The coronavirus epidemic continues to sweep across Russia. As of March 31, there are 2,337 infected people in the country, the vast majority of them in Moscow. Some patients suffer from mild COVID-19 and are therefore allowed to be treated at home. However, the majority of infected people have to be sent to the hospital. And it may well happen that due to emergency hospitalization, minor family members will be left at home alone - without food, water or support. We tell you how in Moscow they help families where children, due to a number of circumstances, were left at home unattended.
From what age does a child stay in the hospital alone?
According to the RF IC, adulthood occurs when a citizen reaches eighteen years of age. In some cases, independence is acquired from the age of 16. However, to do this, the teenager must register an official union at the registry office or receive income from business activities.
The following cases are provided for when responsible persons are with the patient:
- With minors under 4 years old.
- With children older than the above age, if indicated.
The management of the institution cannot demand money from accompanying persons for a place to sleep and food. At the same time, current regulations do not imply the establishment of such an obligation on the part of the organization. This means that comfortable conditions for the mother (father) are created on the initiative of officials.
Important! The child's legal representative has the right to be with him at any time, regardless of age. In addition, the condition of the minor, as well as the availability of special places in the hospital for relatives, are not taken into account.
In addition to the mother and father, grandmothers (grandfathers), sisters (brothers), and other close relatives can become representatives of the minor.
Even after reaching the age of four, a child cannot independently cope with adaptation to new conditions. Left without the support of loved ones, the baby can experience strong emotions and receive psychological trauma.
In practice, the child goes to the hospital with the mother. If the ward does not allow it, then they sleep on the same bed, and the woman eats the food provided by her relatives. Some children stay from the age of 12. At this age, adaptation occurs much faster, and a child is able to independently solve problems related to hygiene.
Who needs help
Photo: depositphotos/AndrewLozovyi
A memo on what to do if children are left unattended while their parents are in the hospital was developed by lawyers from the capital’s family centers. The algorithm of actions is not suitable for all cases: social services and law enforcement agencies will work with “cuckoo mothers”.
The information published by the Department of Labor and Social Protection is intended mainly for single-parent families who need emergency assistance in caring for minors. And it applies not only to cases of hospitalization specifically because of COVID-19; the mechanism works for any hospitalization, even planned.
It may happen that a mother, father or guardian, raising a child alone, ends up in the hospital, which is especially important in modern realities. The child will need supervision and company - in the form of grandparents, other relatives or close family friends. This would be the best and least stressful option for the child.
However, help may not arrive immediately or may not be available at all due to various circumstances. There is no need to worry: social services will do everything possible not to leave the baby in trouble.
Do parents have the right to stay in a medical institution with their child?
According to paragraph 3 of Art. 51, as well as paragraph 4 of Art. 80 Federal Law No. 323, the legal representative of a patient under 18 years of age may stay free of charge in a medical organization when providing assistance to a minor. This rule applies throughout the entire time the teenager (child) is in the hospital.
As already noted, when the offspring reaches the age of fourteen, those responsible for his upbringing can be constantly in the ward only for medical reasons. The latter refers to conditions that impede the child’s ability to independently attend procedures, change clothes, eat, and take a shower.
If there is no evidence, then the parent also has the right to be with the baby, but the administration of the institution will refuse assistance in providing the adult with food and additional space.
Regime object
It is unlikely that it will be possible to organize life in a hospital like at home. The hospitals have their own, downright Spartan regime. Early rise, procedures, meals on a schedule - all this can become additional stress for the child. But children quickly adapt and learn to live by new rules.
The main thing is that mothers or fathers do not wring their hands in horror or lament, but, on the contrary, demonstrate complete equanimity with their entire appearance. Then it will be easier for children to adapt.
If your child is small, and there are older guys in the room with him, be prepared for the fact that they follow the regime very roughly. After lights out, the lights will be turned off, of course, but they won’t go to sleep. And if they are busy with their gadgets, then you will be very lucky, since they will not interfere with the kids’ sleep. But if teenagers want more communication, then get ready for the fact that you will have to choose one of two: either work as a ward Cerberus and calm the guys down, or endure midnight conversations. Therefore, I recommend stocking up on earplugs and (for a child) a sleep mask.
