By Brenda Owen

Daily Journal

Smiling children blowing bubbles, eating popsicles, and taking rides in little red wagons. Is the circus in town? No, it's just a typical day in the pediatric wards of Northeast Mississippi hospitals.

Sickness, pain and disease know no age limits, but a hospital stay does not have to make a child even more frightened, say area professionals who deal with youngsters at these traumatic times in their lives.

Dr. Nuray Metin, pediatrician at Clay County Medical Center, said loss of control is the biggest issue children face in the hospital. To help them regain some semblance of control, she offers children choices throughout her examinations.

"Even small choices, such as where they want the shot, can make them feel more in control," she said.

Metin said being isolated and taken from familiar surroundings also intimidates children.

"They are afraid of being separated from their families and placed in the hands of strangers in a strange place," she said.

To help alleviate these fears, she said most doctors attempt to form a rapport with the child as soon as possible, coaxing the child's trust as they perform the examination.

"I talk as I work, telling them what I am about to do before I do it," she said. "We try to make the treatment as painless as possible, but if something is going to hurt, we don't lie to the child. If you tell them it's not going to hurt and it does, they won't trust you after that."

It is also important to create a "safe" environment inside the hospital, she said.

"I always take children out of their room if I have to do something that is going to be very painful or scary," she said. "Once the procedure is done, the child can return to his room and feel more secure."

Parent participation

Few things are more frightening for parents than the prospect of their child's hospitalization. Not only are they concerned for their child's welfare, but the procedures and language of a hospital may be as confusing to the parents as they are to the children.

Parents, however, can not only reassure themselves, but they can be a child's advocate every step of the way if they follow some simple steps. Here, garnered from the various professionals interviewed, are a few suggestions:

-Ask questions. Once your child has been examined make sure you get a chance to speak privately with the doctor. That way you and the doctor can openly discuss the situation without frightening your child.

Some questions you can ask the doctor:

What are our options?

What risks are involved?

How long will the treatment or procedure take?

How long will the recovery period be?

- Take notes. During your meeting with the doctor, write things down. It is important that you are sure you understand the risks and probable outcomes of procedures and tests before they are done.

- Be persistent. If you have questions that were not answered, or if you are unclear about something, don't feel intimidated about repeating the question.

Planning ahead

Parents can ease the pain of hospitalization by preparing their child in advance when they are being admitted for treatment or surgery.

Judy Hughes, head nurse of the pediatric unit at North Mississippi Medical Center, suggested letting your child select a favorite toy, book, or stuffed animal or other familiar item from home to take with them.

"They can even bring their own pajamas, their own pillow or their favorite blanket," Hughes said.

It's a good idea to arrange for the care of siblings at home. They will be uncomfortable at the hospital and may distract you from remembering important information or asking critical questions. Siblings are also likely to feel left out and may even feel responsible for a brother or sister's injury or illness.

When your child is scheduled for surgery as part of treatment, fears about surgery outcome and the child's recuperation are only multiplied by worries about long waits, painful tests and how to comfort your child.

Diana Chiles, Child Life manager at Le Bonheur Childrens Medical Center in Memphis, said, "A basic instinct for parents is to protect their children. But when a child is facing surgery, the parents are often fearful. They may think, 'If I'm this upset, then how does my child feel?' "

Parents should prepare their children in a way that is honest, safe and developmentally appropriate without adding to the child's anxiety, she said.

"Children are not small adults and their needs are very different when hospitalization occurs," Chiles said. "Parents can do a lot to help their child be in the best emotional shape to handle surgery."

Emergency procedures

More than 25,000 people per year come through the Baptist Memorial Hospital emergency room in New Albany, many of them children, according to marketing director Nancy Kidd.

Dealing with sick and injured children in these emergency situations is the job of Dr. Al Prater, the hospital's emergency room physician.

"It's tough on kids when, in addition to their physical distress, they have to deal with the apprehension of being in the hospital," Prater said.

One main problem with children in the emergency room is dealing with the emotions of the parent, he said.

"Parents should take several minutes to calm down if the situation isn't life-threatening," he said. "If a parent acts as if the world is ending, the child will be even more anxious."

Other suggestions for parents in emergency situations:

- Bring these items with you to the emergency room: health insurance card, record of your child's immunizations, containers of any medicines your child is taking and your child's favorite toy, book or blanket. But, don't waste time looking for these things if you can't find them right away. Just get as many of them as possible.

- When you arrive at the emergency room, ask if there is a patient advocate on staff if you need help. These personnel are there to assist you by making phone calls to other relatives or whatever you need so you can stay with your child as much as possible.

- Before you leave the emergency room, ask that all instructions about care and medication for your child be written down.

Spoonfuls of sugar

Sweetening the pain of administering medical care by offering children treats and toys is an old tactic that still works well.

Passing out popsicles is one way the staff at the New Albany hospital calms youngsters down, but Prater and the emergency medical technicians and nurses have also developed another technique which not only works wonders for the children but relaxes the staff as well.

"We blow bubbles," Prater laughed as he handed a bottle of the soapy solution to a young patient.

Distraction is also the name of the game at Amory's Gilmore Memorial Hospital where nurses wear brightly colored uniforms rather than the traditional white, which children have learned to associate with medical personnel, said Donna Williams, vice-president of patient care at the hospital.

"We also hand out coloring books and other toys, and we give the children awards and stickers as rewards for brave behavior," she said.

Tupelo's NMMC pediatric staff offer their tiny patients free rides in a little red wagon when it's time for x-rays or examinations.

"The main thing is to get the kids to trust us," head nurse Hughes said. "It upsets me when I hear a parent tell a child if they misbehave the nurse will give them a shot. Children get the idea their sickness is a punishment. They need to know that we are here to help them. We're their friends."

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