By: Alanna Higgins Joyce, MD, MPH, MST, FAAP
Taking your child to the hospital can be stressful, especially when it's unexpected. There are many reasons kids might need to be admitted to the hospital. For example, children may need fluids after they've been
vomiting or had diarrhea. They could also need antibiotics for an infection or breathing treatments for wheezing or asthma. Some kids may need to get a broken bone fixed, have imaging tests, or get tubes put in their ears. Other children have more complicated medical problems and may visit the hospital often for treatment.
Here are answers to common questions and what you can expect when your child is admitted to the hospital.
Who works at a hospital? Why are there so many people to meet?
The hospital is often a busy and complicated place, with many different people helping to give the best care possible.
Administrative staff. These are the people who check you in, get your insurance information, and give you hospital bands or ID badges.
Nurses. Your child will always have a nurse, usually a
registered nurse (RN), assigned to care for them in the hospital. Advanced practice nurses (APNs) or
nurse practitioners (NPs) are more highly trained and can write orders and prescriptions.
Licensed practical nurses (LPNs) are similar to RNs but have less training and responsibility.
Certified nursing assistants (CNAs) help RNs and LPNs with their daily tasks.
Physicians (MD or DO) have completed college and four years of medical school. Some train for up to seven more years in a specialized field during “residency," or do additional specialty training known as “fellowship."
Residents and fellows, physicians still completing training, may take care of your child. In some hospitals, medical students may help provide care.
Physician assistants (PAs) have completed two years of schooling after college to work with doctors. They help diagnose and manage illnesses and prescribe medications.
medical assistants and
support staff. Technicians specialize in specific tasks like taking x-rays, giving breathing treatments, performing ultrasounds, or doing blood draws.
Medical assistants help with general tasks like feeding, bathing, or taking vital signs.
environmental services staff bring bed linens and meal trays.
Child life specialists, who are specifically trained in child development, help children understand and cope with the hospital, their illness, and procedures. They might use breathing exercises, counting, or distractions such as bubbles, lights, sound or movies to assist your child during difficult procedures.
Social workers and case managers help address specific needs you may have, such as getting a new car seat. They can also help arrange for any equipment or care your child may need at home and find companies that accept your health insurance.
What does a day in the hospital look like?
Mornings begin quite early with visits from your care team. This may include doctors, nurses, residents, fellows, and trainees. Your care team may be different each day, especially on weekends or holidays.
“Rounds" is when team members examine your child and decide on a plan for the day. This may include ordering tests, performing procedures, or consulting with specialty doctors. This is your time to ask questions, advocate for your child, and get a sense of when they might be able to go home.
Your child will probably have their vital signs checked about every four hours. A nurse or medical assistant will count their heartbeat and breathing rate and take their temperature. They may measure your child's blood pressure with a “hug" sleeve on their arm and check their oxygen level with a device clipped on their fingertip. “Vitals" happen around the clock, even in the middle of the night, unless the doctor says it is OK to skip.
Sometimes your child will have little stickers on their chest with wires connected to a screen. This shows a constant measurement of their heart rate, breathing rate, and oxygen levels. These machines sometimes beep if they pick up something abnormal or a sticker falls off your child's skin.
Sometimes a different doctor will check on your child again in the evening. If all is going well, usually evenings and overnights are quieter with time to sleep. Visitors might just be your bedside nurse or meal delivery.
Will I be able to stay in the hospital with my child during the COVID-19 pandemic?
Hospital policies on family presence may vary by location. The American Academy of Pediatrics
recommends allowing one or two family members or caregivers to stay with their child, as long as you don't have symptoms of COVID-19. Visitors will probably be limited, and you'll need to wear a face mask as directed. If you have questions, contact your child's hospital about their policies.
My child has never had trouble breathing and suddenly had difficulty. What will the hospital do?
Sudden respiratory problems, especially during cold and flu season, are among common reasons children need to visit the hospital. Hospitals have lots of ways to help. There are breathing treatments to help some causes of wheezing. If your child needs oxygen, they may have a soft plastic mask placed over their nose and mouth or through two small soft prongs in their nose. Sometimes kids need more help breathing, like with a breathing tube or a ventilator. When this happens, they're monitored in an intensive care unit (ICU) by specialized doctors, nurses, and therapists.
What if my child needs an IV for medications and fluids?
IV stands for “intravenous," meaning “into the vein." An IV can deliver medicine or fluid to your child if they aren't able to eat or drink by mouth. First, a tiny needle is used to find your child's vein. Then a small plastic straw is slipped in just under your child's skin and the needle is taken out. An IV is a fast and easy way to give your child antibiotics for an infection or fluids if they are not drinking well, cannot eat for any reason, or have severe vomiting or diarrhea.
What if my child needs surgery?
Sometimes doctors will need to perform a procedure or a
surgery to best care for your child. They will discuss this with you ahead of time and ask you to sign a paper giving your permission, called “consent." Your child will likely not be allowed to eat anything after midnight before the procedure. They might be given a medication to keep them calm on the way to the procedure (though many kids don't need this).
During the surgery or procedure, you will be asked to wait nearby and share your contact information so your child's doctors can give you updates. Your child may still be sleepy when you see them. Most kids will be able to have liquid to drink during recovery and go back to their hospital room. Some may require extra breathing support as the anesthesia wears off.
What if my child needs a scan or imaging?
Computed tomography (CT) scans and magnetic resonance imaging (MRI) are the most common ways to take pictures of the inside of children's bodies. Your child will lie on a bed near what looks like a big doughnut with a hole in the middle. The bed will slide into the hole when it is time for the pictures. The machine will not touch your child, and the pictures are not painful. Lying still may be difficult or frightening to some children, so medication can be provided to keep them asleep or calm.
Other ways to take pictures is with x-rays or ultrasound, which uses sound waves to create images. An ultrasound is also painless and is done by applying a small wand to the body.
Tips to make your child's hospital stay easier
Pain, fever, interrupted sleep, stranger anxiety, new medical equipment, and separation from their usual caregivers and familiar environments can all take a toll on children and caregivers in the hospital. Here's how to help make your child's stay easier:
Bring your child's favorite items from home, such as stuffed animals, photos, and blankets or pillows.
Line up friends and family to help at home with your other children, bring meals, or coordinate transportation.
Be present and participate in your child's care as much as possible, especially during those morning “rounds."
Try to give your child some of the usual limits and structure you would at home, such as setting aside time to turn off the TV and
reading a book together.
Make sure you give older kids and teens privacy whenever possible.
Use dim lights during night hours and natural light during the day.
Stick to a somewhat consistent eating and
sleeping routine when possible.
If a choice is available, offer it. For instance, you could give your child the option to drink their medication right from the cup or with a straw.
behavior changes. Younger children might have potty accidents, while adolescents may display anger or misbehavior. Don't worry—they will regain their progress later.
Be honest and detailed about what is going on with their care. When they don't know what's happening, their imaginations can run wild and cause them more stress.
About Dr. Higgins
Alanna Higgins Joyce, MD, MPH, MST, FAAP, is a hospital-based pediatrician in Chicago, a former public middle-school teacher, and a mother of three growing boys.