The right to visit a patient in intensive care
Federal Law No. 323-FZ establishes that the patient has the right to visits from legal representatives, lawyers and other persons who protect the rights and interests of the citizen. The Russian Family Code, in turn, classifies his mother and father as representatives of a minor. They have the opportunity to enter into relations with any authorized persons and organizations.
A similar procedure is provided for the mother of a newborn placed in the department of pathology of newborns and premature babies. Appropriate conditions must be provided there to allow an adult to sit there.
If the administration of a medical institution denies the legal right to be present in the ward, the citizen can submit an application to the prosecutor's office. The prosecutor is authorized to submit a proposal to eliminate violations of legal requirements to the body or directly to the official.
adopt.ru
Many Russian orphans end up in hospitals as infants, where they are alone, without care or care. Children with serious illnesses living in orphanages often cannot receive high-tech medical care, because care for them in a hospital is not provided for in any way by law. For the last 20 years, Russian public organizations have been demanding that the state create a service for accompanying orphans and children without parental care in hospitals, but the problem has not yet been solved. Even the corresponding instructions of the Russian President were not carried out by the government.
“Unaccompanied children are not accepted for complex operations”
Christina is 6 years old, she spent 4 years in bed in an orphanage
Photo: from the family’s personal archive
Christina rides slowly on a tricycle. Christina walks along the path, holding her mother's hand. Christina climbs the stairs to the second floor, her mother belays her from behind. Christina is six years old. A little less than a year ago she started a family. She spent her entire life before that in an orphanage and hospitals. Until the age of four, Christina did not get out of bed because her puny body could not support her large head. Christina has congenital hydrocephalus, a disease in which cerebrospinal fluid accumulates in the brain. If such a child does not undergo surgery at an early age, his head will begin to grow, which will lead to profound disability. Children with compensated hydrocephalus can live a full life, move around, attend kindergarten and school. In the region where Christina was born, for a long time doctors did not undertake such operations. When the Moscow charity foundation “He Needs You” began visiting orphanages and orphanages, its employees saw children there with huge heads. “This is a big problem - high-tech medical care for children without parents,” says foundation co-founder Lyudmila Ushakova. “In many regions there is no opportunity to perform such operations on children. But even if doctors are available, unaccompanied children are not accepted for complex operations. It’s the same in federal clinics: nowhere are there personnel who could provide high-quality care for a child for a long time. A nurse can change a diaper, give an injection or a drip, but she will not slowly spoon-feed the child, turn him over, do gymnastics, light massage, she does not have time for this.
I have seen children who had tubes placed only because there was no one to spoon feed them. Young children get used to eating through a tube, they don’t develop a chewing reflex, and then many of them remain on tubes.”
Kristina was lucky - the foundation agreed to have her examined at the Moscow Research Institute of Pediatrics, hired a nanny, and the director of the orphanage allowed the foundation to treat the girl. Christina spent a year and a half in Moscow. During this time, a shunt was installed in her head, her kidneys were treated, the tube was replaced with a gastrostomy tube, and finally, neurosurgeon Dmitry Zinenko performed a unique operation to reduce Christina’s head. “After each operation, long-term rehabilitation was needed, and all this time Christina had a nanny with her,” says Lyudmila Ushakova. “She gave her a lot, every day she verticalized her according to the recommendations of rehabilitation specialists, taught her to hold her head, the girl began to eat from a spoon, develop, socialize . All this contributed to her rapid recovery. No public clinic can provide such high-quality child care - it’s expensive and requires different staffing.”
After the foundation found a family for Christina in 2021, the girl got back on her feet. Looking at her now, it’s hard to believe that just two years ago she was lying in bed with a big head and couldn’t even sit up. “Christina’s quality of life has increased, and many children with this diagnosis lie in bed all their lives and die very early,” says Lyudmila Ushakova. “It turns out that often accompanying a child without parents to the hospital is a matter of life and death.” In 2021, the “He Needs You” Foundation monitored the federal data bank of orphans and children without parental care (FBD) and found 300 profiles of children with noticeable hydrocephalus, 100 of them were in critical condition. “We contacted the Ministry of Health, and we were told that, according to official data, more than 700 children with hydrocephalus live in orphanages,” says Lyudmila Ushakova.
