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Your Visit Here

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Whether your child is coming to Duke Children's Hospital & Health Center for a surgical procedure, routine check-up, or an extended stay, we want to make sure you have all the information you need to help make being here as convenient and pleasant as possible for you and your child.

For detailed information about what to expect during your visit to Duke Children's, read the sections below.

Outpatient Appointments

At Duke Children's, your child will receive compassionate care provided by our team of experienced healthcare professionals. Nurses, technicians, and trainees may assist your child's doctor during your visit. All members of our healthcare team are dedicated to providing the best care for your child during his or her stay.

Length of Your Child's Visit

Please allow ample time for your child's appointment--typically, one to two hours. Your physician will spend as much time as needed to ensure that your child receives the appropriate level of care.

Checklist for Your Child's Visit

The following list will help you remember items and information to bring with you to your child's appointment:

  • Doctor's or specialist's name
  • Location of appointment and telephone contact number
  • Name and telephone number of your referring physician
  • Referrals or authorizations from your child's primary care doctor's office
  • Insurance card(s)
  • Your child's Social Security number (for insurance)
  • Co-payment for your insurance, if applicable
  • Medical records (consultation, operative, radiology reports)
  • A list of all medications the patient is currently taking (including supplements and over-the-counter (OTC) medications
  • Radiological films (CT, MRI, X-ray), if appropriate
  • Any forms you were asked to bring with you
  • A list of questions you may have for your child's doctor
  • Books, games, snacks, formula, diapers, change of clothes, as appropriate

Preparing Your Child

To help you and your child adequately prepare for your visit to the hospital or doctor's office, see our guidelines for preparing your child for the hospital.

How to Schedule an Appointment

To make an appointment, please visit our Patient Services section for the appropriate contact information.

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Inpatient Visit

At Duke Children's Hospital and Health Center, we understand that the process of diagnosing and treating your child's illness can be stressful and confusing. If your child is being hospitalized, we can provide some information to help you prepare your child for the experience. We also offer some basic information that will help you to familiarize yourself with services and amenities that are available to make your child--and you--as comfortable as possible during his or her stay.

You also may want to speak with the Child Life Specialist who works on the floor where your child will be staying. Child Life Specialists can provide you with detailed information about what to expect during your child's stay at Duke Children's.

If your child has been exposed to a cold or a contagious disease, such as chicken pox, measles or mumps, or is sick just before the day of admission, please call your child's doctor or healthcare provider at Duke Children's. You may need to reschedule your admission and appointment.

Admission (Checking In)

Your child's doctor will tell you on what day your child will be admitted to the hospital. Please discuss with your child's doctor any special steps that must be taken before admission.

A nurse will call you the day before to give you the time you and your child should arrive at the hospital. The nurse will also review a Checklist for Your Child's Visit to ensure that you arrive with all the necessary information and personal belongings you will need to check in. We will try to meet your needs during the admission process, but you may experience delays while waiting for your room. We regret any inconvenience.

Each patient gets an identification (or "ID") band when checking into Duke Children's. The band contains important information about your child that helps us meet his or her individual needs. If your child's band is removed, falls off, or becomes uncomfortable, let your nurse know immediately.

Discharge Day

You and your child's healthcare team will begin planning for your child's discharge as soon as you arrive. The team will help you understand your child's care at home and help you identify community resources available to you. If any prescriptions are required, they will be given to you or another adult member of your family the night before discharge. Please ask your nurse or physician if you have any questions about your child's care after your hospitalization.

A family member should be available to take your child home at discharge time. If your child is an infant or toddler, please remember to bring a safety seat.

Billing and Insurance Questions

We understand that billing and payment for health care services can be confusing and complicated. We are here to assist you with information on how we process your bill(s). Please visit Patient Billing on DukeHealth.org for detailed information to help you understand what we can do to assist you, what you can do to assist us and your insurance plan, and how we can help if you have difficulty paying your bills.

