The Journal of Continuing Education in Nursing

Leadership and Development 

Animal-Assisted Support: Actionable Intervention for Burnout

Jan Jones-Schenk, DHSc, RN, NE-BC, FAAN, FAADN

Abstract

The impact of long shifts, the puzzling illnesses and manifestations of COVID-19, its personal and family impacts, and the sustained grief of many losses in the past 6 months requires consideration of interventions to lift caregivers' spirits. Burnout has long been a challenge for nurses working in intense acute environments. Today, the risk and effects are even greater. Animal-assisted support is one intervention that shows some promise in supporting employee well-being. [J Contin Educ Nurs. 2020;51(11):496–497].

Abstract

The impact of long shifts, the puzzling illnesses and manifestations of COVID-19, its personal and family impacts, and the sustained grief of many losses in the past 6 months requires consideration of interventions to lift caregivers' spirits. Burnout has long been a challenge for nurses working in intense acute environments. Today, the risk and effects are even greater. Animal-assisted support is one intervention that shows some promise in supporting employee well-being. [J Contin Educ Nurs. 2020;51(11):496–497].

Animal therapy has its origins as far back as Florence Nightingale and Sigmund Freud. Many iterations of animal therapy exist, including equine therapy, dolphin therapy, and canine therapy, to name a few. Pet ownership alone has shown significant health benefits both in mood and in physiological changes, such as reduced blood pressure and other cardiovascular improvements.

The use of therapy dogs in nursing homes has grown as the benefits for residents have been illustrated. Benefits have included improved sense of belonging, reduced stress, improved outlook and reduction in resentment or feelings of regret, greater feelings of control, and improved engagement with others. In studies focusing on the use of animal therapy in addiction programs, additional benefits have been identified, such as a noticeable unlocking of feelings. The presence of a therapy dog and the ability to interact with it through physical stroking, holding, and even talking to it improved patients' abilities to release deep-held feelings and engage more thoroughly in the exploration of their feelings and needs with their therapist.

One of the many losses imposed by COVID-19 and the pandemic it has brought is the loss of or reduction in the amount of physical contact recommended because of the transmission mode of the disease. The former norms of hugging, kissing, holding hands with family, friends and even as supports for coworkers are disrupted by COVID-19. Nurses and other caregivers working in isolation units or critical care units experience some of the most extreme restrictions as they focus on balancing the risks to family members, especially the most vulnerable elderly or chronically ill family and friends. These limitations of touch and direct interaction have a negative cumulative effect on patients, families, and caregivers. Touch is a human need, and the benefits of human– animal interaction may offer a mitigation for these reduced human touch interactions. The human–animal bond is an underlying concept for animal-assisted therapy, with a large body of research demonstrating its benefits (Human-Animal Bond Research Institute, https://habricentral.org).

How Does It Work?

The most used animal therapy methods use trained and certified dogs and handlers. Dogs are easier to transport, and canine training programs are well-established. Some health care organizations have animal therapy programs in place for use with patients and families. These organizations, such as Mayo Clinic for example, already have capacity that could be expanded or repurposed to provide services to caregivers. Typically in a patient-focused model, a trained dog and handler visit patients and families who are in the hospital or who are visiting clinics for special interventions at a scheduled time. The Mayo Clinic has more than a dozen trained animal therapists as part of their Caring Canines program. The therapeutic interactions are simple. The patient or family interacts with both the dog and the handler, petting and engaging with the dog and asking the handler questions. The visits usually last 10 to 15 minutes, but the results are long lasting. As with most interventions, a cadence of regularity enhances sustained positive outcomes.

Is Animal Therapy Still Possible with COVID-19?

The Centers for Disease Control and Prevention (2020) has provided guidance for animal therapy handlers, their dogs, and service animals. Although there is no evidence that dogs transmit COVID-19 to humans, there is some evidence that dogs can contract the virus. Just as general practices for all care settings have changed dramatically over the past 6 months, the practices for the uses of therapy animals have also undergone change. It is not recommended to use therapy animals in COVID-19 units or with patients who are known to be infected with COVID-19. In some cases, hospitals or clinics may limit access to animal therapy, as they have limited general visitor access to reduce risks of transmission. Animal therapy guidelines in established programs include strict protocols for sanitation, training, and screening of the pet therapists. In addition, handlers are advised to maintain 6 feet of distance and wear masks. Individuals who interact with the dogs should also wear masks.

A recent implementation using animal therapy for clinic employees was tested in a multidisciplinary Veterans Affairs clinic where data about employee mood and burnout were collected and analyzed with t tests. This study (Etingen et al., 2020)—the first of its kind—showed promising results in improvements in employee mood and reductions in the measures of burnout (using the Copenhagen Burnout Inventory) and employee satisfaction. Comments and qualitative data also suggest there were associated benefits for employees who did not participate directly in the animal therapy sessions but noted overall improvement in the morale of the unit. One employee noted in their survey comments that they “enjoyed how much [their] colleagues enjoyed [the dogs]. It appeared to lift the morale on this unit” (Etingen et al., 2020, para. 42). Finally, there were findings of improvement in the feeling of being supported by the organization through the implementation of something specifically focused on the team environment and caregiver well-being. Participating employees noticed and noted appreciation. Expression of gratitude and appreciation are elements of personal resilience and indications of mood improvement.

What Is A Professional Development Leader to Do?

Balancing risks and potential benefits is a critical skill for professional development leaders. The mental and physical health of the caregiver workforce is as critical in these times as their knowledge and skill development. Increased absenteeism, turnover, and declining mental health are indications of caregiver burnout and decline. Methods of intervention to boost optimism, a sense of control, and unburdening of grief and sadness should be explored and evaluated. Learning is social and emotional, and in the presence of sustained grief, depression, and exhaustion, a caregiver's capacity to fully engage in a healthy and satisfying personal and professional life is significantly eroded. Exploring a design for animal therapy for hospital staff is worth investigating. Small-scale pilot studies would be valuable in adding to the knowledge about benefits and risks of an animal therapy intervention for staff.

References

  • Centers for Disease Control and Prevention (2020). Guidance for handlers of service and therapy animals. https://www.cdc.gov/coronavirus/2019-ncov/animals/service-therapy-animals.html
  • Etingen, B., Martinez, R. N., Smith, B. M., Hogan, T. P., Miller, L., Saban, K. L., Irvin, D., Jankowski, B. & Weaver, F. M. (2020). Developing an animal-assisted support program for healthcare employees. BMC Health Services Research, 20, 714 doi:10.1186/s12913-020-05586-8 [CrossRef] PMID:32746817
  • Human-Animal Bond Research Institute. (n.d.). Resources for the study of the human– animal bond. https://habricentral.org
Authors

Dr. Jones-Schenk is Executive Dean, College of Health Professions, Western Governors University, Salt Lake City, Utah,

The author has disclosed no potential conflicts of interest, financial or otherwise.

Address correspondence to Jan Jones-Schenk, DHSc, RN, NE-BC, FAAN, FAADN, Executive Dean, College of Health Professions, Western Governors University, 4001 South 799 East, Salt Lake City, UT 84107; e-mail: jan.jonesschenk@wgu.edu.

10.3928/00220124-20201014-03

Sign up to receive

Journal E-contents