Childhood Cancer

Your Child in the Hospital

My Hospital Journal

My name:__________________________

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Date I came to the hospital:__________________________

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Name of the hospital:__________________________

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Before I came to the hospital

What I thought it would be like:__________________________

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What my parents told me:___________________________

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What the hospital tour was like:__________________________

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What I packed:___________________________

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My room

My room number:____________________________

My bed:____________________________

What I see out my window:__________________________

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How I decorate my room:___________________________

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Why I am in the hospital

How my parents describe it:__________________________

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How my doctor describes it:__________________________

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What I think of it:_____________________________

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My doctor(s)

My doctor’s name: ___________________________

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What I call him/her:__________________________

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What I like best about my doctor:____________________________

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My doctor writes a note:_____________________________

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My nurses

My nurses’ names:____________________________

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What I call them:__________________________

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What I like best about my nurses:____________________________

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My nurses write a note:__________________________

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My roommate(s)

My roommate’s name:__________________________

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Why my roommate is in the hospital:__________________________

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Where my roommate lives:__________________________

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What I like about sharing a room:__________________________

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What I don’t like:__________________________

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My school

My teacher’s name:_

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My best friends at school:__________________________

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How my class will know I am in the hospital:__________________________

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How many days of school I am missing:__________________________

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How I do my homework:__________________________

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People who sent me cards or gifts

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Friends’ sign-in sheet

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Relatives’ sign-in sheet

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Meals in the hospital

What I order for meals:__________________________

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Favorite breakfast:__________________________

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Favorite lunch:__________________________

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Favorite dinner:__________________________

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Hospital food I don’t like:__________________________

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Food I can’t have:__________________________

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Places I’ve been to in the hospital

____ Lobby

____ Gift shop

____ Cafeteria

____ Playroom

____ Elevator

____ Operating room

____ Recovery room

____ Nurses’ station

____ X-ray room

Others:__________________________

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What happens at night in the hospital

What it sounds like:__________________________

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When the nurses come in:___________________________

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What nurses do at night:___________________________

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What I like:__________________________

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What I don’t like:__________________________

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What I miss from home

My brother(s):__________________________

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My sister(s):__________________________

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My pets:__________________________

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My friends:__________________________

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My bed:__________________________

What else?__________________________

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Playing in the hospital

How I play in my room:_

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What the hospital playroom is like:_

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How I go to the playroom:___________________________

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Who helps kids in the playroom:____________________________

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What toys are there:__________________________

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Other kids I met in the playroom:__________________________

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Medicine

Pills I have to take:__________________________

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How the pills taste:__________________________

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Liquid medicine I have to take:__________________________

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How my liquid medicine tastes:__________________________

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How often I have medicine:__________________________

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How I feel about my medicines:____________________________

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Tests in the hospital

____ CAT scan

____ X-ray

____ Blood draw

Others:___________________________

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Tests I like the best:__________________________

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Tests I don’t like:____________________________

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Prizes I get:__________________________

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Operation

What my operation is for:___________________________

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What my bandages look like:_

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My surgeon’s name:__________________________

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What I remember:__________________________

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Going home

How long I stayed in the hospital:____________________________

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The day I left the hospital:__________________________

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How I went from my room to the front door of the hospital:

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What it was like outside:__________________________

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Who drove me home:__________________________

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How I felt about leaving:__________________________

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Memories

What I remember most:__________________________

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How I’ll feel if I have to go to the hospital again:_______________

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