Healthcare Team

During your hospital stay, many health care professionals may see your child. These include physicians, nurses, technologists, physician extenders, medical students, physical, occupational and speech therapists, respiratory therapists, dieticians, radiology technologists, laboratory technologists, phlebotomists (experts who draw blood), social workers, and child life specialists. All members of our healthcare team are dedicated to providing the best care for your child during his or her stay.

Physicians

Several doctors may be involved in managing your child's care. The physician who is chiefly responsible for the care your child receives during his or her hospital stay is known as the "attending physician." This senior physician works with other Duke physicians as needed to ensure your child gets the appropriate treatments and therapies. He or she will also keep your child's primary care physician or referring physician informed about hospital treatments, follow-up care, and other information that will be needed after your child returns home.

Residents

Residents are physicians who have completed medical school and are training in a specialty, such as pediatrics or surgery. Interns are residents in their first year of training. Because Duke Health System is a teaching facility, resident physicians play a valuable role in providing care to your child under the guidance of a senior physician.

Nurses

Our professional nursing staff provides constant, personalized care and support to pediatric patients and their families. The registered nurse coordinating your child's care will keep you informed of progress and be available to answer questions about treatments or hospital services. Nursing attendants will be working in conjunction with the nursing staff, helping to feed your child, taking vital signs, or helping your child to walk.

Therapists

Therapists specially trained in physical therapy, occupational therapy, respiratory therapy, and speech therapy may become part of your child's care plan. Your child's nurse or physician will explain their role in your child's care.

Pharmacists

Pharmacists and pharmacy technicians work closely with your child's medical team to ensure the effectiveness of all drug therapies.

Health Unit Coordinators

The Health Unit Coordinator (HUC) stationed in each patient unit schedules many of your child's special tests, orders supplies, and answers the unit telephone. The HUC can help you contact your child's physician or nurse and can direct you to other individuals or departments for answers to any questions you may have.

Patient Resource Managers

The Patient Resource Manager works closely with the physicians and healthcare team to coordinate your child's care throughout their hospitalization and to make sure you have the resources you need once you leave the hospital.

Child and Adolescent Life Specialists

Trained Child Life Specialists provide psychosocial and emotional support for pediatric patients and their families. This support is designed to foster a positive health care experience. Knowing what to expect can help children cope more effectively with their hospitalization and treatments. Child Life Specialists also provide age-appropriate information to children about surgical, diagnostic, and medical procedures and help children and families cope with the child's illness.

Patient Representatives

The Patient Representative serves as a link between you and your child's health care team. They can inform you about patient rights and responsibilities, hospital procedures, policies, resources, and services. The patient representative can assist you with resolving questions or concerns you may have about the care your child is receiving.

Social Workers

Clinical social workers are available to help your family manage the stresses that may be associated with your child's illness. They are also available to help make arrangements for your post-hospital care, including home health care or out of home placements. Clinical social workers can provide the following services:

  • Assessment of you and your family's situation
  • Current needs crisis intervention
  • Individual, family or group counseling
  • Planning for your post-hospital needs
  • Information about and referral to available community resources and/or financial assistance
Volunteers

Duke Children's Hospital has many devoted volunteers who read and play games with our patients or assist with meals. If you feel that a volunteer could help your child in some way, please inform your child's nurse.

Your Room

Each regular pediatric room has a bed for your child, a recliner chair for one parent to spend the night (it opens out flat to become a twin bed with linen provided), a TV, telephone, VCR, a small apartment refrigerator and a private bathroom. A "privacy curtain" inside your room door can be closed when needed.

Almost all rooms are private. There are several semi-private rooms for some overnight patients. In semi-private rooms, a parent can still stay with their child. Beds are assigned by availability and medical/surgical need. This is not based on insurance or request.

TV & Telephone

All patient rooms are equipped with a television and VCR, and you are welcome to bring your own videotapes from home. Duke Children's Hospital provides age-appropriate television programs on our closed-circuit television system, which includes educational programming as well as several in-house channels dedicated to Duke Hospital patient information needs. Your doctor or nurse will tell you if there is a particular program you should watch, and you are welcome to watch any patient education programs as your time and interest permit.

