How you can answer those tough questions from kids

Kids not only say the darndest things, as television personality Art Linkletter says, but they also ask some tough, specific questions when facing a day of same-day surgery.

"You have to answer questions honestly, but be sure you think about your answers from the children’s perspective," says Emily Fazio, CCLS, a child life specialist in day surgery at Children’s Healthcare of Atlanta at Egleston.

For example, at Children’s Healthcare, staff members never say, "We are going to put you to sleep," she notes. "Most children have heard that phrase used to describe killing a sick pet, and we don’t want to make them associate anesthesia used for their surgery with that experience," Fazio points out. "Instead, say that the doctor has some medicine that will help the child sleep."

Here are some other common questions from children:

  • What will happen if I wake up during surgery?

    "I explain that there are a lot of people in the room with them, and there is one person who is always there to make sure the children have enough medicine to stay asleep," Fazio says. "It’s important to reassure the child that everyone in the room is going to make sure they stay safe and don’t hurt."

  • Is it going to hurt?

    "I explain that they won’t hurt during surgery, because the medicine they will be given helps them sleep so deeply that they won’t feel it, and that we also give them pain medicine," Fazio says.

    Be honest about possible aches or pains after surgery, Fazio adds. Be sure to describe any soreness the child may feel and explain that parents will have medicine to help with the pain, she says.

    Fazio’s same-day surgery program also helps minimize pain with simple techniques such as topical anesthetics used at any sites in which a needle might be placed for intravenous lines, she adds.

    "We minimize the use of needles by using only mask induction," says Annette R. Svagerko, RN, CNOR, OR clinical coordinator at Children’s Surgery Center in Columbus, OH. "We rarely have to draw blood, and we start IVs after the child is asleep," she adds.

  • When can I play again?

    The best way to talk to children about post-surgical recovery is to first find out what they like to do, Fazio says. "Ask about hobbies, sports, games they play with friends, then talk about their time after surgery in those terms," she says.

    Don’t say that they can’t do something for several days; instead phrase the information positively by saying that they can ride their bike again in three days, or whatever time period is appropriate, Fazio says.

    While it is almost always preferable to phrase the information positively, there are instances when a negative for an adult is a positive for a child, she points out.

    "Boys always love to hear that they can’t take a bath or shower for a few days," she says. "Their moms, however, always jump in with the statement that they can sponge bathe them."