Voiceover: This podcast is for informational and educational purposes only. It is not medical care or advice. Clinicians should rely on their own medical judgements when advising their patients. Patients in need of medical care should consult their personal care provider. Welcome to "That's Pediatrics", where we sit down with physicians, scientists, and experts to discuss the latest discoveries and innovations in pediatric healthcare.
Dr. Poholek: Welcome to That's Pediatrics from UPMC Children's Hospital of Pittsburgh. I'm your host, Amanda Poholek, assistant professor of pediatrics and immunology. And today, our guest is Angie Gordon. Angie is the lead coordinator in the volunteer services department at UPMC Children's Hospital of Pittsburgh. Angie serves as the coordinator of pet therapy program, the pet friends program, and the college volunteer program. Under her direction, volunteers, with their highly trained certified therapy dogs, provide comfort, reduce hospital related fears, normalize the hospital environment, reduce stress, and elevate the moods of our patients, families, and staff. Angie holds a master of social work degree from the University of Pittsburgh with a specialization in community, organization, and social action, and a certification in non-profit management. Prior to joining the UPMC Children's Hospital Volunteer Services Department, she worked for 17 years at the University of Pittsburgh in the office of Pitt Serves and Office of Volunteer Services as the senior site manager of the Jumpstart Pittsburgh program. Today our topic is Therapy Dogs at UPMC Children's Hospital of Pittsburgh. Thank you so much for being here today, Angie.
Angela “Angie” Gordon: Thank you for having me.
Dr. Poholek: So maybe we can start, as we often do on this show, by telling us a little bit about your background and your path to your position at UPMC Children's and what drew you to your role as a coordinator of the therapy program.
Ms. Gordon: I'd be happy to share that. I started at the University of Pittsburgh pretty long time ago, really focusing on providing children with educational opportunities, realizing that both our underserved communities and our college students, that community service is a really important piece of their learning process. So got to a point where wanted to make a change and thought that UPMC would be a good option as a position in the volunteer services department opened up. Actually, my mentor from the school of social work mentioned that it would be a good parallel with my passion and my value set. So five years ago, I started and really came into just redesign some of the things that we do within the department, so our college volunteer programming and our pet therapy program. So when I started, we had almost 50 dogs in the program, but some of the schedules were a little inconsistent and we really wanted to make consistency... It's just important for our families and for our patients to know that.
So I've had some experience volunteering in animal settings and really took on a role of just learning that piece and going to a lot of obedience classes, dog training, that type of thing, really relying on our experts, but then really landing in a place here where I'm able to just really grow the program here.
Dr. Poholek: Cool. So tell me a little bit how therapy dogs play a role at Children's Hospital?
Ms. Gordon: So we have a set of dogs that come in. Like I mentioned, consistency is important, very specific days and times on our units. Our Child life staff really gets to know our patients and figures out who is appropriate to see a dog. So appropriateness could be that they're having a little anxiety, that they miss their dogs, that they are a little depressed by being here. So once they make that decision that it's an appropriate, we would call consult or appropriate visit. We're able to pair our dog that's on the unit to go do that visit. And we've seen that our patients really show... It's just a joyful experience to see some of our dogs do tricks some of our dogs do. So it's been interesting to be able to accommodate some of the requests from the kids. So some of our kids need to focus on fine motor skills, so we have them give treats to the dogs.
Some of them, in our rehab unit, are working on walking, so we have a dog that he runs on his treadmill at home. But our handler, his owner is a retired nurse here, and so she will walk with our patients in the rehab unit. So in addition to kind of spreading joy, calming really those fears, we really focus on some other things as well. But we also provide our caregivers, so our parents and our staff with just a really nice bright point in their day. Yeah, it's interesting when I go to the units and see that just the staff get really excited about the visits and say, "This is the best part of my day," or "We had a really tough day yesterday and I really needed this." So you see them hugging the dogs, as well as our caregivers, and really trying to combat and compassion fatigue with our caregivers and our staff as well.
Dr. Poholek: Oh, that's so fascinating. Yeah. I was wondering if you could share maybe one or two sort of specific examples of the impact of the program. I was going to start with patients, but also staff, as you just mentioned.