Children's health programming can be found on Channel 33. You may also wish to view Channel 9, a special channel featuring the cultural resources of North Carolina, with emphasis on our writers and visual and performing artists. The program listings for the patient education channels can be found in your child's room. If you need help with your television, please ask your nurse. Check DUMC-TV2, the Patient Information channel, for updated channel listings.

Local phone calls can be made from your child's room. For long distance calls, the parents of inpatients can either purchase a phone card or use cell phones in the elevator core and lobby area of the hospital.

Meals and Nutrition

Duke Children's Hospital provides patients with quality foods to accommodate individual preferences. Unless your child is on a special diet, he or she selects meals each day for the following day. Should your child have special dietary needs, a dietitian will visit to discuss his/her meal plan. Because nutrition is an important part of your child's care, please let your nurse know if you or other visitors bring your child any food. This will help prevent any interference in your physician's plan for your child's care.

Hospital Safety Policies

Gifts

Gifts can do a lot to cheer up a hospitalized child. Flowers, toys, stuffed animals, books, and games are terrific items to give a patient. Because Duke Children's Hospital is committed to ensuring a safe environment for patients and their families, mylar (metallic) balloons are welcome and make a hospital room brighter and more colorful. However, latex (rubber) balloons are prohibited because such balloons are a choking hazard for young children and can cause allergic reactions for patients and staff. Thank you for your understanding. Also, please note that flowers are not allowed on some intensive care units.

Valuables

Please leave all valuables at home. Items such as jewelry, expensive toys, clothing, or excessive cash should not be brought to the hospital. Duke Children's is not responsible for the loss or damage to any personal property kept in your child's room. If you must keep valuables with you, please contact Patient Access Services at Duke Hospital at (919) 681-2002, weekdays until 4:30pm to arrange for safekeeping.

Electrical Appliances

Electrical appliances from home are not permitted on patient care units. Special permission may be granted in some instances. All electrical appliances brought from home must be examined by the Biomedical Engineering Department prior to use.

Cell Phones

The use of cellular phones is allowed in the elevator core and lobby area of the hospital, but is prohibited in some areas of the hospital, such as patient care areas. If in doubt, please inquire with hospital staff before using a cellular phone.

Smoke-Free Environment

The use of tobacco products will not be permitted inside or outside any Duke Medicine hospital campus, outpatient facility, physician or administrative offices, or medical and nursing schools. By providing a tobacco-free environment for our patients, visitors, physicians, and employees, we are doing our part to promote good health.

Preparing Your Child

To help you and your child adequately prepare for your visit to the hospital or doctor's office, see our guidelines for preparing your child for the hospital.

What to Bring

Packing for a hospital visit is an important part of preparation. Have your child help by identifying what they want to bring. Making choices helps your child feel in control over the situation and helps your child get involved with the process of hospitalization. This can also help add a sense of adventure rather than a sense of fear to the hospitalization experience. Some important items to pack include:

  • toys, games, books, audio or videotapes and photos
  • a favorite stuffed animal or blanket, and pillows
  • glasses, hearing aids, crutches, braces, corrective shoes, or other orthopedic aids
  • medications your child is currently taking and a list of those medications
  • toothbrush and toothpaste
  • hair brush/comb
  • pajamas, socks, underwear
  • diapers, formula, pacifier (if appropriate)

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Surgery Visits

Preparing Your Child

If your child has been scheduled for surgery, our caring team of pediatric surgeons, anesthesiologists, and nurses will help you and your child understand the process and be as prepared for the experience as possible.

To help you and your child adequately prepare for your surgery visit, please review our guidelines for preparing your child for the hospital. By reviewing this section, you will learn what part of surgery may be most stressful for your child, the various ways to prepare your child--and his or her siblings--for the upcoming surgery, and the possible emotional reactions your child may express.

Pre-Admission Visit

If your child has been scheduled for surgery, and you would like some professional help in explaining what will happen in the hospital, our Child and Adolescent Life Specialists recommend that you, your child, and siblings take a tour of the hospital to learn about the hospital in a friendly, non-threatening way.

