Inpatient Care (Pediatric)

Social workers and case managers are available to support and guide families coping with a child’s illness.

Services include:

• Counseling for children and families
• Referrals to community resources
• Assistance with preparation for a child's return home, including arranging for transportation and post-discharge care
• Helping families understand and access their insurance benefits. Case managers work with all insurance companies including Medicare and Medicaid.

The surgeon or pediatrician will let you know if your child will need blood tests or other procedures before surgery.

On the evening before surgery, a preadmission nurse will call to give preoperative instructions, answer questions and tell you when to arrive:

• When to arrive
• Where to go once at the hospital (directly to Pediatrics)
• Eating and drinking restrictions (Your child should not eat or drink after midnight, unless specifically instructed to do so.)

Note: If your child has a cold, fever, or has been exposed to chicken pox, notify your doctor immediately. The surgery may have to be rescheduled.

An important way to prepare for surgery is to schedule a Preoperative Pediatric Tour, prior to admission. Tours are open to all children, their parents and siblings. Getting to know the hospital staff, procedures and environment before the day of surgery can help to make you more comfortable and ease your child's fears.

Your tour will be conducted by a volunteer or by a staff member from our Pediatric Unit who will be involved in your child's care.

You should have your tour during the week prior to surgery. Make the appointment as far in advance as possible. Tours are held on Tuesdays and Thursdays at 4 pm.

To schedule your tour, contact Greenwich Hospital Volunteer Department at 203-863-3222, or e-mail [email protected]. You may also want to watch the pediatric pre-op tour video with your child.

A day or two before the scheduled surgery, pack the things your child will need at the hospital, including a favorite book, toy, blanket, game or activity. Older children and teenagers may bring battery-powered devices; electrically powered devices are forbidden. If you are unsure whether an item is allowed, please check with the pediatric nurse at 203-863-3553. Do not bring valuables and try to label anything that is precious to your child. If you are planning to stay overnight with your child, bring along whatever you will need.

Hospitalization and surgery can be a new and difficult experience for both parents and children. Our Pediatric team provides ongoing guidance and preparation to make the experience as comfortable and positive as possible. Each child responds to new experiences in a unique way. However, there are some general concerns that arise for most children, depending upon their age. Here are some helpful hints:

• Parent Involvement: At Greenwich Hospital parents are an essential part of the healthcare team. We encourage parents to participate in their child's care in any way that they feel comfortable, including feeding, bathing, assisting in treatments, or simply just by being there to put their child at ease.
• Infants and Toddlers: Language limitations make infants and toddlers the most difficult age group to prepare for surgery or hospitalization. Their biggest fear is being separated from their parents. Bringing a favorite stuffed animal, a pacifier or blanket along to the hospital may be helpful. Most of all, your child wants you nearby. Hold your child and reassure him or her that you'll be there.
• Ages 2-6: Ages 2-6 can be a challenge. It's important to tell children the truth about why they are going to the hospital, how long they will stay, and what they can expect to see and do there. (Example: "You will wear a hospital gown and see nurses and doctors.") Encourage your child to express fears and to ask questions. Children this age worry about being separated from their parents, so it's important for you to reassure your child that you will be there as much as possible. Reading books or watching videos about going to the hospital can help both of you learn how to cope with feelings and concerns.
• Ages 6-12: Ages 6-12 is a time when children love to ask questions. Encourage your child to do so. Begin discussions when the child seems ready, at least a few days before admission. Be honest about what to expect. Explain that anesthesia will be used during the operation; the child will feel no pain and will wake up when it's over. Books can be very helpful at this age.
• Teens: Teenagers are concerned about what will happen to them in the hospital. Encourage your teenager to ask questions (No question is stupid!) and to talk directly to the nurses and doctors. Offer reassurance that any fears or feelings he or she may have about the surgery are normal. Include your teenager in any discussions or decisions about his or her care. Assure your child that personal privacy will be respected.

You should arrive at the hospital on the scheduled day, at the specified time. After stopping at the Admitting Office to verify information, you will be escorted to your child's room on the Pediatric Unit. Nurses there will check your child's weight, pulse, temperature and breathing, and provide a hospital gown to wear to surgery. In the surgical area, the surgeon and the anesthesiologist will ask more questions.