The charity foundation “He Needs You” found a nanny for Christina. After the operation, the girl was found an adoptive family
Photo: Olga Allenova
The Road of Life charity foundation also often comes across stories of children who did not receive high-tech treatment in their time. “Children with hydrocephalus and spina bifida need to undergo operations in very early childhood, up to three years, and high-quality care during such operations is extremely important,” says Anna Kotelnikova, director of the foundation. “If the operation is not performed, disability occurs, as a result of which the child will no longer be able to develop fully.
In all the regional orphanages where we have been, there are such children - they are already big, they spend their whole lives in bed, and it is no longer possible to radically help them. We take them to federal clinics, hire nannies for them, they have quota operations, their quality of life improves, but they will never be able to even sit - it’s too late.”
Recently, “Road of Life” received a letter from a volunteer who told about a resident of the orphanage, Angelina, who was denied medical care by decision of the director of the institution. “Angelina lives in one of the Russian regions, she has very severe scoliosis, literally a hook-shaped back,” says Anna Kotelnikova. “The director of the boarding school sent her, accompanied by a teacher, for a consultation at the Turner Institute in St. Petersburg. After the consultation, the specialists said that the girl would need several operations, after each one - traction and rehabilitation, that is, the treatment would take three to four months. Having learned about this, the director refused to treat the girl. We contacted her, and she explained her position to us by saying that she does not have extra employees who can be sent to St. Petersburg for four months.” A family was found for Angelina who is ready to get the operations the girl needs and take care of her in hospitals. But there are many orphans in the country that the funds do not know about. “Our foundation treats many children with advanced neurological diseases - hydrocephalus, spina bifida, as well as severe scoliosis, cerebral palsy,” says Anna Kotelnikova. “At one time they did not get treatment for the only reason: they had to be nursed for a long time, but there is no escort for them. Many of them are children with intact intelligence. The lack of quality medical care leads to their condition deteriorating, and all that awaits them in the future is a boarding school for adults.”
“Or I might not live long enough”
In Russia, the law does not oblige the management of an orphanage to organize accompaniment of a child in its care in the hospital
Photo: Children's Charity Foundation “Sunny City”
There are indeed many children with orthopedic disorders living in orphanages, confirms the president of the regional public movement “St. Petersburg Parents” Lada Uvarova: “In St. Petersburg, children undergo severe operations on tendons, but after them we need to make sure that the child’s orthoses (orthopedic products) do not come off to fix the joints. — “Kommersant” ), you need to work out his muscles, and you also need to wash the child, comb his hair, change him into clean clothes, talk to him, sometimes just comfort him if he is in pain. This is not treatment, this is care, and hospitals don’t have it.”
Lada Uvarova talks about her adopted daughter, who at the age of seven broke her leg and was hospitalized: “She then still lived in an orphanage, and no adults were with her. She wanted to go to the toilet, but no one came to her, as a result the child relieved himself in bed, and this is still the most terrible memory for her.”
According to the expert, orphans get sick in the same way as their parents’ children, and sometimes more often due to weakened immunity. And they need the same operations that pediatric surgeons perform throughout the country, but very often their right to quality and timely medical care is violated. “The child had an operation on his intestines, and he has to be given pureed food by the spoonful, and also persuaded to eat, because everything hurts,” Lada Uvarova continues. “And the nurse puts him a plate of pasta. In the oncology department, after surgery or chemotherapy, an adult must follow the child, monitor nutrition, cleanliness of hands, and the operation of the infusion pump (an electronic device for dosed administration of drugs. - “Kommersant” ). Without such support, all treatment may be meaningless. That’s why doctors don’t take unaccompanied children for operations.” “St. Petersburg Parents” has a staff of nannies who can stay with orphans in hospitals. But this is a charity program, largely funded by private donors. Sometimes a public organization receives a social subsidy from the city, which partly covers the costs of hospital nannies, but last year they didn’t give the subsidy, and “they had to get out of it.”
