At four years and three months, Jean was in hospital for three days, accompanied by her mother, for the removal of tonsils and adenoids. This was a well-managed hospitalization and the outcome was good, but it is clear from the record that the experience was fraught with anxiety for the child.

  A PLANNED HOSPITALISATION

  My husband and I believed that hospitalization for tonsillectomy could be traumatic to a child of this age, but that if the mother were present to play a supportive role throughout, the risk of aftereffects could be greatly reduced. The children’s physician and the ward sister (charge nurse) were specially sympathetic to our views and interested in the possibilities of nursing by the mother. We discussed the practical implications of my wish to be present during all of Jean’s conscious experience.

It was eventually agreed that I should be with her until she became unconscious, and again immediately after the operation. There was initially some reluctance to allow me to be present during the early stages of returning consciousness. They then believed that she would have no awareness in that phase, and that I should therefore be spared the anxiety of witnessing an unfamiliar scene of blood and apparent distress.

Jean and I would share a cubicle in the children’s ward. She would be allocated to one nurse in accordance with the practice of this ward, but in fact I would do everything for her except the technical nursing.’

1 We wish to thank the staff of the children’s ward at Guy’s Hospital, London, and in particular Dr. Ronald MacKeith, Children’s Physician, and Miss J. Tanner, Ward Sister, for their cooperation in this experiment.

 

PREVIOUS HISTORY

  From birth Jean suffered from eczema and food allergy, which created problems in feeding and management. The eczema was managed with a minimum of restraint. There was inevitably some frustration and interference during the first two   years of her life, but there were no disturbing investigations or treatments and no hospitalization. The eczema then cleared, except for mild spring outbreaks, but left a tendency for common colds to develop into bronchial asthma.

  Her social development was slightly retarded by the difficulties of the first two years, but by the age of four this had been largely made up. She had friendly relationships with the children of the neighbourhood, and with adults whom she knew well, but was noticeably slow to accept the advances of strange adults. In illness she tended to be more negative and withdrawn than most children.

  During the winter preceding her admission to hospital, she had several attacks of otitis media and tonsillitis, and during treatment was found to be allergic to the antibiotics. Since the attacks were becoming more serious and could not be satisfactorily dealt with medically, it was reluctantly accepted that her tonsils and adenoids should be removed.

I intended to say nothing about this to Jean until about a week before the operation, which was arranged for six weeks ahead. But as will be seen from the Diary, I was compelled to begin telling her almost immediately.

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