Taking children to the OR...

[Jrh121]

Hello everyone :) I am a fairly new RN graduate who landed a job in the OR as a circulator. While I absolutely love my job, one aspect that I find very nerve-racking is when I have young patients. I am not sure if it is because I am not the best with kids or it's that their parents make me extremely nervous, but I always get anxious when I have to do my pre-op assessment and take a child to the OR. Do you OR nurses out there have any tips on how you explain the surgical experience to kids? Do you inform the parents of anything they might witness in the OR (such as a child twitching as a result from the medication they are receiving). I think I am having the most trouble finding a way to explain things in terms that children can understand. Any advice would be greatly appreciated! Thanks :)

[TraumaORnurse]

I work for a large hospital with a children's hospital attached, so my situation may be a little easier, but hopefully can be helpful. Because our dept treats kids from the Peds hospital, we have pre-op Peds decorated rooms as well as ORs. We also have a Child Life Specialist in pre-op and ED, that talk to them and play games and stuff to distract the kid. If they have to be on a gurney, they get an iPad to play a game, even as they are going off the sleep. Toddlers that can, are pulled in a wagon with the CLS blowing bubbles at them; kids a little older get to drive those power wheels jeeps into the OR. We also have fellowship trained Peds Anesthesiologists. Except for babies obviously, they are the ones to explain what's going to happen. Kids under 13 don't get IVs unless they are already IP until they're asleep so that's one less trauma, so they go to sleep with gas. We have scented masks, so they let kid pick out what scent, show them how it will go over the face while mom/dad are there, then let them keep the mask til they come back to the OR. As the OR nurse, I always explain to the parents the process. If the kid is old enough, I try to tell them again what's going to happen. Until they are a little older, taking them away from the parents is hard on them no matter what you say or do. Some parents will walk to the main OR doors with us, others will stay back and you just have to go, even if you're carrying them kicking and screaming all the way. They are awake in the OR such a short period of time I don't think there's really anything for them to see that you need to warn the parents about, that may just make the parents more nervous. And only on very rare occasions do we allow parents to come back with us, I think that makes it more difficult on the kid.

[NurseQT]

When my daughter went in for a tonsillectomy my husband was a nervous wreck (and that's putting it very lightly!), I was afraid that when they took her back to the OR she would get scared, start to cry, and my husband would lose it. The nurses were brilliant though, they told my daughter they were gonna pretend the gurney was a train and she was the conductor, in order for the doors to open she would have to blow her horn. She was concentrating so hard on making sure the doors opened that she never even looked back as they wheeled her into the OR. Helped keep my husband sane for sure!