Supporting children and young people in hospital.

It has long been recognized that hospital admission for children can have deleterious consequences and many children’s and young people’s nurses have endeavored to overcome this. I remember visiting Toronto Sick Children’s Hospital in the late 1980s to learn more about their pre admissions programs, which were designed to inoculate children against the stresses of hospital admission. Such programs were predicated on the knowledge that children who are prepared for hospital procedures cope belter than children who have not been prepared. Mellish (1969), in a seminal paper, indicated that surgical success in childhood must be measured not only through intact wounds but also must include intact emotions. Strategies to ensure this have been implemented in most children’s hospitals and units. However more still needs to be done to ensure that Florence Nightingales mantra of ‘‘first do the patient no harm’’ is actually delivered in all areas where sick children may be cared for. For example In England the National Health Services (NHS) Institute for Innovation and Improvement has developed the 15-Steps Challenge which are a series of toolkits designed to help nurses and others work