The right parent calms a child
Look for steady, reassuring manner
Over the years, outpatient surgery program managers have struggled with the dilemma of whether parents should be allowed into the operating room. While some programs have prohibited the practice, other programs do allow parents in the operating room with the belief that a parent’s presence reduces a child’s anxiety.
A study published in the September issue of Anesthesiology1 demonstrates that a blanket invitation to all parents might not be in the best interests of the child.
The researchers developed a measure to determine the motivation levels of mothers who want to be with their children and correlated the results with the anxiety level of the children. The authors found that many mothers who have a high desire level and low hesitancy to go into the operating room were anxious, and their anxiety translated into higher levels of anxiety for their children. Mothers who exhibited a low desire and were hesitant to go into the operating room, but who went anyway, had children with lower anxiety levels than those of the first group.
"We do allow parents in the operating room until the child is asleep," says Joanne L. Floyd, MD, anesthesiologist and medical director for Midwest Surgery Centers in Terre Haute, IN. "Although I believe that a parent’s presence can reduce anxiety, I know that this is not true for all parents and children."
Although all of the nurses know that a parent may be allowed into the operating room, a nurse never offers it to a parent, she notes. "As the anesthesiologist, I am the only one who can invite the parent," she says. Floyd offers it to a parent who is calm and steady and appears to have a calming influence on the child. "I ask the parent to sit next to the child and hold the child’s hand during induction," she says. "Once the child is asleep, a nurse escorts the parent back to the waiting area."
Floyd does think that it’s a good idea for an outpatient surgery program to have the option to invite parents into the operating room if the anesthesiologist, or surgeon, has assessed their ability to calm their child. While there is no chance to conduct a scientific assessment on the day of surgery to determine if a parent will be a good influence, "a calm voice and a reassuring manner during pre-op assessment of the child is a good indication that the parent will help calm the child," she says.
Reference
- Caldwell-Andrews AA, Kain ZN, Mayes LC, et al. Motivation and maternal presence during induction of anesthesia. Anesthesiology 103:478-483.
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