Setting a Positive Tone Vital for Kids Facing Surgery

Smallest surgical patients get special treatment

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CHAMBERSBURG – The smallest surgical patients get special treatment at the Roy A. Himelfarb Surgery Center, and it shows in their faces.

A look inside the surgery center on any day reveals the scenes and emotions you might expect in such a facility. Long corridors and endless pastel curtains, medical scrubs and beeping monitors, nervous patients and busy staff. 

The center, recently re-accredited by the Accreditation Association for Ambulatory Health Care, has consistently been recognized as a quality facility.  An AAAHC accreditation means that the surgery center continuously improves its care and services, and commits to a thorough, on-site survey by AAAHC surveyors every three years.

Also found – perhaps heard whistling cheerily before seen – donning blue scrubs, and a genuine smile: Dr. Roger Weiss, an anesthesiologist whose 31 years of experience has helped carve processes to help bring the greatest comforts to the surgery center’s smallest patients.

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The center isn’t just recognized for its quality of care. A deeper look shows scenes you might not expect inside a surgical center. Here you see laughing children, relaxed parents, stuffed animals lovingly tucked in the crooks of tiny arms while surgeons above them carefully operate.

“We have this opportunity to get it right,” Weiss said of his chance to set a positive tone for his young patients. Between high-fiving and fist-bumping a four-year-old, a genuine connection doubled as a distraction while checking the boy’s vital signs.

“Our approach is to inspire trust in children by telling them exactly what is going to happen to them,” Weiss said.

It’s not lost on Weiss that going through surgery is a game-changer for a pediatric patient. Often it is a solution for ongoing issues, such as chronic ear or throat infections.

But while the procedures may be minor by medical classification, the event itself can be monumental for both child and parents. It is an experience that not only can bring with it stress. It also has the potential to set a negative tone for the remainder of the young patient’s medical interactions.

Dr. Roger Weiss interacts with a four-year-old boy at Dr. Roy A. Himelfarb Surgery Center
Dr. Roger Weiss interacts with a four-year-old boy at Dr. Roy A. Himelfarb Surgery Center

Reducing Stress

Weiss and the staff of the surgery center see a direct correlation between the stress level of a young patient ahead of surgery to the positive outcome of the operation.

Keeping that stress to a minimum is related to the total experience the patient has, which begins before they arrive for surgery.

During a preoperative medical background call a few days before the procedure, parents are told to bring their child’s favorite stuffed animal. They learn they will be able to accompany the child into the operating room and stay with them until they receive anesthesia.

Staff carefully ensure that when possible, children are scheduled first-thing in the morning. Most surgeries require fasting and the less time the children must be hungry, the better.

When the patient arrives at the surgery center, the staff involve them in the necessary surgical preparations. They ask them and their parents’ questions. They explain what is happening, step-by-step, rather than talking over them or ignoring their questions.

“The older the child is, the more I try to involve them in the process, by focusing on them first, asking them questions,” Weiss said. “We try to put them at ease and bring out laughter. That helps decrease anxiety at the same time.  The child will do better in a surgery when they are not panicking before it starts.”

Parental Escort

Through his three decades of preparing patients for surgery, Weiss has seen a direct correlation between the separation of a child from the parent and increased anxiety.

“Gone are the days of us ripping the child out of their parent’s arms, with that child screaming in fear as strangers lead them down an unfamiliar hallway,” Weiss said. “Now we are marching into the operating room together, talking, laughing and sharing what’s going to happen next. It’s better for every person involved.”

The surgery center allows a parent to go into the operating room with their child until the child is “put under.” Once the child is prepared for surgery, the parent is gowned up in a sterile suit, complete with shoe covers and a cap, and can carry their child, or walk hand-in-hand back to the operating room.

“Both the parent and the child do better with this,” Weiss said. “The child doesn’t feel torn apart from their parent at a time where they already have overwhelming feelings.  It’s also calming for the parent, who can see their child is in good hands.”

Inside the operating room, the care team, in a carefully choreographed act, accomplishes getting the patient on the operating table, properly positioned, and hooked up to appropriate monitors all while the child and their loved one are engaged in the process.

Once the child is given anesthesia, the parent is escorted to the waiting room and the surgery can begin. 

Waking Up

Not escorted out of the operating room is the child’s favorite stuffed animal or toy. That comfort item remains with the child for the duration of their surgery. When they wake up postoperatively, their beloved stuffed animal is snuggled with them. 

The postoperative care team has a delicate touch with children, who often wake up a bit confused, scared and upset by the IV in their arm.

The team quickly brings the parent to the child and encourages, if possible, the parent to sit with or hold the patient.

Usually, the child must successfully consume a drink or a popsicle before being discharged. Staff manages to make this feel more like a treat than a “task”.

Inspiring Trust

While making patients comfortable is extremely important, Weiss says the child-friendly processes at the surgery center point to longer-term benefits. He says his biggest reward for putting his patients at ease is simple: seeing them smile. He hopes his efforts stay with his patients long after their sleepy grins.

“Children are precious,” Weiss said. “They connect with you, and making them laugh and smile is a gift.  I am inspiring trust – trust that children feel they are treated fairly by their doctors and nurses, and that they can know what to expect.  Surgery is not always without pain, but children are resilient and handle that pain better than most adults, especially when we tell them what to expect, and that we are here to help them.”

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