The VIPs in Our Patients' Lives

Lisa Schulmeister, RN, MN, APRN-BC, OCN®, FAAN

Editor-in-Chief OncLive Nursing

Oncology Nursing Consultant, Adjunct Assistant Professor of Nursing Louisiana State Health Sciences Center in New Orleans, Louisiana

Nearly everyone working in the infusion suite is either crying or wiping away tears. A nurse tells me that Melinda has died.

Melinda is the pet therapy dog, who for the past couple of years, has provided companionship in the infusion suite every Friday. Melinda never missed a day of “work” and now she’s gone.

Some of the staff are surprised at how affected they are by the dog’s death and are angry that other staff members say “she’s just a dog” and go about their jobs as if nothing has happened. The death of the beloved pet therapy dog also affects the patients who had bonded with Melinda. Staff needed to acknowledge the patients’ grief, as well as their own.

It is well-known, and scientifically proven, that interactions with gentle, friendly pets are beneficial. These interactions lower blood pressure, release endorphins that induce a calming effect, decrease feelings of isolation, encourage communication, and provide comfort. Data also suggest they may reduce pain and lessen depression.

The bond between a pet and its owner can be strong, and in some cases so strong that the death of a pet is just as devastating as the loss of human life. The Huffington Post reported “10 Ways That Losing a Pet is Worse Than Losing a Human,” and Former president Bill Clinton told Newsweek in 2002 that the death of his dog, Buddy, who was hit by a car, was “by far the worst thing” that Clinton had experienced after leaving the White House. The sudden death of a pet may be especially traumatic.

The infusion suite staff decided to start asking about patients’ pets when they conducted new patient interviews, and started asking current patients about their pets during chemotherapy treatments. Staff reported that the patients “lighted up” when they talked about their pets, and it became clear to the staff that many of these patients thought of their pets as family. Some of the nurses noted the names of patients’ pets in the patients’ medical records, and made it a point to ask about the pets during subsequent visits. These nurses reported that the patients appeared to genuinely enjoy giving updates on their pets, and some patients even provided these updates without prompting from the staff.

Before long, including pets in conversations about family became routine in the infusion suite. A couple of months later, a patient’s cat died unexpectedly, and the staff found themselves providing grief counseling to the patient. The cat’s death also rekindled memories of Melinda’s death.

In the months that followed, other pets died, and the staff observed that the intensity and longevity of grief following a pet’s death can vary widely. One of the nurses researched how to support pet owners following the death of a pet, and found that talking about the pet is therapeutic. Other helpful advice includes strengthening positive memories, finding solace from one’s own spiritual beliefs, and seeking support from individuals and resources. Several veterinary schools and nonprofit animal organizations around the United States have pet loss support hotlines. There also are online forums for pet loss support, books, and online information on pet loss, as well as grief counseling specifically for pet loss.

Actions that are not considered to be helpful include encouraging the pet owner to get a new animal right away, since this may be perceived as “replacing” the pet, and pet owners need time to grieve. Advising the bereaved to “just get over it” devalues the importance of the pet, pressures the pet owner to bottle-up emotions, and impedes the grieving process.

Supporting patients through the death of a pet is likely a role that oncology nurses don’t think much about. However, considering how important pets are in the lives of their owners, nurses can provide holistic care by including patients’ pets in their assessments and conversations.