Since time immemorial—or at least the 1956 publication of “Old Yeller”—stories about remarkable dogs who save humans from death have abounded. But stories about remarkable dogs who help patients in need of emergency medical attention? Those have been less common—except for Lassie—until now. They’re getting out thanks to a new PLOS One study about the powerful effects of therapy dogs in the emergency department (ED).¹

Therapy Dogs Deliver the Data

Consider the tale of Murphy, a 10-year-old English springer spaniel who does the rounds throughout Saskatoon, Saskatchewan, Canada. Not long ago, Murphy was visiting the ED at Saskatoon’s Royal University Hospital when he and his handler learned that a retired farmer, agitated after waiting two days for a bed, needed sedation. Murphy got the farmer’s permission to hop up onto his stretcher with him—and as the farmer stroked Murphy’s head, he told the spaniel about all the different dogs who had lived on his farm. “The man’s family was there, and they were crying,” says James Stempien, MD, co-author of the PLOS study, who is also provincial head of emergency medicine for the Saskatchewan HealthAuthority and University of Saskatchewan, in Saskatoon. After about fifteen minutes of communing with Murphy, the farmer told Dr. Stempien he’d be able to wait calmly a while longer without drugs; thanks to Murphy, he was plenty calm.

Dr. James Stempien (R) and Jane Smith (center) with Murphy and colleague Dr. Lindsey Broberg at a 2017 medical conference in Whistler, BC, where they presented earlier research about therapy dogs.

Though therapy dogs seem to be the exception rather than the rule in EDs, hospitals that use them find that they significantly benefit people being triaged: Canine companions reduced pain scores by more than half for 43 percent of patients, anxiety by more than half for 48 percent, and feelings of depression by more than half for 46 percent, as the PLOS paper reports. Similarly, a 2012 study in the Western Journal of Emergency Medicine, which looked at therapy dogs in the EDs at University Hospitals Cleveland Medical Center and at its Rainbow Babies and Children’s Hospital in Cleveland, Ohio, found that 93 percent of patients and 95 percent of staff approved of therapy dogs.²

Health and Hygiene

If the dogs are so clearly beneficial, then why aren’t they more common? Possibly because hospital administrators focus on risks rather than benefits, Dr. Stempien suggests. Certainly, the decision makers at Royal University Hospital initially resisted his proposal to use canine comforters in the ED, citing concerns that the animals might be dirty or badly behaved—though Dr. Stempien explained that therapy dogs are groomed before they enter the hospital; and only amicable, unflappable pets make the cut. Dr. Stempien also had to assure the hospital that any patients who were nervous around dogs wouldn’t have to interact with them: “If there was any anxiety on the patients’ part, the therapy dog team would respect that and wouldn’t go near them,” he says. Eventually, Dr. Stempien got the go-ahead—and plaudits ensued. “Once therapy dogs became a common occurrence in the ER, everyone understood their value,” he says.

The therapy dogs at Cook Children’s Medical Center in Fort Worth, Texas, help reduce anxiety for patients who do not have parents or other support people with them while being cared for in the emergency department.

Of course, COVID changed the workplace for therapy dogs, too: They were banned from EDs while the pandemic raged, out of concern their handlers could spread or catch COVID. But the Saskatoon EDs have slowly begun to re-open their doggie doors. American EDs with similar programs, initially feeling equally cautious, have nonetheless found ways to allow the dogs to resume their work supporting staff. At six of the seven hospitals operated by Atlantic Health System in northern New Jersey, ED team members can relax with therapy dogs in a central location—off-unit in a lounge, or outdoors in a picnic area. “We even schedule office hours so that our team can come to them in a designated location during their break to decompress,” says Ashley L. Flannery, DO, associate director of pediatric emergency medicine at Atlantic’s Goryeb Children’s Hospital in Morristown, N.J.

Dr. Jamye Coffman, medical director of the Child Advocacy, Resources, and Evaluation Team at Cook Children’s Medical Center in Fort Worth, Texas, and therapy dog Kitty often work with ED staff after caring for traumatic cases.

At Cook Children’s Medical Center in Fort Worth, Texas, therapy dogs are also focusing on ED staff for the moment. One of the physicians at Cook Children’s, Jamye Coffman, MD, medical director of the child advocacy, resources, and evaluation team, is also the handler for Kitty, her golden retriever, who started at Cook Children’s in 2015. “Kitty has gone to the ED to help patients who, for whatever reason, don’t have a parent or support person to reduce their anxiety,” says Dr. Coffman. “But primarily we’ve taken Kitty over for staff support after a particularly emotionally traumatic event. She also stops in the triage area pretty much every morning just to say hi. And any time we walk by, one nurse always calls out, ‘Kitty, I love you!’”

A Better Work Environment

Indeed, the canine teams may be as important for ED employees as for patients. “The amount of stress that the staff is under, particularly right now with COVID, staffing shortages, boarding issues, and overall societal angst, makes the ED a very challenging work environment,” says Jeffrey Lubin, MD, MPH, co-author of the 2012 study, now a professor of emergency medicine and public health sciences at Penn State College of Medicine in Hershey, Pa. “Taking a break for a minute to pet a dog really can reset and refocus you. I saw that in Cleveland and I’ve seen it in Hershey, too.” Dr. Lubin’s new ED in Pennsylvania has welcomed back therapy dogs, post-COVID-19, although his old ED at University Hospitals Cleveland Medical Center is limiting their use to ED staff. Dr. Lubin started the Cleveland program, where he moonlighted as the handler for his Labrador retriever, Quincy. The sweet-tempered black lab was particularly helpful with a frightened four-year-old. The boy refused to hold still for a computed tomography scan—until Quincy obeyed a command to lie down and stay put. Then the boy exclaimed, “If Quincy can lie still like that, I can too!”

This “Quincy card” was handed out to patients who met the dog in Cleveland, Ohio.

Still not convinced of the power of therapy dogs? Check out “Murphy Mondays,” a 2018 children’s book written by the spaniel’s handler, Jane Smith, in which she describes their Monday visits to the ED at Royal University Hospital.³ As Smith explains, “In every ED we visit, the staff lights up. So many patients, doctors, nurses, and staff tell me Murphy has made their day.”

Maura Kelly, a health writer, is a special contributor to Annals of Emergency Medicine.

References

1. Carey B, Dell CA, Stempien J, et al. Outcomes of a controlled trial with visiting therapy dog teams on pain in adults in an emergency department. PLOS One. 17(3): e0262599. Doi:10.1371/journal. pone.0262599.
2. Nahm N, Lubin J, Lubin J, et al. Therapy dogs in the emergency department. West J Emerg Med. 2012;13(4):363-5. doi: 10.5811/westjem.2011.5.6574.
3. Smith, J. Murphy Mondays: The First St. John Ambulance Therapy Dog in a Canadian emergency Room. Regina, SK: DriverWorks Ink: 2018. https://www.skbooks.com/bookstore/Murphy-Mondays-The-First-St-John-Ambulance-Therapy-Dog-ina-Canadian-Emergency-Room-p119867717. Accessed September 14, 2022.