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How to Prep a Child or Sibling for an Upcoming Test, Procedure, or Surgery with Annie Gunning, CCLS, CIMI, GC-C

July 11th, 2023  | Child Life Resources  | News

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Welcome to the inaugural edition of our Child Life Specialist Q&A Series, where we dive into the invaluable insights and expertise of Hope for HIE’s Certified Child Life Specialist, Annie Gunning! During our live session, Annie shared her expertise regarding the ways in which parents, caregivers, and families can prepare both a child and their sibling for an upcoming test, procedure, or surgery. 

Read our key takeaways below to see Annie’s specialized tips and strategies to ease anxiety, promote understanding, and empower families during these challenging medical situations.

BUT FIRST – LET US REINTRODUCE ANNIE AND THE ROLE OF A CHILD LIFE SPECIALIST

Annie joined Hope for HIE in February of 2023 and has been an invaluable resource for our community members ever since. 

For those who may not know or have yet to utilize her services as a Child Life Specialist, Annie specializes in supporting the whole family (children, siblings, parents/guardians, and extended family members) through stressful or uncertain events, especially those that take place in medical settings. 

To help alleviate anxiety, she develops individualized coping plans and enforces them through preparation, education, creative expression, and medical play. 

Annie is also a certified grief counselor and can offer grief support, coping strategies, and suggestions for end-of-life and bereavement.

PART ONE: PREPPING A CHILD FOR AN UPCOMING TEST, PROCEDURE, OR SURGERY

Facing an upcoming test, procedure, or surgery can be an overwhelming experience for any child. The uncertainty, unfamiliar environment, and potential discomfort can trigger anxiety, but Annie is here to tell us that there are many strategies to help prepare and support the patient during the experience.

Key Takeaway 1: Ask for hospital resource staff in advance

There may be many unknowns when it comes to an upcoming test, procedure, or surgery, and that’s why Child Life Specialists want you to know that it is okay to ask for help! One valuable resource to reach out to is the hospital’s resource staff, especially if they have a Child Life Specialist on call. 

Prior to the procedure, they can provide pre-op tours, coping support, and preparation strategies to help ease your child’s anxiety and help them navigate this medical experience with greater confidence. Don’t hesitate to approach the hospital’s resource staff – or any member of the healthcare team, for that matter – to ask them to explain the steps involved or demonstrate the tools they will use. It is your right as a parent/caregiver to have a clear understanding of what will happen and to ensure your child feels supported throughout the process, especially if they have sensory needs or are easily-overwhelmed by unfamiliar environments. Your active involvement as an advocate will contribute to a smoother and more comfortable experience for you and your child.

Key Takeaway 2: Have honest conversations and establish clear expectations

Narrating the medical experience and verbally outlining its process in a sequential manner can be very beneficial! Breaking down the experience into manageable steps provides a roadmap of what to expect, giving your child a sense of structure and predictability. 

Here’s an example of a step-by-step approach that also discusses the senses related to each of the experiences and events. This narration can benefit every child across all ages and impacts!

• Check-in process: Let your child know that upon arrival at the hospital or medical facility, you will go to a designated area where they will be asked some questions and required to complete necessary paperwork.
• Room introduction: Outline how a hospital staff member will guide your child to his or her designated room or procedure area. Mention how there might be some large medical equipment or the hum of machines.
• Changing into a gown: Depending on their age, children may be surprised to know that they will be asked to change into a hospital gown. This is another great opportunity to bring in a sensory discussion – what might the gown feel or look like?
• IV placement, if applicable: If an IV will be administered, explain what an IV is and why it is needed [or ask your child  to tell you what he/she knows!] Mention how there might be a small poke or pinch when it is inserted and that a sticky bandage will be placed over the site afterward.
• Procedure explanation: Depending on the nature of the test, procedure, or surgery, provide a simplified explanation of what will happen. You can mention the type of equipment that will be used, such as an MRI machine, and the lights, noises, or other sensations related to each. This is where relevant and appropriate books, pictures, or videos can come into play, as well!

No matter how you decide to navigate this conversation, DO allow for appropriate processing time. Annie suggests the following, developmentally, but as the expert of your child, you may need to further adjust this timeline based on the range of their medical complexities and needs:

• Preschool/Toddler = 1 day before 
• Elementary = 2-3 days before
• Middle/Teen = 1 week before

Key Takeaway 3: Honor your child’s reaction and response

Each child processes information differently, and it’s crucial to meet their individual needs and provide them with the space and time to process the conversation. One key aspect of this is recognizing signs that indicate your child may need a break, whatever that looks, sounds, or feels like to them! Let them know that you understand they need some time to process the information and assure them that you are available to continue the discussion when they are ready.