Ms. Gordon: Yeah. I went to the PICU recently, our pediatric intensive care unit, and had a staff that said it was a really rough night. And didn't get into specifics, but we sat on the floor and the dog sat between us, and she just petted. And you could tell her breathing evened out and she was ready for the rest of her day. It was a very interesting... She said, "I'm on a longer shift." And so it was just one of those things that she felt really kind of boosted her mood, which was great. From my first summer here, we had a patient that lost a leg, lost his one leg. He was young. He was about 11 years old. And we had a dog in our program that was an amputee, and so what we were able to do was match our dog and that patient so that they could walk.
And so he would come in, our owner and the dog would come in and they would meet with this patient on their unit and they would walk, just so that our patient could see that Lulu, our dog, she lived a really full life and she just did things a little bit differently than her brothers and sisters because we had three of the dogs in a siblings set. But that was a really great experience to witness as well.
Dr. Poholek: Oh, thank you. Those are great. So yeah, maybe leading into that, I'm curious a little bit about the... I think it seems intuitive and obvious that dogs are wonderful and cute and fluffy, and of course spending time with something that's cute and fluffy helps you feel better. But I'm kind of curious, are there any studies, data driven metrics that actually demonstrate that there is a meaningful impact for patients?
Ms. Gordon: Yes.
Dr. Poholek: And specifically, what is that data and how does it help these kids?
Ms. Gordon: There are studies, but I will be honest, not as many as we need to further grow animal assisted therapy programming. So that is a goal of mine and a goal that we really focus on that. A lot of it is qualitative data, but we do have data that states that they measure blood pressure before and after, they measure heart rates, things like that. We have not, to my knowledge, have done any studies here. So that would be a goal of our program in the future, to be able to do that.
Dr. Poholek: Oh, wonderful. Yeah, that seems like something that would be really exciting.
Ms. Gordon: Yes.
Dr. Poholek: So what does it take to become a pet therapy dog? Do you have a lot of people interested. I imagine lots of people think their dog would be a great pet therapy dog, but what do you really need to have to have what it takes?
Ms. Gordon: You're absolutely right. I believe all dogs are wonderful.
Dr. Poholek: Of course.
Ms. Gordon: I'm an equal opportunist of course. I think that they're all wonderful. However, it does, it's a very long process. So right now, I have 34 dogs on our wait list. I also have four dogs that have not returned back COVID, from our COVID hiatus, basically because they're still kind of going through the process of getting their paperwork back and reevaluated. So all of our dogs have to be a year old at minimum, but we mostly see dogs that are over age two because it does take a while to go through all of the training. All the dogs need to be a certified therapy dog through a few... There are a few agencies that have been approved by UPMC, two of which are local, and then there are a few national organizations as well.
And to get certified to be a therapy dog, you do have to go through a series of tests. Some of the agencies require the Canine Good Citizenship certification, but it is a few classes, a few testing, a few ways to go through that process. So dogs really do need to be able... They have to be directable, they have to be trainable, they have to be able to leave it, which is an interesting... If a dog and a handler goes into a room and there's a pill on the floor, the dog can't take that pill. So we have to be really careful about that. They have to be comfortable with petting, comfortable with people that pet in a way that's not maybe gentle. Our kids are kids and they come up and they hug the dog and they may touch their ears. And so they can't really have any areas of sensitivity, they have to be able to walk on a leash, they have to be able to tolerate the sight, smells in the hospital, which is different than what it would be like in a school.
Dr. Poholek: Yeah, yeah, absolutely. So how long does it take then when you start? Let's say even once you've gone through these training sessions, you have your certifications. Is there still another process in order to actually starting to come to the hospital?
Ms. Gordon: Yes, the owners would contact... And that's also... There's an owner responsibility as well, and credentialing as well. So all of our owners are handlers, our credentialed volunteers. So I'll start with them, and then we'll go to the dogs as well.
So for our volunteers, they complete an application and a pre-interview questionnaire. So we vet them in two ways prior to even having an interview. We interview and then if we choose them as part of our program, they are required to submit a series of clearances. They have to go through training. It's called the PA Act 31. It's a mandatory child abuse and neglect training. They also have to submit immunizations and vaccine records. So there's a series of those that they would have to do, go through orientation. So that's kind of the human side. And then for the dog side, they do have four vaccines that they're required to have.
