Innovative Nurse Brings Care to Caregivers

A nurse-led program not only helps reduce stress among caregivers, it also illuminates the importance of nurses being able to conceptualize, develop, and implement such programs.

One of nursing's occupational hazards is compassion fatigue, that unique brand of emotional exhaustion that comes with the continuous and sometimes thankless job of caregiving.

"I think the people who care for everyone else get forgotten sometimes," says Heather Matthew, MSN, RN, clinical practice leader in the ED at the Hospital of the University of Pennsylvania (HUP).

A few weeks ago, this column looked at some of HUP's programs that aim to make its adult patients feel better-cared for. Among those programs is HUP's Pups, which brings volunteer therapy dogs onto units to interact with patients and families.

Seeing that program in action gave Matthew an idea.

"There's a ton of research [showing] that animals just seem to make everything better," she tells HealthLeaders. "I noticed that when [the dogs] would come, the few times they would visit the ED, the staff loved it." The dogs not only lifted the patients' spirits, but the staff's, too.

Matthew wondered: If a program like HUP's Pups can exist for patients, why couldn't a similar program be developed to help the staff?

That's why she founded Pet the Pooch, a program that teams the hospital with the Pennsylvania Society for the Prevention of Cruelty to Animals. SPCA staff members bring shelter cats and dogs to the hospital about once a month to give doctors, nurses, and other staff a chance to interact with the animals.

It's not only a stress-reliever (and a chance to get some unconditional and unquestioning affection), but has also sometimes resulted in the rescue animals getting adopted.

Although the way HUP is helping to reduce stress among its caregivers is interesting, there's another reason for telling this story: It illuminates the importance of a nurse like Matthew being able to successfully conceptualize, develop, and implement such a program. That's because HUP's nurse leaders aim to encourage all nurses, regardless of rank, to bring their ideas forward, and when they do, those ideas are treated with respect and seriousness, Matthew says.

"I felt very comfortable taking this to my director and proposing this to her," she says. "What's the worst they could say, no?" Moreover, Matthew says the culture of HUP is such that all nurses are treated like important players in hospital goings-on.

"From the time you come to Penn to work here, they really emphasize that nursing is valued," she says of the hospital leadership. "They involve nursing in almost every decision they make… they hear you out and encourage you to attend hospital-wide meetings."

AnnMarie Papa, clinical director of emergency nursing at Penn Medicine, says that their chief nurse executive has spearheaded a "really phenomenal shared governance" that's "in the lifeblood" of nursing there. So when Papa first heard Matthew's Pet the Pooch idea, she knew she wanted to give it a chance.

Rather than directives coming from the top down, "the communication is bidirectional," Papa says. "It often comes from the frontline to say, here's what we're struggling with, here's what we'd like to trial, can you support us?"

Very often, the answer is yes. And the nurses who spearhead such initiatives are trusted to do their due diligence.

For instance, in preparing for Pet the Pooch, Matthew learned that when it comes to "bringing any animal into a hospital, people are always skeptical." So she did a great deal of background research to quell people's fears about things like infections for example, and found that there have never been any infections caused by pet therapy programs.

The Pet the Pooch program started small with an event in the ED conference room; once it was successful, Matthew says that with Papa's help, they were able to take it hospital-wide.

Now they're several months into the program, which has been gaining in popularity. Participants fill out surveys after each event, and "the feedback has been excellent," Matthew says. People ask for the animals to come more often; they say "thank you" for such progressive thinking.

Although Matthew says Papa helped her usher the program into existence, Papa says it's Matthew who deserves all the credit, saying, "She really spearheaded this whole initiative for us."

"There's a great deal of trust," Papa says of the relationship she has with her staff. "I do that because that's what my boss gives me."