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 PreOperative 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!