One day, Uvarova saw a baby with a severe heart defect in a child’s home; he was hospitalized several times, but each time, while preparing for surgery, he fell ill and was returned to the institution. “I asked: “What if he dies?” — she recalls. “The director answered me: “What can I do?” We found a nanny who lived with this boy in the hospital for a month; she wore him in a warm scarf and nursed him. The operation was performed, the child is already in the family. Or I might not live.”
According to Federal Law No. 323-FZ “On the fundamentals of protecting the health of citizens in the Russian Federation,” when a child is hospitalized in a medical hospital, a parent, guardian or family member can be with him. This right is provided free of charge during the entire period of treatment, regardless of the child’s age. The guardians of orphans and children left without parental care and living in orphanages and orphanages are the heads of these institutions, and they do not stop fulfilling their duties, even if the child is in the hospital. This means that directors, like ordinary parents, are obliged to take care of the interests of the child in the hospital - organize support, monitor treatment. But this does not happen, because the institutions do not have enough staff and not every employee is ready to go to the hospital with a pupil.
This state of affairs violates the rights of children, experts are convinced.
“Perhaps our officials should imagine their children or grandchildren in a hospital room all alone”
Charitable foundations in federal cities hire nannies for orphans in hospitals
Photo: Anna Galperina / “Road of Life”
In addition to orphans in need of treatment, healthy children removed from their families often end up in hospitals. Marina Aksenova, director of the Novosibirsk charitable foundation “Sunny City,” has been talking about this aspect of the problem for a long time. In its region, the foundation achieved that children removed from their families and not showing any symptoms of illness were directly placed in orphanages. But in the rest of Russia everything happens differently.
The UN Convention on the Rights of the Child states that “a child who is temporarily or permanently deprived of his family environment or who, for his own best purposes, is unable to remain in such an environment, has the right to the special protection and assistance provided by the State.” In Russia, the state’s “special protection and assistance” means that children taken from their families or found by the police and declared neglected are placed in a hospital - regardless of the presence or absence of medical indications. No federal law obliges government officials to place healthy children who have lost parental care in the hospital, but Order No. 633 of the Ministry of Internal Affairs of August 20, 2003 offers such a solution, and officials use it. At the same time, the length of stay of a neglected child in a hospital is also not regulated by law. According to Federal Law No. 120-FZ “On the fundamentals of the system for preventing neglect and delinquency of minors,” guardianship and trusteeship authorities are required to establish the status of a child who has lost parental care within 30 days and transfer him to an orphanage institution or to a family. In practice, children may stay in hospital much longer. In many regions, abandoned children are placed in isolation wards, where they become infected with infectious diseases from other children. Thus, the child can stay in the hospital for three months or six months until he gets sick.
“One official told me, just think, the child will stay in the hospital for a month, nothing will happen to him, but this is terrible! - says Marina Aksenova. “A child without medical evidence should not be in the hospital, he takes someone else’s place, he diverts funds, but most importantly, this damages his physical and mental health.
The child already experiences severe trauma from the fact that he is deprived of his family, and he is also placed in a hospital where there is no care for him. Nurses are not obligated to care for children, they are only obligated to treat them.”
According to Lada Uvarova, the practice of placing healthy abandoned babies in hospitals is based on officials’ misunderstanding of child psychology and the importance of parent-child relationships. “There should be a close adult next to the child, otherwise the child experiences severe stress and trauma, which can then affect his psyche and further development,” says Uvarova. “Perhaps our officials should imagine their children or grandchildren at the age of two in a hospital box all alone".
Not all regions have funds that can hire hospital nannies for orphans. Because of this, many children who need high-tech medical care do not receive it
Photo: Anna Galperina / “Road of Life”
In 2021, the Naked Heart charity foundation published a book in Russia by foreign researchers Charles Nelson, Nathan Fox and Charles Zina, which talks about scientific research conducted by American and British scientists in Romanian orphanages, as well as in foster families at the turn of the 20th century. XXI centuries. Its results showed that the group education system negatively affects all areas of a child’s development - physical, cognitive, linguistic, social-emotional. “This influence can be traced at different levels: behavioral patterns, the ability to build relationships with others, brain development, and even negative changes at the genetic level,” the book says. The longer young children were without a close adult, the more disorders scientists discovered in them.
