The BC Children’s Hospital Surgical Office Secretary will contact you once a date has been confirmed. You will be provided with important information including an overview of your child’s surgical procedure, preoperative instructions and logistical details (how long your child will be in the hospital, when to arrive, whether or not a Pre-Admission Clinic visit is required, etc.). 

Parents and families can expect to receive a lot of information after the surgery date has been confirmed. It is important to organize all of the information you receive (a folder or notebook can help) and review everything. Arming yourself with knowledge will help alleviate your fears and make it easier to maintain your strength throughout the process.

Even though you will be receiving a lot of new information, try to be as active and engaged as possible. Discuss any questions or concerns you have with your Surgical Nurse Coordinator. Remember, no question is too small, and it is OK to ask more than once. In stressful situations, we sometimes need to hear information multiple times before being able to process it.

Preparing Your Child

Your Surgical Nurse Coordinator will provide you with pre-op instructions to help you prepare your child and ensure they are as healthy as possible. It is important that you fully understand and adhere to these instructions. Always ask questions if you’re unsure. 

In addition to making sure your child is ready physically, you also need to make sure they are ready psychologically. This means talking about the surgery with them in an age-appropriate way and reassuring them about what’s going to happen. Your Surgical Nurse Coordinator can direct you to potential sources of support and resources to help.

When talking to your child about their surgery and hospital stay, use their age as a guide. If your child is between the ages of two and three, talk to them just a few days before the surgery. If your child is over the age of three, start talking to them a few weeks in advance. 

Older children may ask more detailed questions about what will happen. It is important to understand that every child is unique and each will require different amounts of information to feel assured. You know your child best, so trust your instincts. Your child will usually ask questions about what they want to know, so try to be attentive and responsive. 

You can use the BC Children’s Hospital Photo Walkthrough (found on the overview tab) to become familiar with the hospital. As the hospital can be a new and unfamiliar experience, knowing what you’ll see can help both you and your child feel more comfortable. Make sure to look through the gallery first and share only the photos you feel are appropriate. The BC Children’s Family Support and Resource Centre can provide you with books or videos to help as well.

Try to be as honest as possible when you talk about the surgery. Sometimes we conceal the truth in order to keep our children feeling safe from harm. Your child may be upset or angry, but telling the truth strengthens their trust in what you say. Stay calm and matter-of-fact throughout the situation. Your child will get the impression from you that this is something they can handle. Some useful topics to discuss include:

• What your child will see, hear and feel.
• Who they will meet and how they will be involved in the care.
• Your own plans for staying with him or her at the hospital.
• What he or she might be asked to do, such as “take a deep breath” or “hold out your hand to have cream rubbed into it”.
• Help your child understand that things will be very different in the hospital. For example, the food, the bed and where they play will be different. Tell them what will be the same, such as having their toy or blanket and you.
• It is hard for children under five years old to understand “surgery.” We suggest you don’t focus too much on the technical details.

Acting as a dedicated resource for families, Child Life Specialists can provide guidance, support and tools to help you talk with your child about surgery. They also work directly with children to help them learn about, cope with, and process the experience of being in hospital, and help to make the experience more positive through play, therapeutic intervention, preparation, and creative arts. Typically, you will meet the Child Life Specialist during your pre-op visit.

For more information on talking to your child about surgery, refer to the Preparing Your Child For Surgery information sheet. Your Surgical Nurse Coordinator has experience working with children of all ages, so feel free to ask them for advice.

Preparing Yourself

As a parent of a child requiring surgery, it can be easy to forget about your own wellbeing. Managing your own anxiety while keeping your child reassured can feel overwhelming. It is important to know that you are not alone. There are people and resources available to help.

Staying informed is one of the most important things you can do to prepare. Make a point of reading through all of the information that has been provided to you. Ask as many questions as you need to and don’t hesitate to request additional information. 

