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When a child is admitted to hospital with burns, she is suddenly separated from her familiar environment and placed in a strange, frightening place, where her parents are no longer in control and where strangers are hurting her. The burned patient is usually fully conscious at the time of admission, unlike patients with other severe trauma. With severe burns there is often deterioration after initial treatment, before improvement begins.

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The burned child in hospital feels shock, fear, bewilderment, and intense pain. It is easy for medical professionals to forget how frightening gowns, masks and ward equipment can be. Setting up drips and catheters can be the source of terrifying fantasies. During the weeks that follow, the frightening experiences continue as younger children try to come to terms with the pain and separation from their mother. parents appear to be all-powerful to little children, and anything that goes wrong tends to be seen as the parents’ fault. These children do not understand that their parents cannot control certain situations and this often makes them feel that their parents do not love them.

Frustration is added to emotions when the child cries for her mother and she is not able to be there. This sense of not being in control can lead children to start shouting and flinging things about, refusing to eat and talk, regressing to babyish ways, bed-wetting, rocking and thumb sucking.

After the burn injury, in the acute hospital phase, most of the attention of the medical staff is focused on the suffering patient. Family members remain in the background and few people are aware of their suffering and emotional needs. Just as the patient must adjust to her injury, so the family must go through understanding, accepting and adjusting to the illness and distress of the loved ones

Wound dressing

 

Burn care involves repeated painful procedures for dressing and skin grafting.  Anxiety about the future is inevitable; not knowing what to expect, anticipating the worse, yet hoping it will not happen, all combining into anxious feelings. Older children are worried and anxious about themselves, about operations and being cut about dying, about change in their appearance and body and about losing control of their bodily functions and consciousness.

The anxiety that a burn patient may feel from the beginning of the impact of the event, through to hospitalisation and later long-term recovery is continuous traumatic stress. Although the traumatic event itself has ended, the patient still faces a period of severe psychological and mental suffering that may qualify for the definition of further or multiple trauma as well as post traumatic stress disorder.

 
By Bronwen Jones and Charissa Bloomberg
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Page Created By: Gary (admin) 08 July 2004 3:18pm
Page Last Modified: 23 July 2004 9:24am

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