So we do require a well visit every year. So they do need to be checked by their veterinarian just to make sure that nothing has changed physically with the dog. So we have those four vaccines. They have to have a negative heartworm and fecal test, and then they have to be on year-round heartworm and flea and tick control.
There's a grooming process as well, but those are the main things. Once they go through all of that and it aligns, the volunteers values match ours, the dog has been certified, we have all their paperwork, they do come in for a sniff test. It's the sight, sounds, and smells in the hospital. So we walk the dog through a couple different units in a couple of scenarios to make sure that they're comfortable with the beeping, the smells, people rushing up to them, using the elevator. We had a dog that couldn't use the elevator. And so it's very challenging to be here without being able to do that.
So if they pass that, then the owner does a shadow visit without their dog so that the owner can see what it's like. And we had an owner who did the shadow visit recently and came back and we debriefed. And the owner said, "The patients I saw, they're all going to get better, right?" And I said, "I can't make that guarantee. I know we're doing everything we can to make that happen." So really having a conversation with those owners, it's... We've had these conversations, but seeing it is a lot different.
Dr. Poholek: Yeah.
Ms. Gordon: So we're going to move that dog into more of a staff role. We have an ED request. We have a few other things. So I think that those are... We're able to make those accommodations when necessary. After all of that...
Dr. Poholek: Yeah.
Ms. Gordon: It's a very intense process. After that, then our owners come in and do a monitored first visit. And then if they pass all of it, they start.
Dr. Poholek: Wow.
Ms. Gordon: Yes.
Dr. Poholek: Thank you. That's incredibly comprehensive, and I think obviously not something that you think through all those little pieces, but obviously so critical once you kind of go through it. So then once you... You mentioned consistency in hours, so getting volunteers and their pets to be able to come out a regular basis. How do you then go through the matching process for patients in particular? And then once that matches made, how long does that sort of therapy last? Is it as long as the patient is in the hospital? If they could return, do they get rematched to the same pet? How do those kinds of things potentially play out?
Ms. Gordon: So we've matched our dog and handler groupings with specific units. So based on if the dogs are appropriate based on energy level, interest level. I also like to mix breeds, because if everyone only has a lab, or if everyone only has one type of dog, not everyone might like that certain type of dog.
Dr. Poholek: Right.
Ms. Gordon: So I do that kind of process, and really just match with the unit vibe almost. So if a patient is on our oncology unit, they'll see one of two dogs during the course of the week. We have a lab, and then we have a Chinese crested that goes there currently, completely different, which has been interesting. So those kids who might be a little apprehensive about seeing a bigger dog, the Chinese crested fills that need. And he's small, he can jump into bed once we have all the infection prevention things figured out, which it's nice for those patients that might be a little apprehensive. If a patient does move to a different unit, I try to make sure that the dog that they're most comfortable with, that they have the relationship with will stop down and visit as well. So we have some of our kids that have had to move units.
So we've been able to do that. Our families sign a consent form for the visits. So after child life, just make sure that the visit is appropriate. Then our families will sign the consent form, and that consent form is good for a year.
Dr. Poholek: Okay, fantastic. So you had mentioned earlier that when you started, I think you said five years ago, there were 50 dogs. I was curious, how many dogs do you have now in the program? And I'm was kind of wondering if there were any challenges that you guys had to navigate getting started back after COID, and kind of where you are now with that?
Ms. Gordon: So volunteer services programming was placed on hiatus in March of 2020, including our pet therapy program. So we were on hiatus with in-person visits during that time. We did develop a virtual visit process. We had a really phenomenal dog who literally was a showboat. And he could sing, so he barked to certain songs. He danced. He was phenomenal on camera. Unfortunately, he unexpectedly passed, but he was so great. And we had some of our longer term kids who just really... They missed having the dog, so we were able to do that. We also used another therapy team and they would read with the kids. So the kids would have one book and they would read the same book, and it was an interesting kind of experience to do that. But getting the dogs back from COVID... So we were allowed to restart our programming on May 16th, 2022. And we restarted at a very small pilot, making sure that we had one dog per week per our inpatient units.