While your care team will do their best to prepare and inform you prior to the surgery, it’s always good to have a few questions ready to ask. Some ideas include:

• Who will perform the operation?
• How long will the surgery take?
• How long will the recovery take after the surgery is done?
• How soon after the surgery will I be able to see my child?
• How long will my child need to be in the hospital?
• Will any medication be required during the recovery period?
• Will my child need rehabilitation or physical therapy?
• How long will it be before my child can resume their normal activities?
• Does my child’s school require any information or training?
• Will I need to adjust my child’s immunization schedule?

Knowing the answers to important questions like these can help you build a plan, alleviating your own anxiety and ensuring your child sees you as composed when discussing the surgery. Most children can sense if their parents are anxious, so try to project confidence to keep them at ease.

While it is important to increase your knowledge, it is just as important to care for your mental and emotional health. If you need to talk to someone, your Surgical Nurse Coordinator (or your home hospital clinic nurse if travelling from another province) can put you in touch with a hospital based Social Worker and/or a Psychology Counsellor. 

There are also family support groups in each of the Western Provinces that can provide assistance. Through these groups, you can connect both in-person and online with other families who have been through similar experiences. Not only can this help build your support system, it can provide a way to comfortably ask questions and seek advice from peers. 

Children requiring surgery usually need to attend an appointment at the Pre-Admission Clinic before the surgery. Your child’s appointment may be a few weeks or a few days before their scheduled surgery date. If possible, both parents or caregivers should attend this appointment. The purpose of the clinic visit is to assess your child’s general health prior to surgery. There are numerous tests that must be completed, so plan on staying at the hospital for the day. Your child should be prepared for the following:

• A physical exam by the Nurse Practitioner
• A blood test
  • A special cream that numbs the skin called EMLA will be offered and put on before the blood test is done
• An interactive play with the Child Life Specialist (this also may occur on the morning of surgery)
• A chest X-ray
• An electrocardiogram, also called an EKG or ECG
• An echocardiogram, also called an ECHO
• Other testing that may be required prior to surgery
• A tour of the hospital including where to report for surgery

During this appointment, you will be given an overview of what to expect during your child’s surgery and hospital stay, including:

• When to arrive at the hospital on the day of surgery.
• Important things to do before the surgery such as:
  • Making sure your child has an empty stomach. This is called fasting and is very important. The surgery can be delayed if these instructions are not followed carefully.
  • Making sure your child is properly bathed and cleaned using a special soap (which will be provided to you on the day of the PAC appointment).
• The possible use of medicine to calm and relax your child before surgery. This medicine is called a sedative and is given before the surgery so your child does not feel pain and is not aware during the procedure. More information can be found here. 
• The surgical procedure and the possible need for blood products. You will be asked to sign two consent forms. One is giving your consent for your child to have the surgery. The other gives your consent to give your child blood products if needed. More information can be found here. 

You will also meet your child’s surgeon. This is an important time to ask questions and discuss any concerns you may have. Some parents find it beneficial to prepare a list of questions ahead of time. Depending on your child’s age, it might be helpful for them to make a list of questions that they would like to ask. You may also meet other members of your child’s care team, such as the Anesthesiologist and Child Life Specialist.

The day of surgery can be an anxious and long day. You can stay with your child up until the time they are taken into the operating room and will be reunited with them as soon as possible after surgery.

Your Surgical Nurse Coordinator will have already given you instructions on when and where to arrive. Make sure to follow these instructions and leave plenty of time for travel, parking, and checking in. Directions, parking information and a hospital map can be found here. 

Your child will need to stay in the hospital after surgery to recover, so make sure to bring everything you’ll need. If you are going to be staying overnight or for an extended inpatient stay, make sure to pack accordingly. Always label items with your child’s name. Here are some packing suggestions:

For your child:

• Make sure your child is wearing loose fitting, comfortable clothing (for example: pajamas, sweatpants and a sweatshirt)
  • Clothes that button up are preferable
• Non-slip footwear
• Robe
• A change of clothes
• Toothbrush and toothpaste
• Hairbrush
• Any favourite items (such as a toy, movie, iPad or blanket)

For a baby:

• Sleepers or t-shirts that fasten up in the front
• Soothers
• Cups, spoons, bottles
• Any favourite items (such as a toy or blanket)

