Christmas can be a trying time for hospitals with large numbers of children. Iva Pocock reports
In these days of festive hype, planning for Christmas is a daunting task. Even mothers who've had decades to hone their family organisational skills get flustered at the prospect of co-ordinating the dinner, the gifts and the guests.
So imagine the challenge of organising a special day when you don't know how many will be staying, what kind of presents they'd like and whether they'll be well enough to tuck into a plate of turkey and Brussels sprouts.
This prospect faces the 73-bed National Children's Hospital in Tallaght, Co Dublin every year - the number staying over on Christmas Eve is hard to predict, they range in age from toddlers to teenagers and they may be very ill.
The solution? To try to get as many children home as possible.
"The general principle is Christmas is such a special time of year for kids that we really go to enormous efforts to get people home, even if it's only for the day," says consultant paediatrician Dr Peter Greally.
This means scheduling treatments for chronically ill patients, who have to attend the hospital on a regular basis, before the holidays.
"In my own speciality, respiratory medicine, we look after a large number of patients with cystic fibrosis, and a lot of those get routine intravenous anti-biotics. We would give those so that they are finished prior to the Christmas break."
For such children who become acutely ill and in need of hospitalisation, each case is treated on its own merits. "Obviously for terminally ill children there are particular sensitivities but the same principles apply."
For other acutely ill patients "we are really dependent on what comes through the door of the A&E department", says Greally.
"A lot of them are respiratory infections, gastroenteritis, the winter vomiting bug, which require maybe a day or two in hospital."
Whether they can go home on Christmas Day depends on the particular circumstances, and each case is treated on its own merits, he says.
"Last year I was in on Christmas Eve and Christmas Day and my kids had me up at 5.30 a.m. so it was quite easy to come in here early. I did a round and I got everybody home that I could."
Christmas is a great motivator for families, he says. "People would take their kids home for the Christmas period when they wouldn't normally take them home. Their threshold drops a little bit."
If a sick child has to stay over on Christmas Eve, at least one relative will have stayed with them, explains Matron Maura Connolly. "And no matter how sick they are, Santa arrives," she says.
During the day if a patient has to stay in bed and can't get home, if needs be, their family will also have Christmas dinner in the hospital. "For example, if a child's from Galway we'll feed the whole family," says Connolly.
So do children find it difficult to be in hospital over Christmas?
Caroline McGrath, clinical nurse manager on the Oak ward, thinks not. "Children have greater coping mechanisms than adults and they cope better with these difficult situations," she says. "They just accept that they have to be here and the fact that Santa comes here means they still have the joy of Christmas."
A few weeks before Christmas, staff are busy helping patients bring some festive cheer to the wards and corridors of Europe's second-oldest children's hospital, now part of the AMNCH group which includes the Adelaide and Meath hospitals.
Both medical and clerical staff lead the carol singing at a party organised for patients and their parents, with hospital porter John Cahill accompanying on the guitar.
Catherine Garland, one of two play specialists, says they were expecting at least 10 children, but seven went home that morning, so there are more adults than kids at the sing along.
In between Rudolf the Red-Nosed Reindeer and Away in the Manger the party-goers share details about Christmas traditions from around the world, researched by resident national school teacher David Carroll.
Next comes a talk by hospital chaplain, Rev Mark Wilson, who reminds listeners that "sharing is the name of the game".
Most seem to be enjoying themselves, although one girl whispers to her mother "When are we gonna get out of here?" half way through the carols.
Arts officer Sarah Dobbs, who is brightening up the corridors with her sparkly red nose, oversaw the creation of paper angel wings and crowns adorning a number of party-goers.
With all the coming and going of patients it's "difficult to plan", she says as some kids want to keep their craftwork while others are happy to leave it behind when they head home.
Eight-year-old Rebecca Whelan, who is in and out of the hospital every three weeks for immunoglobulin transfusions, and has been going there for seven years, is wearing one of the pair of wings tied to her back with ribbon.
She reckons the staff, especially Dobbs, are "all cuckoo" and just hopes she'll be at home for Christmas.
Teenager Nathan O'Halloran from Bray, Co Wicklow, skips the Christmas carols, choosing to stay in bed playing an X-Box instead.
"I've tonsillitis so I can't sing," he says, adding that he hasn't noticed many festive activities other than a few Christmas decorations about the hospital.
His mother, Ann, hasn't had a chance to hang any decorations. "Nothing will get organised until he's okay and I go home. Then it'll be a mad dash."
Shortly after the party ends members of the number one Rotary Club in Dublin arrive to accompany Santa on a pre-Christmas tour of the wards. They've been helping him out for years.
Play specialist Garland also helps him out each year by marking presents for girls and boys, just to make sure there are no upsets.
Santa's also due for two more daytime visits and will be escorted on one occasion by a Dublin bikers club, who'll make sure to drive by the windows so everyone can have a good look at their motorbikes.
"We've very little to offer them and they've a whole load to offer us," says Connolly of Santa's helpers.
And on Christmas Day, Santa, as usual, will make sure he's got up-to-date information on each child's whereabouts.
Mathew Meagher (5) from Cabinteely, Dublin, who is in for some tests, is confident Santa will know where he is on Christmas morning. He's also sure of what presents he's getting - a new scooter, a new computer and a Thomas the Tank train.