We've been able to grow a little bit more. So we have 12 dogs now. We'll have another two in the next few weeks, as long as they pass all of those things. They're at the final stages of that process, so I am pretty confident that we'll be able to bring them on, but it has been really challenging. We invited all of our families, all of our pet therapy teams back, but unfortunately we did have some dogs that passed. We had some that retired. We have two dogs that are 13 and... One in 13 and one is 14, so it's just not conducive for them to walk our units at this point. So it's always challenging when you have to say goodbye to the therapy teams. But anybody who was able to come back, all of those dogs had to be re-certified as therapy dogs because I don't know what happened in those two years. So they had to get all of their paperwork. The process that I just went through, they had to do the entire process again because it was such a long time between their visits.
Dr. Poholek: How long does one dog tend to stay in the program?
Ms. Gordon: So we tend to have a lot of people who stay long term.
Dr. Poholek: Nice.
Ms. Gordon: A lot of dogs stay long term, so we have dogs that have been here throughout eight or nine years, but a few years. I've only been here for five. I've started with some that are going to continue. What we're seeing, we have a lot of dogs right now that are not older, but they're six, seven, eight. And so it'll be nice to get some new dogs in that maybe are a little younger as well, just so that we have a nice mix.
Dr. Poholek: What would you say are the sort of key resources that you need at this point in order to grow the program sort of back to where it was?
Ms. Gordon: Honestly, time. It is really challenging. And we're blessed to have a lot of interest. It does take a long time to go through this entire process. So I have two of my colleagues from the child life department that are going to start assisting with the evals, which makes that nice in terms of that. Funding is always an important piece in everything, just making sure if we could have some help with some of those other components would be great. We also are trying to grow animal assisted therapy and incorporate facility dogs as well, because facility dogs would be another way to add a really valuable component to the hospital. Being a top 10 hospital, it would be wonderful to have at least one... I think most of the top 10 hospitals, I think all but two, including us, have at least one facility dog that is a... They essentially come in with their owner who is an employee here. We have targeted a treatment targeted interventions that the dog and the handler do. So that has been a project that we've been working on as well.
Dr. Poholek: Fantastic. Yeah. And I did want to just quickly come back, since we're talking about resources and future goals, to the idea of a study. What would it take to make that happen?
Ms. Gordon: Honestly, have not done a lot of research into figuring out how to make that happen. I do know that I would to... It'd just be a collaboration trying to figure out who would be a good fit. I envision, if we would have a facility dog, one would be wonderful in supportive care, so to see how that would happen as well. But I think I would just need to spend a little bit more time to figure out...
Dr. Poholek: Yeah. Yeah.
Ms. Gordon: ... what I need to...
Dr. Poholek: One imagines that having that then would help grow those additional resources to grow the program, right? So it's sort of all fits in together. Well, I think that is just really wonderful work that you guys are doing, and I want to take the opportunity to thank you for being on the show, and thank you for sharing with us the experiences that the therapy dog program has here and for your work, making sure that that happens. And this is the kind of stuff that, exactly as you said, makes this hospital such a great place for patients and their families.
Ms. Gordon: Thank you so much. I appreciate it.
Voiceover: You can find other episodes of That's Pediatrics on Apple Podcasts, Google Podcasts, Spotify, and YouTube. For more information about this podcast or our guests, please visit chp.edu/ThatsPediatrics. If you've enjoyed this episode, please be sure to rate, review and subscribe to keep up with our new content. You can also email us at podcast.upmc@gmail.com with any feedback or ideas for topics you'd like our experts to cover on future episodes. Thank you again for listening to, That's Pediatrics. Tune in next time.
Angela (Angie) Gordon, MSW, is a Lead Coordinator in the Volunteer Services Department at UPMC Children’s Hospital of Pittsburgh. In this capacity, Angie serves as the coordinator of pet therapy programming, the Pet Friends Program, and the college volunteer program. Under her direction, volunteers with their highly trained, certified therapy dogs, provide comfort, reduce hospital related fears, normalize the hospital environment, reduce stress, and elevate the moods of our patients, families, and staff. Angie holds a Master of Social Work Degree from the University of Pittsburgh with a specialization in Community, Organization, and Social Action (COSA) and a certification in Nonprofit Management. Prior to joining the UPMC Children's Hospital Volunteer Services department in 2018, she worked for 17 years at the University of Pittsburgh in the Office of PittServes and Office of Volunteer Services and as the Senior Site Manager of the Jumpstart Pittsburgh program. 