“Two problems need to be solved,” summarizes Marina Aksenova. “Firstly, do not place small children without medical indications in a hospital, but place them directly in orphanages, because these are also medical institutions, there are doctors and nurses there. And secondly, it is necessary to create a service to accompany children in hospitals who are left without parental care and in need of medical care.”
“The service of accompanying orphans in hospitals must appear”
NGOs have been talking about the problem of accompanying orphans in hospitals for the last 20 years. In 2021, it would seem that the problem was attracted to the attention of the federal center: the Ministry of Education of the Russian Federation held several round tables with the participation of NGOs and representatives of relevant departments. In 2019, a working group under the Ministry of Education adopted a resolution stating that orphans and children without parental care, identified by the authorities and who do not have medical indications, do not need to be placed in a hospital. The resolution also spoke of the need to create a social system in the country.
In October 2021, the commission on organizing public control over the implementation of action plans carried out within the framework of the national project “Decade of Childhood” (operates under the President of the Russian Federation) instructed the government to change the existing practice of identifying children who have lost parental care in hospitals in the absence of medical indications, as well as “to develop a regulatory framework in the field of providing, accompanying and supervising children in institutions for orphans and children in difficult life situations who are being treated in inpatient medical organizations.” These instructions were not carried out.
Even large foundations do not have enough funds to provide care for all orphans in need of hospital care
Photo: Anna Galperina / “Road of Life”
Instead, in December 2021, the Ministry of Education developed changes to the 481st government resolution on the activities of orphanages, which obligated the directors of such organizations to organize support for their wards in hospitals. However, these changes were not made - according to Marina Aksenova, after the January resignation of the Russian government, specialists who worked in the Ministry of Education with the problems of orphans left for other positions in the government and “the issue hung.” At the same time, she is convinced that shifting the responsibility for accompanying orphans in hospitals to the management of orphanages and orphanages will not solve the problem - they still, in fact, bear such responsibility.
The service of accompanying orphans in hospitals must appear, and a hospital, an orphanage, or an NGO can act as its provider,” says Kommersant’s interlocutor.
On January 22, 2021, at a meeting between President Vladimir Putin and representatives of public organizations, Marina Aksenova spoke about the problem of “hospital orphans.” The President instructed the government to “analyze the practice of placing orphans and children without parental care in medical organizations and, based on the results obtained, develop a procedure for the early placement of such children in appropriate social or educational organizations”, as well as “develop a procedure for the provision of social services related with supervision and care for children left without parental care, placed in medical organizations for treatment, providing for the possibility of providing such services by non-profit organizations.” Prime Minister Mikhail Mishustin was appointed responsible for the execution of the order; the deadline for execution of the order is July 1, 2021. However, the deadline has passed and the problem has not been resolved.
“So far our state is coping with the parental function very poorly”
Today, the services of hospital nannies for orphans are provided only by NGOs thanks to private donations. They hire nannies, but cannot count on compensation from the state, and there are not enough charitable funds for all the children who need hospitalization. “The service itself is not in the law, so it’s unclear what we are doing,” explains Marina Aksenova. A draft service for accompanying and caring for children in hospitals has already been written by the charitable organizations “Sunny City”, “Change One Life”, “St. Petersburg Parents” together with the Public Chamber of the Russian Federation. It states that the service provider can be a legal entity or an individual entrepreneur.
Recipients of the service are orphans and children without parental care, whose legal representatives are orphan organizations or guardianship authorities, as well as children temporarily placed in such organizations at the request of their parents and in need of treatment in a medical hospital. The goals of such a service are defined as “providing comfortable, safe conditions for children; improving the social and living conditions of children’s stay in a medical organization; constant presence near children; helping children." Fulfillment of these goals, according to the authors of the project, will lead to an increase in the quality of life of children, a decrease in the level of disability, an increase in the effectiveness of treatment and a faster recovery of children, as well as their psychological comfort. To finance the service, the authors of the project propose to use funds included in the budget of orphanages for medical care; special regional programs guaranteeing the provision of free medical care; voluntary property contributions and donations from legal entities and individuals; government subsidies to non-profit organizations. The draft also specifies the maximum workload for a care specialist (no more than six children per specialist) and the conditions for allowing such specialists to work (medical examinations, psychiatric examination, no criminal record).