For you:

• Pillow (optional)
• Personal items as well as any medications you may require
• A phone charger 
• Things to help pass the time
• A list of your questions for the surgeon and nurses

The hospital has:

• Diapers
• Food for your child
• Bedding for children and parents
• Formula and bottles for babies

When You Arrive

Upon arrival at the hospital, go directly to the Special Procedures Unit on the 4th floor of the Teck building (use the elevators directly to your right when you enter the building). When you check in, nursing staff will ask you questions about your child’s health and overall condition. It may seem like you are repeating yourself, but rest assured that the surgical team is only trying to gather information to ensure a safe surgery.

Your child will change into a hospital gown and a nurse will check their vital signs. You’ll be asked questions about their health and will need to confirm the last time they had something to eat or drink. The Anesthesiologist will meet with you and explain how your child will fall asleep for the surgery. They may also prescribe medication to help them relax. 

You may have to wait a period of time before surgery. Families and children can take advantage of the designated play area which includes video games, movies, toys and books. You can also bring your child’s personal toys, books or iPad to help pass the time. Do not bring food or drinks.

In certain circumstances, your child’s surgery may be postponed. Sometimes things happen in the hospital that necessitate a reschedule. This can include medical emergencies, pre-operative concerns and so on. While this can be stressful, it is important to know that this is only done when absolutely necessary. Surgery will not take place if the hospital is unable to provide adequate pre- and post-operative care.

During Surgery 

Keep in mind that it is not uncommon for surgery to take longer than expected. While waiting for surgery to complete, some parents choose to remain in the waiting room, while others choose to visit different parts of the hospital or campus. 

Within the hospital, there are many areas you can visit to pass the time. You can walk through the outdoor areas, visit the many cafes and restaurants, or take advantage of the Family Support and Resource Centre. Information about the on-site amenities available during your visit can be found on the BC Children’s website. If you need to access support resources while you wait or need to talk to someone, your Surgical Nurse Coordinator can connect you. 

You must leave your cell phone ringer on (not on vibrate) so that staff can contact you when the surgery is complete. Because cell phones may not work in all areas of the hospital, it is important to frequently check to make sure you have reception.

After Surgery

Once the surgery is complete, you will be called to return to the waiting area. Your child’s surgeon will meet with you to discuss how the procedure went. While every effort is made for you to be able to see your child immediately after surgery, you may have to wait a little while until your child and the team are ready. 

Following surgery, the majority of children are transferred to the Cardiac Intensive Care Unit on the 4th floor of the Teck building. This area is staffed by nurses and care professionals who are experienced in caring for children who have undergone surgery. They will monitor your child’s condition and assist them as they gradually wake up.

You will be escorted to your child’s bedside once they are settled in. In most cases, one or two parents or adult visitors are permitted. Other children will not be permitted into the unit.

Your child may appear very sleepy, pale and a little puffy after surgery. This is normal. The nurse who is caring for your child will administer medication to help them remain settled, calm and pain free. You may remain at your child’s bedside at all times if you wish. Many families use the bed and reclining chair that are in the room. 

Going home after heart surgery can be both a happy and an anxious time. Before you leave, your child’s care team will provide you with discharge information and instructions. You may also be given prescriptions for drugs that are required during recovery. It can be helpful to fill these as soon as possible (you can use the pharmacy on site). You will also be given information on who to contact if you have any questions or concerns.

If you have travelled from another city or province, your home hospital and care team will work with the surgical team to ensure all the necessary information is transferred. We know that going home can be stressful, but you can rest assured that both teams will work together to make sure you have a smooth transition.

When back at home, it can take time for things to return to normal. This is OK. Surgery is a stressful experience, and a visit to the hospital is a significant event in the life of a child and their family. You may notice small changes in your child’s behaviour like nervousness, bed wetting, nightmares or eating changes. These types of changes are usually short-term. If you are concerned about any changes in behavior, contact your child’s cardiac care team.

For more information, you can refer to the BC Children’s Hospital Heart Surgery Booklet, which includes a section on “Going Home After Surgery”.