit to the hospital or clinic if possible. Talk about why your child needs to go, and explain what will happen during the visit. Children and teens like to know what they will see, hear, feel, small, and taste. Listen to your child’s specific fears and concerns. Use simple words and truthful responses—this is especially important if the experience will involve pain or discomfort.

Other suggestions:

• Purchase a toy medical kit and allow your child to gain control of his/her experience through role play
• Read age-appropriate books and/or software that relate to the visit
• Allow your child or teen to talk to other children who have had similar experiences

Books and software to help children prepare for their visit
Your local library or bookstore will have some of these books. You may also check with the Junior League Family Resource Center at Vanderbilt Children’s Hospital for available resources.

Toddlers and preschoolers

• Miffy in the Hospital by Dick Bruna (Kodansha America, Inc., 1999)
• A Visit to the Sesame Street Hospital by D. and M. Hautzig (Random House Children’s Books, 1985)
• When I See My Doctor by Susan Kuklin (Bradbury Press, 1988)
• What to Expect When You Go to the Hospital by Heidi Murkoff (Harper Festival)
• Curious George Goes to the Hospital by A. H. Rey (Houghton Mifflin, 1966)
• Going to the Hospital by Fred Rogers (Putnam, 1988)

School-age children

• Madeline by Ludwig Bemelmans (Viking Press, 1967)
• Your Doctor, My Doctor by Joan Drescher (Walker & Company, 1987)
• The Hospital Scares Me by P. and K. Hogan (Raintree Publications, 1980)
• The Hospital Book by James Howe (Crown 1981)
• Franklin Goes to the Hospital by Paula Bourgeoius and Brenda Clark (Scholastic, Inc., 2000)
• Hospital by J. Vaughn (Silver Burdett, 1988)

Adolescents

• The Teenage Hospital Experience: You Can Handle It by Elizabeth Richter (Coward, McCann and Geoghegan, 1982)

AFTER SURGERY:

A discharge nurse will provide the appropriate paperwork to all parents preparing for their child’s discharge from the hospital. The clinical specialist/case manager will facilitate arrangements if your child requires complex assistance or Home Health care. Families with unique social needs or financial constraints will be seen by a Vanderbilt University Medical Center social worker.

Upon your child’s hospital discharge, you will receive instructions for his or her care after surgery. Once you have returned home, contact our office immediately if your child experiences any of the following complications: fever, problems with voiding or defecation, inflammation in the incision area, vomiting, abdominal distention, or pain.

Most instructions will be given to you before leaving the hospital so you will know how to handle difficult situations; however, you may have questions about pain management, defecation or urination problems, postoperative incision care, and resumption of physical activity after surgery. Please contact your child’s pediatric surgeon or the Pediatric Surgery clinical nurse specialist for instruction by calling the main office number for your child's surgeon.

LABORATORY OR PATHOLOGY REPORTS:
Only an attending surgeon or clinical nurse specialist may convey results from laboratory or pathology studies to the patient’s family. Please call the Pediatric Surgery office for any results.

Please see the “Contact Information” section for additional instructions about communicating with our healthcare team.

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