During your pre-operative tour, your child will meet our staff and become familiar with every area of the hospital that they will see from the moment they arrive on the day of their hospitalization to discharge day. Both you and your child will have the opportunity to ask questions throughout the tour.

Teenagers are also encouraged to take a preoperative tour, which will be specifically geared to their age group.

To schedule a tour, call the Child and Adolescent Life Office at (919) 681-4349.

The Day Before Surgery

A nurse will call you the day before your child's surgery. During this call, she will tell you what time to arrive and what you need to bring. The nurse will also will let you know at what time your child can no longer can have any food or drink and will answer any other last minute questions that you have.

In addition, your nurse will do an assessment, asking you general health questions about your child, his or her immunization status, and other routine questions.

If your child has been exposed to a cold or a contagious disease, such as chicken pox, measles or mumps, or is sick just before the day of admission, please call your child's doctor or healthcare provider at Duke Children's. You may need to reschedule your admission.

The Day of Surgery

Please arrive for your child's surgery at least 90 minutes prior to the surgical time. Valet parking service is available in front of Duke Children's Hospital on Erwin Road. If you are going to be late, please call the contact number of the preoperative area that has been provided to you. If your child has become ill overnight, please call the contact number of the preoperative area.

Remember that it is important that your child's stomach is empty prior to surgery. Follow the guidelines that were given to you during the preoperative screening visit. Otherwise, the surgery may have to be postponed.

A parent or legal guardian who is capable of signing consents on behalf of your child must be with the child before, during, and after the operation.

Please limit the number of people that will be present during the preoperative period, especially young children who may make the waiting period more difficult. For the safety and comfort of our young patients, children who are not having surgery will not be allowed in the preoperative area or the recovery room.

Check-In / Preoperative Evaluation

You and your child should arrive at the specified location and check in to the reception desk. It is important to arrive on time for surgery. You will be given an arrival time that is 90 minutes prior to actual surgery time. This time is used for processing your child's chart, preoperative evaluation, and discussions with medical teams.

You will then go to the waiting area where there are toys and games. A nurse will meet you and take you and your child to an exam room. There, your child will change into a hospital gown and receive an identification bracelet, which will be worn until he or she is discharged from the hospital. A limited number of lockers are available for personal items.

The nurse will conduct a brief examination, including taking your child's temperature and blood pressure, measuring height and weight, and listening to his or her heart through a stethoscope.

You and your child will then return to the play/waiting area. At some point, your surgeon will come and take you to a private area to speak with you and your child.

Pediatric Anesthesiologist

You and your child will also meet with the pediatric anesthesiologist. Please let the anesthesiologist know if anyone in your family has had reactions to anesthesia. The anesthesiologist will discuss the way in which the anesthesia will be administered--either by breathing through a mask (most common method) or intravenously.

Consent Form

You probably will already have signed a consent form in the surgeon's office. If not, then you will be required to sign one in the hospital before the surgery.

Going into the Operating Room

In most cases, we encourage parents to accompany their child into the operating room where they can remain until the anesthesia takes effect. Because there may be situations where this is not advisable, the decision for a parent to be present is individualized and is made by evaluating factors like the child's age, developmental stage, emotional status, and degree of anxiety.

If you do plan to go into the operating room with your child, you will need to put on a special cover-up over your clothing, as well as a cap, shoe covers, and a surgical mask, which you will be given before you can enter the operating room. You will be able to stay until the anesthesia has put your child to sleep. You must then leave the operating room and go to the parents' waiting room.

Following Surgery

After surgery, your child's surgeon will meet with you to discuss the outcome of the surgery. Soon after this discussion, your child will be taken to the Post Anesthesia Care Unit (PACU) or recovery area. Up to two adults will be allowed in the PACU during the recovery period. Depending on individual circumstances, a child may need to stay overnight in the PACU for observation.

Overnight Stay

After surgery, your child will either go to the recovery room or to an Intensive Care Unit (ICU). Before the surgery, you will be told where your child will go. If your child goes to the recovery room, you will be notified when you can visit. Both parents may stay in the recovery room until your child is transferred to an inpatient room.