According to monitoring data from the Public Chamber of the Russian Federation, in 2015–2017, inpatient medical care was provided to 41,899 orphans and children without parental care. In the Novosibirsk region alone, more than 1 thousand children receive inpatient care services annually (1,077 in 2019). In fact, there are more children in need of hospital treatment, but not all of them can receive such help.
“The amendments to the Constitution adopted on July 1 say that the state assumes the parental function in relation to children left without parents,” summarizes Marina Aksenova. “But not a single parent would leave their child without medical care, not a single parent would I would abandon a small child in a hospital without attention and care. So, so far our state is coping with this parental function very poorly.”
On July 7, “Sunny City” wrote a petition demanding the creation of a service for accompanying orphans in hospitals and a ban on placing children there without medical evidence. In two days, more than 1 thousand people signed it.
Olga Allenova
https://www.kommersant.ru/doc/4408522
The right to receive information about the patient’s health status
The parent has the right to receive information about the child’s condition. Information must be provided in an understandable form. The data includes examination results, information about diseases and established diagnoses. In addition, adults must be informed about the prognosis for the development of the disease, treatment methods and the risks associated with the measures.
A mother or father should not be afraid to ask questions about the condition of their child. The attending physician must inform the legal representatives of each action he performs. Children who are already 15 years old can request and learn about the nuances of their condition themselves.
Particular attention should be paid to such a concept as the accessibility of the form for providing information. This action is the communication by a hospital employee of information about the patient’s condition to the parents using accepted medical terms. After this, the information must be deciphered in a language understandable to a lay person so that the latter understands what is being said.
According to the law, a parent can familiarize himself with all official acts related to the health of his offspring. The list of such documentation is unlimited.
How to entertain a child
For babies under two years old, take:
- Toys (they should not be too noisy, brightly glowing, etc., so as not to disturb other children and not cause fatigue with sharp monotonous sounds, melodies or light effects).
- Age appropriate books.
- Something that can be torn, crushed, twisted, thrown: paper, napkins, a small light ball or a crumb cube (it’s convenient and safe to throw it to each other).
- Tablet for drawing. It's good because it doesn't get dirty.
For older kids, life will be brightened up by:
- Books with good illustrations.
- Various mosaics and constructors
- Stringing kits
- Everything for drawing: paper, pencils, markers, etc.
- Kits for simple handicrafts: paper folding, glue-based applications,
- Plasticine. It is advisable to provide a board for modeling. It will allow you to sculpt even while sitting on the bed and will not stain hospital furniture or clothes.
- Well, and, of course, toys. In addition to your favorite ones, I advise you to buy one or two new ones, which can keep your sick baby busy for a long time and provide good entertainment. But it is advisable to save them for especially sad or difficult moments.
- Board games.
I advise you to take all this with a reserve: perhaps your roommates will want to join your games, especially if they are alone, without their parents. Longing children often “flock” to a benevolent adult who will help and support and, to some extent, replace their absent parents. Therefore, if you are lying with a child, be prepared to take care not only of him, but of all children.
Is it possible to refuse medical intervention?
The citizen responsible for the minor has the opportunity to refuse any procedures. If the attending physician proposes to perform procedures, he must obtain appropriate permission to do so. The document is drawn up in the form of voluntary consent to medical intervention and signed by the parent. The paper is also endorsed by the doctor who monitors the patient and prescribes appropriate treatment.
Important! Before signing the papers, a person must carefully read their contents and talk with the doctor treating the minor. In this case, it is important to understand all the manipulations that will be performed on the minor. If any of the terms remains unclear to the parent, you need to ask a specialist to explain its meaning.
