Humber River Regional Hospital’s Hug & Hold Program: Helping pediatric patients and their families cope with surgery

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It’s early Wednesday morning and two-year-old Malachi has arrived at Humber River Regional Hospital for surgery. He is busy playing with a bright yellow toy car as his mother, Latoya Sinclair-Dennis, helps him change into a pinstriped hospital gown. As they walk down the hall, Malachi appears a little shy and reaches for his mother’s hand, but is quickly distracted when he enters a classroom filled with stuffed animals, games and other children. Latoya leads him into the room and takes a deep breath as she sits down at the table. Pre-surgery class is about to begin.

For most children and their parents the idea of surgery can be daunting, especially not knowing what to expect. Children are afraid of the anesthetic process and refuse to let go of a parent’s hand when the nurse carries them into the operating room. At the same time, parents experience emotional trauma when they are separated from their child.

But that’s not the case at Humber River Regional Hospital in Toronto. Thanks to a unique and innovative program called Hug and Hold, children like Malachi walk hand-in-hand with one of their parents into the operating room everyday.

“The program is very good. I felt calm and really prepared for everything that was going to happen,” said Sinclair-Dennis.

“In our Hug and Hold program, the child receives anesthesia while being hugged by their parent in the operating room,” said Alexandra Christofides, a Humber River Child Life Specialist who’s been leading the program since she proposed it in 1998.

And the parental role extends well beyond that.

“Parents become a part of the multidisciplinary team by placing their child on the operating room bed, or sitting with them in their lap to hold the child in position for their anesthetic mask or intravenous start,” Christofides said.

The parent also plays an important role by providing emotional support to their child and coaching them through the breathing technique during induction. And that, says Christofides, is a very important part of the process, especially given the diversity of the Humber River Regional Hospital community.

“The program is so wonderful because it allows parents to coach their child in their own language during induction. Both the parent and the child feel much more comfortable,” she adds.

Before surgery, parents and children participate in a preparation session where they practice their preferred method of hugging and holding with an anesthetic mask.

“We have great success with this program because we do all the teaching and preparation on the day of surgery,” said Christofides. “We use toys and tools in our multimedia classroom to explain every step of the anesthetic process to our patients and their parents. The program has made a significant difference in the way parents and children cope with the idea of surgery,” she said.

During the preparation, children from multiple families have the chance to interact with each other while parents are prepared for such normal occurrences as the “Thrashing Stage” and the “Excitement Phase” of anesthesia.

The classroom preparation also includes what Christofides says is a fundamental teaching philosophy.

“In many cases, we follow the Montessori method where we pair an older child with a younger child. This gives younger children the opportunity to learn from older children and enables the older children to be role models. It works really well.”

Parents also find the group learning sessions helpful. “The preparation was really valuable because I met other parents who were going through the same thing. They were very nice and it’s comforting to know that we can look out for each other,” said Sinclair-Dennis.

Christofides has a strong presence throughout the process; from conducting the preparation session, to facilitating the anesthetic induction and providing support during the surgery and after.

Looking back, Sinclair-Dennis said she couldn’t have gone through this without her support. “Alex was amazing. It was great to have her there to guide me the whole way through.”