Wednesday, March 25, 2009

Hospital Procedure Advice

Where the last post was about things to bring, this is more about what to do and what to ask for while you are in the hospital. There will be some overlap. Also, this is mostly for parents of older infants and toddlers.


Someone needs to stay in the hospital with the child, so you need to be sure that you are comfortable. Children who are under 2 or 3 will be given a crib. If your child will sleep fine in a strange crib and you are okay to sleep in the folding chair thing, it's easier. Do not be afraid to ask for a bed. They can get you one. If you sleep in the bed with your child at home, or even if you don't normally, it is a lot more comfy to use the bed. We used to bring an airbed, but it was too much of an extra pain in the patoot. Depending on the size of your room and who is with you, you may still want one.

You probably won't get much sleep until you get used to the extraneous hospital noise. Also, they will come in and take vitals overnight.

If you can stay on the same sort of sleep schedule that you do at home, then that's great, but if it doesn't work out, just catch sleep where you can. Try to nap when your child naps even if you don't think you need it (although if you need to do some straightening, do that).


Diapers get weighed at the hospital, so you need to save them. We get one of those little pink basins from the hospital and put all used diapers in there, and the basin stays in the bathroom, so that the diapers aren't sitting out in the room. If you use cloth and take those to the hospital, be sure that the staff knows the dry weights of your diapers (they will weigh them) and then you should keep a record of the dry weights as well, in case they need to ask again.

Babies/toddlers in diapers who are on chemo need to be changed every two hours (more if they poo, obviously). Try to get on a schedule with that, and then if it changes due to poo or very wet pee, just shift the schedule (be on "odds" or "evens"). At night, do ask the nurses to change the diapers. They will try to let you sleep although it is a disturbance that may wake you and your child.

If your child is potty-trained, be extra-vigilant about making sure that they go to the bathroom because being on IV fluids makes them go more. If there is any issue at all about getting to the bathroom, you could try a little potty by the bed. Diapers or training pants are an option; you might just use them overnight, but remember that they'd still need to be changed every two hours if they are wet.

Also remember that pee/poo/puke is toxic when it comes from a child who is receiving chemo or who has recently had a dose of chemo. You need gloves to change diapers or clean up messes. If it gets on you anyway, wash it off immediately. Call the nurse if you need help and tell them what happened--they'll likely send someone pretty quickly.


Every hospital is different in how they deal with menu. Some make it like room service; others have meals that come 3 times a day and that's about it. Often the floor will have a patient fridge with things like milk, juice, pudding, jello, and applesauce, along with other food in the pantry. Bring snacks if your child has certain preferences. If the meal schedule doesn't line up with when your child wants to eat, try giving just a little snack so that your child will eat "real" food.

In terms of what to eat, that's up to you and your child. Rice and mashed potatoes are good if stomachs are sensitive. Most hospitals have a pretty good selection. Ask for what you want. When The Boy was first diagnosed, they tried to bring him baby food, which he never ate in his life, so I had to keep asking for regular food for him. Order extra stuff so that you can have it too, and if you can store leftovers for when you child gets hungry later, do so.

Ask for a high chair if your child needs one. If you can't get one, ask again. Another option is to bring a booster chair with/without a tray. But then, that's another thing to bring with you. We pack plastic bibs with pockets, which are easy to wash.

Try to keep track, at least a bit, of what your child eats and drinks, and tell the nurse. If he/she is over a year old, they won't need anything like exact measurements, but let them know. If you are still breastfeeding, they may ask you to time it. Don't bother because that will stress you out and is completely inaccurate with older babies anyway--just tell them when you breastfed and whether it was a little snack or a large feeding.


We don't use the playroom, even when we get private time. The first time we were inpatient for chemo, we all got stomach viruses and apparently it was going around. The playroom is supposed to be for patients who are not "sick" but who are hospitalized for something else, but sometimes things get in there. The staff in the playroom is supposed to keep things clean, which they do, but if they miss something, then it can be an issue. They can, however, bring toys and games and videos to you. They stop by, or you can call them. If they bring something to you, they will clean it thoroughly.

That said, we come with our own travelling playroom. Infants/toddlers need a wider place to play and will want to play on the floor, so we bring a playmat. I wipe the floor with disinfectant wipes (the hospital will sometimes have really strong ones; Clorox/Lysol wipes also work and smell better) and then put down the playmat tiles. We have toys that for the most part are only used at the hospital. The Boy gets all excited to see them because he hadn't seen them since the last stay. Everyone's toy preferences are different, but our favorite toys are the Playskool Pop-Up Pals, the LeapFrog Piggy Bank, and the Mega Bloks keyboard (different blocks change what the keyboard does); he also loves stickers and coloring so we make sure that he has those as well.

We clean the mat and the toys once a day, with Lysol wipes. It is easier if you have more adults in the room, but you can also do it at bedtime. This is for infection control--if we're already in the hospital, we'd rather not stay longer.

Speaking of which...

Infection control

Everyone who enters the room must wash/sanitize hands right away upon entering the room. Don't take no for an answer either, and don't listen to someone who says that they're not going to touch your child or that they'll wash hands once they do plan to touch your child, because they still might touch something else in the room. You can make exceptions if a person is just walking in the doorway and you send them on their way.

No shoes on the playmat. If your child is just learning to walk or has been directed to keep shoes on more often, clean his shoes frequently and make the exception for the child. I assume that you, being the one reading this, are one of the people in charge of setting protocol in a child's hospital room. So you can decide.

We have people take shoes off when they arrive to visit. Not sure how effective it is, since the nurses and docs don't. The housekeeping staff should, hopefully, wear shoe covers.

With housekeeping, make sure that the room is relatively uncluttered so that they can clean thoroughly. Also don't be afraid to tell them to come back in ten minutes so that you can straighten up. Call them additional times if you feel that it is necessary. That said, be pro-active about cleaning little messes.

Other Procedural Items

Get extras of all linens that you might need ahead of time when you arrive, either by asking the staff or just going to get it yourself if you know where it is (at our hospital, it's right there on a cart). Get hospital gowns, bedsheets, absorbent pads (these are the quilted squares, about 3 feet by 3 feet. Quilted on top and waterproof on the bottom), pillowcases, towels, blankets and whatever else, so that you don't have to worry about waiting for them if there are any accidents or issues. As I mentioned in a previous post, it is easier to keep The Boy in a hospital gown than to worry about accumulating laundry. We brought a few diaper covers this time (to go over the disposables, oddly enough).

In general, don't be afraid to ask for anything that you need for your child. That's why the hospital staff is there. When things take longer than they should, be sure to ask the nurse, nicely, for help. She may be able to make an extra call and find out what is going on. Something that may have been ordered correctly might need some quick reminding in order to get it going properly. Don't get too impatient because nothing moves quickly in a hospital, but letting your wishes be known will help. For example, The Boy's chemo that he just finished is a 5 day treatment, but it is a long day of treatment with the extra medicine and can easily be a 6 day treatment if the chemo starts too late. So the doc had the chemo moved a bit earlier each day.

Ask for things even if you're not sure that they do them. You never know. There's no need to be miserable in the hospital, any more than you already might be.

I think that covers most of the important things. Feel free to add, if I've forgotten anything.

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