What to do during planned hospitalization
Photo: depositphotos/IgorVetushko
During planned hospitalization, the mechanism for providing child care is slightly different. You should notify the relevant services in advance and independently.
Contact your nearest family center
There are 30 family centers in Moscow - in every district of the capital. If you understand that you are facing hospitalization or a long trip on which you cannot take your child with you and have no one to leave him with, then contact one of the organizations. It is advisable to choose the nearest center.
You can also contact the hospital or guardianship authorities with a corresponding request. They will help you find suitable solutions to the current situation.
List of documents
Of course, they won’t just take a child to a family center. It will be necessary to provide his passport or birth certificate, or the parent’s own passport. If we are talking about a guardian, he will need to show a document that allows him to represent the interests of the child.
You will also be asked to submit an application for social services, as well as a document confirming their need: a referral for hospitalization, a doctor’s certificate, a travel certificate, and so on.
Time for confirmation
Specialists will also need time to check all submitted documents, find out the situation in the family, and confirm the reasons and circumstances of contacting the family center. Then they will set the time for which the child needs to go to the institution. And only after this the child will be able to move to the family center.
As in the case of emergency hospitalization, the parent will be able to calmly maintain contact with their child. And as soon as the opportunity arises, take him home.
While a child is in a family center, he is provided with state support, which includes six meals a day, clothing and shoes according to the season and age. Schoolchildren continue to attend classes, children have the opportunity to meet and communicate with their relatives. The institutions also organize a leisure program, and, if necessary, provide medical and psychological assistance.
Hospital conditions
The living conditions of a hospital stay vary. It can be:
- Boxed wards if the child is in the infectious diseases department. Such a department should have a separate entrance from the street, a room where the patient is located, a bathroom and an entrance from the department for medical staff. In this way, isolation of the infectious patient is achieved.
- Single or double rooms with a separate bathroom (boxed rooms). Here you can isolate a seriously ill patient, a patient with a high temperature or with a suspicion of an incipient infectious disease to prevent the spread of infection in the department.
- General (multi-bed) wards. Usually in the children's department such wards are designed for three people of the same sex. There are beds, a separate bedside table for each child, a table, and chairs.
The department has a toilet (toilets and (or) potties) for girls and boys, a bathroom, shower, and a dining room. The non-infectious department has a games room.
The work schedule of the children's departments of the hospital is structured differently, depending on the specifics of the hospital (the work schedule of the departments is always posted). What is common is that in the first half of the day, planned diagnostic and therapeutic procedures, operations, dressings, doctors visiting patients, and doctors talking with parents or relatives are carried out. Meals in the departments are four times a day: breakfast, lunch, afternoon snack, dinner. The exception is the departments for newborn children, where the feeding regime depends on small patients.
In the reception department
In the emergency department, a medical history is drawn up for each patient. The emergency department doctor talks with parents, clarifies complaints, and finds out the history of the disease. The doctor also needs information about the child's development. It is important to know how the pregnancy, childbirth proceeded, how the child developed in the first year of life (what kind of feeding the baby was on, whether he was sick until he was a year old, when he began to hold his head, sit, stand up, walk, when he began to talk). It is important to know whether the child has received all age-appropriate vaccinations and when.
It is necessary to inform the doctor of the emergency department about childhood infections suffered by the baby (chickenpox, measles, rubella, scarlet fever, etc.), acute and chronic diseases, injuries, operations, and cases of intolerance to any medications or products (if any). It is also necessary to know about chronic diseases of close relatives, since many diseases have a hereditary predisposition.
Note that when a child is admitted in serious condition, the questioning procedure (history collection) can be reduced to a minimum, since it is important to quickly begin treatment, sometimes even in the emergency department.
To clarify the diagnosis, blood and urine tests can be taken and examined at the emergency department using express methods, and, if necessary, X-rays can be taken. With a completed medical history, the child is taken to the department on foot or on a gurney if the condition is serious.
Directly in the department, the child is examined by the department doctor (if the child is admitted during the day) or the doctor on duty (if the child is admitted in the evening or at night), and prescribes an examination for treatment. The attending physician, like the emergency department doctor, must talk with the parents, collect and record detailed information about the child’s life history and illness.
