I have long realized the benefits of pet therapy or visitation. If I have had a bad day, I can always rely on feeling better after I have petted my cat for a while, even when he may not appreciate it. He is not named after the Tasmanian devil as a coincidence. I have always had pets. They are members of my family. I rely on them for emotional support and company, and I mourn when they die. I cannot imagine leaving my pet behind as many have had to do during recent natural disasters. Thankfully, after Hurricane Katrina, some lessons were learned about how to evaluate pets as well as people.

As a critical care nurse, I have advocated the benefit of pet visitation long before it was discussed in the literature. In the early 1980s, I was caring for a patient with end-stage heart failure. She desperately wanted to see her dog. At the time, the hospital had a strict visitation policy that prohibited pets. So, late one evening, when most visitors and administrators had left for the day, I allowed her son to bring her poodle for a visit. Before arranging the visit, I did not realize the dog was a poodle. I told the son of anyone asked to say it was a seeing-eye dog. He smuggled the "seeing-eye" poodle in under his jacket. The patient was extremely grateful for one last opportunity to visit with her beloved pet. The true benefit was the joy that the dog brought and that cannot be measured. She died a few days later.

Pets are considered by many to be part of the family. Pets may provide emotional support in both good and bad times but may be particularly helpful in times of stress or illness.1 There is growing support of animal-assisted therapy in many areas of healthcare, including critical care, as a complementary therapy.1-4

There is a difference between pet therapy or visitation and animal-assisted therapy.2 "Animal-assisted therapy is a scheduled intervention designed to improve a patient's cognition or physical functioning with specific short- and long-term goals."2^(p20) Pet or animal visitation is used to improve a patient's sense of well-being and is usually a short-term strategy.2

This article will focus on pet therapy and visitation as a short-term strategy. There are many benefits of pet therapy. These include, but are not limited to, the following1-5:

1. provision of emotional support

2. increase in social interaction

3. increase in life satisfaction

4. decrease in depression

5. improvement in psychological well-being

6. decrease in blood pressure and heart rate

7. increased relaxation

8. decreased need for or amount of pain medication

9. decrease in stress level

10. provision of comfort to patients and families

11. companionship

Although many of these benefits are subjective, their importance should not be minimized. It is difficult to quantitatively measure the emotional support or amount of relaxation experienced by a person when united with a beloved pet.

There are also some risks to having animals in a critical care unit. These include, but are not limited to, the following2,3,5:

1. Other patients or family members may object because of fear or allergies.

2. The pet must have the appropriate temperament when exposed to unfamiliar surroundings.

3. Some birds may carry specific bacteria.

4. The pet's personality and obedience may be inappropriate for the healthcare setting.

Some may object to pet therapy, citing infection control concerns. There have been very few incidences of disease transmission from an animal to a human.2 An infection control policy should be implemented when allowing pets to visit in any unit.3 More research is definitely needed to determine the risks, if any, of pet visitation with certain patients, such as those who may be immunosuppressed.

There are certification programs that hospital units, including critical care, can use when establishing a pet visitation or a more formal animal-assisted therapy program. The programs vary from organization to organization but have guidelines available to assist nurses who wish to institute these types of programs.2,3 As nurses, we are patient advocates. If we believe that a visit from a beloved pet is in the best interest of the patient, then we must make that happen.

I truly believe that the benefits far outweigh the risks, but each situation is different. On a more personal note, my brother died about 3 years ago. The last 2 weeks of his life was spent in an inpatient hospice unit that allowed pet visitation. His dog, Bandit, stayed on the bed with my brother. I do not know if my brother was aware of Bandit's presence, but we did. The emotional support provided by Bandit was immeasurable, and he even seemed to know the moment my brother died. On a side note, Bandit also visited other patients in the units and brought many smiles to the faces of patients, families, and staff members.

So I definitely support a pet visitation program, even in critical care. Just remember, each situation is different, and there may be a certain procedure to follow. But if your unit does not have such a policy, consider implementing one. When developing the policy, involve those in other healthcare disciplines, such as nurses, infection control specialists, social workers, chaplains, and representatives from animal-assisted programs. The time spent on implementing a pet visitation program is time will spent and will be appreciated by many of your patients and their families.

Vickie A. Miracle, EdD, RN, CCRN, CCNS, CCRC

Editor, DCCN and Lecturer

Bellarmine University

School of Nursing

Louisville, KY

mailto:[email protected]

References