If your child goes to an ICU, you will be asked to wait in the waiting area on the floor where the ICU is located. One parent is permitted to sleep overnight in a special pull-out chair in your child's room.

Day Surgery

If your child is going home the same day of surgery, you will be able to stay with him or her in the recovery room until he or she has recovered. Your child will then be moved to a short-stay recovery area. Once your child has recovered sufficiently from the anesthesia and can drink some liquids, he or she will be able to go home.

You will be given instructions about your child's diet, activities and medications. You will need to call for a follow-up appointment.

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Preoperative Clinic Visits

The preoperative screening visit allows the healthcare team to fully evaluate your child prior to the surgical procedure. It also allows you and your child to become more familiar with the perioperative process and to have questions answered. This visit may vary in length depending on the workup that is required for either your child's medical condition or the surgical procedure. Please bring items, such as your child's favorite security object (stuffed animal, blanket, pacifier, special toy), videotapes, DVDs, games, or books with you to make the wait easier.

There are three locations where preoperative screening visits may occur depending on the surgeon and where the surgery will be performed:

  • Children's Health Center (CHC), 3rd floor
  • Clinic 2D in the Duke Clinic Building, within walking distance of the CHC
  • Duke Eye Center

Please make sure to check the proper location with your child's surgeon.

History and Physical

During the preoperative screening visit, you will meet either a nurse practitioner (NP) or physician's assistant (PA), who will perform a history and physical. The medical history is an important part of your child's visit and will be most helpful if you are able to provide detailed information regarding past and present medical illnesses, operations, allergies to medications, and any medication your child is currently taking.

A physical examination will be performed that will be similar to an exam that might be done in a pediatrician's office. This exam will focus on the pertinent information given in your child's history and will include a set of vital signs and examination of the heart and lungs.

Laboratory Testing

Blood tests may be performed during the preoperative screening visit if the medical condition or the type of surgery requires these tests. The blood tests would be performed by a technician on the preoperative screening day so that the results would be available prior to surgery.

Additional testing may include a urine sample, X-ray, electrocardiogram, breathing tests, or radiology scans. This depends on your child's medical and surgical condition and is not a routine part of every child's preoperative screening visit. If your child has already had these tests done at a clinic or hospital other than Duke Children's, please bring the results with you.

During your child's preoperative screening visit, a medical practitioner will ask you to sign an anesthesia consent form that outlines the potential risks of anesthesia. Anesthesia options may be presented to you during the preoperative visit, however, not all options are appropriate for all children. Your child's anesthesia team will discuss the actual anesthetic plan and the possible associated risks on the day of your child's surgery.

Eating and Drinking Prior to Surgery

It is important that your child has an empty stomach prior to anesthesia. The following guidelines MUST be followed:

  • Your child may have no solid food after midnight the night prior to the procedure, but may have milk or formula up until six hours before arrival time for the procedure, then no more.
  • Your child may have breast milk up until four hours before arrival time for the procedure, then no more.
  • Your child may have clear apple juice, clear grape juice, or water up until two hours before arrival time for the procedure, then no more.

For example, if your scheduled arrival time to the hospital is 11:00am, your child may have formula or milk until 5:00am, then apple juice until 9:00am, then no more.

Illness Prior to Surgery

If your child becomes ill or has been exposed to an infectious disease such as measles or chicken pox within the two weeks before surgery, please call your surgeon's office. The surgical date may need to be postponed depending on the illness and planned surgery.

Child Life Visit

You and your child may have the opportunity to meet with a Child and Adolescent Life Specialist who will provide you and your child with a comprehensive overview that will allow you to become more familiar with the perioperative environment.

You and your child will learn what will occur on the day of surgery and also have the opportunity to explore some of the medical equipment that may be used in the holding areas, operating room, and post-anesthesia care unit (PACU). Your Child Life Specialist will also give you information regarding perioperative routines, intravenous lines, and overnight information. This overview will allow you and your child to become more familiar with the experience so that the day of surgery will be more comfortable.

