Painful Procedures & Operations - How Can Parents Help?

Key points about painful procedures and operations

• as a parent or caregiver, you know your child best and can help staff to help your child cope with the procedure or surgery
• be honest and calm when telling your child about the procedure and answering their questions
• decide on which coping strategies you and your child think would be most helpful
• it is usually helpful for a child to have a parent with them during a painful procedure or when waking after surgery
• if you feel you can't be present, think about arranging another person your child is comfortable with

How can I help my child cope with their procedure or surgery?

Sometimes, medical procedures can be threatening or painful for tamariki (children) and rangatahi (young people). Hospital staff will always try to reduce your child's anxiety and pain and make medical procedures as stress free as possible.

As a parent, you know your child best so can help staff to help your child cope with the procedure or surgery.

Talk to your child's doctor

Talk to your child's doctor about the procedure or operation. Ask any questions that you or your child may have.

Give your child simple and honest information

Give your child simple and honest information. A good guide is to answer the 5 Ws:

• who?
• what?
• where?
• when?
• why?

For example, Dr X will be doing Y in the outpatients department tomorrow afternoon to fix your arm.

Talk about the procedure before the day it happens

Give this explanation wherever possible before the day of the procedure - keep in mind your child's temperament and developmental age.

It may also be helpful for your child to meet the procedure team before the procedure day. It's important that your child has a friendly relationship with their procedure team, particularly if they are having repeat procedures.

Answer questions

Answer any questions that your child may have. If you don't know the answer to your child's questions, try to find out. For example, tell them that you don't know, but together you will ask the doctor or nurse.

Bring your child's comfort items

It is usually helpful to bring your child's comfort toys or things which help them relax. For example, a teddy, blanket, book, a phone with a favourite game. These familiar items are comforting.

Be there during the procedure if possible

It's very helpful for a child to have a parent present during a painful procedure or when waking up after surgery. It's very important for the supporting adult to be calm throughout the procedure. If you don't feel that you can stay calm, it might be helpful to ask another adult that your child is comfortable with.

Use distraction to help reduce pain and anxiety

Research has shown that distraction is helpful in reducing pain and anxiety during procedures. Distraction involves helping your child to focus on things other than the medical procedure such as:

• blowing bubbles
• looking at picture books together
• watching a favourite movie or TV show
• playing a game on a phone or app
• playing with their favourite toys
• singing familiar or silly songs

Try relaxation strategies

Use of relaxation strategies can also be very helpful. Practice them beforehand at home. There are many ways to relax. Some of these include:

• slow breathing techniques
• guided imagery - your child could picture themselves in a favourite place and imagine what they can see, hear, feel, taste and smell
• muscle relaxation techniques - starting to relax body parts starting from the toes and working slowly up to the head
• listening to music (if your child needs to be still, keep the music relaxed and slow)

Give praise

Praise your child for any attempts at using helpful coping strategies. For example, you could say:

• you used your listening ears
• you are doing great slow deep breathing
• you used your words to tell us
• what a great job you're doing spotting all the stars
• you kept your arm still
• I liked the way you blew and popped the bubbles

Let your child know it's OK to feel upset

If your child cries, let them know that it is OK to feel upset. Your child does not need to be brave.

Give your child some choices  

It can be helpful to give your child some control over what is happening. For example, they could choose:

• whether to sit on the bed or a parent's lap for the procedure
• what distraction to use during the procedure
• who will talk to them during the procedure

Discuss these choices with a health professional first. The choices need to be real choices. 

For tamariki over 3 years of age it can also be helpful to give them a job during the procedure. This allows them to focus on what they need to do – rather than what they can't do. For example, "your job during the blood test is to keep your arm still".

Talk about the procedure afterwards

It's good to talk with your child about the procedure afterwards. It's especially good to focus on what your child did that helped them cope. Some tamariki may want to draw a picture about the experience. This helps your child better understand what happened and may make it easier if they need more procedures in the future.

Repeat procedures

If your child needs regular procedures, try and follow the same routine. Your child will be less anxious if they know what to expect when they go in for a procedure.