Key Takeaway 4: Develop a coping plan

Developing a coping plan empowers your child to navigate the experience with greater comfort and confidence, and this is a wonderful opportunity for you to implement various coping strategies that are tailored to his or her interests and needs! Some ideas include:

• Distraction tools and techniques: Perhaps an ISpy book, watching a movie, or playing a game can let your child cope before or after the procedure. Some children may want to bring headphones to listen to their favorite music, as well.
• Comfort positions and physical support: Talk to your child about finding a comfortable position during specific parts of the procedure, such as when receiving an IV. Explain that they can sit on your lap or adopt a position that makes them feel safe and secure.
• Calming exercises and role play: Practice deep breathing techniques or other calming exercises to help promote relaxation. Also consider engaging in role play, where you and your child take turns pretending to be the doctor, nurse, or patient. This interactive approach can help familiarize your child with the procedure and help build a sense of predictability and assurance.
• Personalized items: Discuss additional coping strategies that align with your child’s interests, hobbies, or comfort objects. For example, if your child finds comfort in a particular stuffed animal or blanket, bring it along to the procedure. If he or she enjoys listening to audiobooks, consider having one available to listen to during the process.

PART TWO: PREPPING A SIBLING FOR AN UPCOMING TEST, PROCEDURE, OR SURGERY

An upcoming procedure or hospital visit does not affect just the patient; it really is a whole-family experience. This is why it’s so important to include siblings in the preparation, as it can allow them to feel included and informed, give them a sense of support, and foster a sense of unity for the entire family as they navigate the medical experience together!

Key Takeaway 5: Include the sibling in the conversation

Just like you would with your child who is undergoing the procedure, include the sibling in the conversation as well! You can use the same tactics, or you can modify the conversation if they are in very different developmental stages. Either way, allow for processing time!

Key Takeaway 6: Provide them with opportunities to help

Siblings can actively participate in the patient’s medical journey, even if they are not of the medical experience itself. Finding concrete, actionable ways to include them in the preparation or coping stages of the experience can help them feel capable, empowered, and more in-tune with the situation! Consider their developmental stages when brainstorming ideas, but here are a few to get you started:

• Help with the essentials: Siblings can help pack a favorite toy or book, and they can also be involved in practical tasks, like organizing clothes, gathering toiletries, or preparing any necessary paperwork.
• Draw a picture: Hospital rooms are not always warm and cozy; encourage siblings to draw a picture or create a decoration to brighten up the room.
• Make a card or write a letter: They can draw pictures, write encouraging messages, or share funny anecdotes to bring a smile to their sibling’s face. If the sibling is older and enjoys writing, encourage them to write a heartfelt letter sharing their thoughts, encouragement, and reassurance.

Key Takeaway 7: Provide them with structure and chances to connect

Start by creating and sharing a timeline that outlines when you’ll be away for the medical procedure and when you’ll be returning home. Address the practical aspects of daily life, too: who will pick them up from school or activities? Who will make dinner? Who will tuck them into bed? 

This structure helps them anticipate and adjust to the temporary changes in the family dynamics. If you don’t have all the answers or if there are uncertainties regarding the plans or procedures, it is okay to admit it! Medical situations can be complex and ever-changing, but emphasize that you are there to support them and that you will do your best to find out more information as it becomes available.

Connection is just as important as structure – this reminds them that they aren’t forgotten throughout this process! You can consider tailoring activities to their developmental stage, age, hobbies, or personal preferences [like making connection bracelets], but it can also be as simple as scheduling a phone call or video chat!

OVERALL RESOURCES, TOOLS, AND ADVICE

One of the many roles you’ll play for your child is that of an advocate: you are allowed to ensure that your child’s voice is heard and that his or her needs and well-being are prioritized. Feel free to approach a member of the healthcare team at any time and ask them to explain what they are doing or to show you the tools they will use. 

You’re not alone in this journey: there are many additional tools and resources you can use to help you navigate this experience and better prepare your family! Consider some of these, below:

• KidsHealth.org: This website offers accessible articles, videos, and interactive tools that help parents and caregivers navigate the complexities of a range of medical procedures and conditions. 
• Simply Sayin’ App: This platform helps children and their families prepare for medical procedures, surgeries, or tests through its use of interactive features, visual aids, and age-appropriate explanations. 
• Hospital Websites or Child Life Specialist Curated Resources: Many hospitals have online resources specifically designed to educate and prepare children for medical experiences. Look for sections dedicated to pediatric care, child life services, or patient and family education. These sections often include information, videos, and guides that explain various procedures in child-friendly language.
• Book Lists: Simple Google searches can also yield valuable resources, such as picture books about various medical procedures that are curated toward younger children. Amazon is a great place to start, but Annie also recommends looking at reputable hospitals around the nation, for they often have specially-curated book lists that were created by their Child Life Specialist or Family Care teams. 
• Child Life on Call App: And, of course, take advantage of Hope for HIE’s partnership with Child Life on Call: with this, you have direct access to our Child Life Specialist, Annie, who can provide you with individualized services and and access to group programs, as well as free access to the Child Life on Call app, which provides you with a range of child life specialist resources in your pocket! Simply download the app, select Hope for HIE, and enter code 048325.
• Hope for HIE’s Comprehensive Support Network: If you want to request services or just learn more about what Child Life services can do to support you and your family, head to HIE.Support to fill out the intake form and get started!