To avoid a separation that could be frightening to your child, parents of children over six months of age will be permitted to accompany them into the Operating Room and to stay until the anesthetic takes effect. You will be reunited in an area called the Post Anesthesia Care Unit (PACU) immediately after the operation. You will be given a beeper so that you can be notified immediately when surgery is over. Your child will be in the PACU until she or he is awake enough to return to the Pediatric Unit. There, post-surgical care will be provided along with any instructions you will need to care for your child at home.

Note: Your child may be wide awake and alert right after surgery, or groggy for a while. If you have any questions or concerns, bring them to the attention of your anesthesiologist.

• General visiting hours are from Noon until 8:30 pm.
• Each child is allowed two visitors at a time.
• Parents may visit 24 hours a day.
• Visits by children under 14 must be prearranged with the nurse.

Wireless Internet connection (WiFi) is available throughout Greenwich Hospital. Please be considerate regarding cell phone use.

If your child is required to stay overnight, one parent may stay with him or her. A sleeping space next to your child's bed will be made available.

Children’s safety is very important to us. We partner with families to keep young patients safe while in the hospital.

Here are some tips:

• The nursing call bell is located on the bed.
• A pull call bell is located in the bathroom.
• Patient ID bands must be worn at all times.
• For children under 2 years of age, a HUGS ID bands will allow monitoring of the child’s location.
• It is not safe to blow up gloves like balloons to play with. They are a choking hazard.
• At night, the bathroom light will be left on with the door ajar as a “night light.”
• Please accompany your child if they are in the play room.
• Breast milk storage is available. Please discuss our policy with an RN.
• All pediatric rooms have security camera surveillance with a monitor at the nurses’ station.
• Pediatrics is a locked unit:
  • When entering the unit, please use the intercom outside the unit to have the door unlocked for entrance.
  • When leaving the unit, please press the button to the left of the doors to open them
• Visitors under 12 years of age should be accompanied by a responsible adult and not be left unattended.
• Siblings and friends may not sleep over

Keeping your child safe from falls in the hospital

Falls can occur anytime, anywhere. Falls may also occur while a parent or family members are present. Here are useful tips on how we can prevent falls while in the hospital.

Please:

• Notify the pediatric nurse if you are leaving the department and will not be present with your infant or toddler.
• Accompany your child to the bathroom, especially if he/she is attached to any equipment, is under medication, or just had surgery. Let the nurse know if the child is getting up for the first time, or if you need assistance.
• Make sure the bed/crib side rails are always up, and the bed/crib is in the position closest to the floor.
• If you feel sleepy while holding your child, please place him/her in the bed/crib, with the side rails up.

Remember:

• Feet need to be covered at all times. Slipper socks are available.
• It is not safe to play with, or ride on equipment, such as IV poles.
• It is not safe to stand or climb on the windowsills and couches.
• It is not safe to run in the hospital.
• Use built in safety straps for babies placed in infant seats, high chairs, strollers and bouncy seats. Do not leave your child unattended.
• Children under 3 years old are safer in a crib even though they may not be in one at home.

We want to be sure your child is in the safest environment possible. We identify all children at risk for falling, and place a “Humpty Dumpty” sign outside his/her room to remind everyone of the child’s risk to fall.

When a child is ready to return home, a case manager works directly with the family to review insurance benefits and make any necessary recommendations or arrangements for discharge. Arrangements may include transportation, support services, home care, medication management and rehabilitation referrals or placements.

Taking care of a child after surgery can be stressful. If there is anything you need to discuss, please don't wait for us to contact you. Call the Pediatric Unit at 203-863-3553 and ask to speak to a nurse. We are always happy to answer a parent's questions. You should also feel comfortable calling your surgeon or pediatrician.

Have your child rest or "take it easy" as much as possible and limit strenuous physical activities. You will be given instructions on diet, medication and other issues. Remember, you know your child best. Your judgment is most likely the right one. We are here to support you.

Part of the discharge planning process includes helping families fully understand the billing process in order to plan for payment. Case managers work closely with families to clarify their insurance benefits.

Please note: You may receive separate bills from providers other than the hospital. These may include physicians, such as the radiologist and anesthesiologist, and the laboratory.

Learn more about billing and how to pay your bill online