Frequently Asked Questions

  • Will I meet with my child 's surgeon during the preoperative screening appointment?
    No. Meeting with your child's surgeon will occur during a separate appointment. Some surgeons schedule this for the same day, but this does not always occur.
  • Will I meet with my child's anesthesiologist during the preoperative screening appointment?
    No. You will meet your child's anesthesiologist and anesthesia team the day of your child's surgery.
  • Do I pay for the preoperative screening appointment?
    No. The preoperative evaluation is included in the general surgical evaluation fee. You will, however, be required to pay for parking.
  • Does every child need a preoperative screening appointment?
    No. Your child's surgeon or physician will decide if your child needs a preoperative screening visit. This decision will be based on the medical history and type of surgery. Each child will be evaluated by the anesthesia team the morning of surgery.

    If your child is not required to have a preoperative screening appointment, you and your child will still have the option of taking a tour with a Child Life Specialist. You may contact the Child and Adolescent Life Program for an appointment by calling the Child Life Office at 919-681-4349.

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Emergency Visits

When to Go

If you are concerned about your child's health, you may come to the Pediatric Emergency Department (ED) at Duke University Hospital at any time without an appointment. Our doors are open 24 hours each day, and there are physicians, nurses, and other healthcare professionals trained in pediatric emergencies to care for your child. You do not have to call the Emergency Department before you come.

If your child has recently received treatment in the Emergency Department and you have concerns related to your child's medical health, you may call your primary care provider or you may return to the Emergency Department. Our staff is always available to perform further evaluation, including additional testing, if needed.

What to Expect

Triage

Triage is the process of evaluating the seriousness of your child's illness or injury. When you first arrive, you and your child will be seen by the triage nurse who is specially trained to take care of children in the Emergency Department. This registered nurse will ask you questions about your child's illness or injury, check your child's temperature and weight, and briefly examine your child. It is important to give all the needed information to the triage nurse. If your child has a life-threatening or very serious illness or injury, he or she will be seen by a doctor with the nurse right away.

Registration

After triage, you will usually go to the registration area. The registrar will ask you for information such as your address, telephone number, and health insurance information. This information will help us to contact you or your child's doctor about your child's care. Paperwork necessary for your ED visit will be given to you to complete at that time.

Waiting Area

You may be asked to wait in the waiting area until an exam room or doctor is available to see your child. Please understand that patients may not be seen in the same order of their arrival to the Emergency Department. Patients with the most serious illnesses and injuries will usually be given priority.

A Child Life Specialist will be available to offer activities, answer questions, and help keep you informed. We have many toys, books and videos available. While you are in the waiting area, please do not to give your child anything to eat or drink without checking with the triage nurse first.

Examination

As soon as possible, you and your child will be brought into an exam room. A team of doctors and nurses will care for your child. Your child may be initially seen by a resident physician, who is a medical doctor in training to care for children. Your child will also be seen by an attending physician, who is a medical doctor trained to care for children with emergencies. The attending physician supervises the care of your child. Depending on your child's condition, your doctor may order a blood test, x-rays, or other tests to help determine what is wrong with your child. Each test will be fully explained to you before it is performed.

A top priority in our Pediatric Emergency Department is to make sure each child is as comfortable as possible, and to quickly evaluate and treat pain. If your child is in any pain, please make sure a doctor or nurse is notified.

Discharge

When your child's care is complete, the doctor or nurse will give you instructions on how to care for your child's illness or injury. They will also tell you about follow-up care. If you have any questions after you leave, call the Pediatric Emergency Department at 919-684-8111 or you may also call your child's primary care provider.

Admission to the Hospital

Your doctors may decide that your child needs to stay in the hospital longer for further observation or tests. Arrangements will be made for your child to be moved to an inpatient bed on either our general pediatrics unit or the pediatric intensive care unit as soon as possible.

When your child is admitted, you will be asked to sign forms that permit the hospital to perform tests and provide treatment. At this time, you will also receive information about insurance coverage and the billing process.

If your child needs immediate medical attention and you cannot safely transport your child to the hospital, please call 911 immediately.

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