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Tuesday, April 3, 2012

Maintaining Professional Distance

Personal information obtained on therapy visits is confidential. When applicable the name/location/sex/condition of persons visited may be changed to protect privacy. However, the interactions, conversations are true and did occur as written. 

Gopher, Chad, and Carla are all volunteers. They do not officially represent any institution that may be mentioned.

As Gopher and I continue our journey it is becoming more and more apparent that those ‘special’ patients who make you want to push the boundary of professional distance are more numerous than anticipated.  It has also come to my attention that the very nature of our volunteer work pushes that boundary in and of itself. We as therapy animal handlers have a few concrete responsibilities first and foremost are the safety and happiness of our partners, second the safety of the patient, and finally respect for the facility and its policies. That is our responsibilities as volunteers. Everything beyond that is additional, and merely supplements to those three rules.  I could give lectures, discussions and article after article giving tips for success while volunteering in this role and Gopher and I are actually working on some of this as well. This will discuss how Gopher and I have handled professional distance.

For this discussion I am going to use stories relating to a single patient with whom Gopher and I have visited the last several months. He is a young boy, incredibly sweet, with a deep love for the dogs that visit him. He is consistent, prompt and had never to my knowledge missed a visiting time. He took time to get to know all of the dogs, their individual quirks, and the names of the handlers. I look forward to seeing him on our visits, and as he is getting to go home soon, I know that I will miss him.
I have on many occasions stayed a little longer on our visits, allowed him some leeway in ‘teaching’ Gopher new tricks, accepted one gift from him (you will see this later) and addressed him by name with enthusiasm every time I see him. I have also made a point of letting him hug Gopher goodbye at the end of every visit, something he had initiated. I allow all patients who want to hug Gopher to do so, there is no change here, I just make a point of making sure this patient was able to do so before leaving. These items have made our visits successful, allowed him some extra comfort, and I have not broken a single one of the three primary rules.

Some persons may feel that allowing Gopher and I to stay a little longer is not keeping consistent with professional distance, we had a job to do, a time to do it in, and the time had ended. Anything beyond that is becoming personally involved with a patient, and goes against maintaining a professional distance. I go back to the three rules, and I did not break or even bend any of them. Gopher was safe, happy and content, the patient was safe, and the facility rules and policies were respected. I also know that although my wife was waiting for me to come home and make dinner, she understood that this happens, and is pleased to be a part of this small compromise.  So I was not truly compromising my personal life. I also have to ask myself, “Would I do this for another patient?” Yes, I would and I have. It is not a common practice for me to extend my scheduled times with any patient, but there are times doing this work, when you realize 5, 10, 15 minutes of extra pets are needed. Whether this is merely to dissolve boredom or something you can tell a patient needs to help ease fear, anxiety and/or sadness. In those moments, there are smiles and laughter. It should not be done every time, should not compromise the three primary rules, but I feel strongly it should be done when needed. How will you know? Time, observation and experience.  If I miss these needed moments, Gopher will also tell me, by not responding to a command that it is time to leave. If this is tip toeing over the line of professional distance then I will confess now that I will continue to do so, and that professional distance although important should not interfere with the goal of this work.

Your animal should always be under your control this is implied by rule one and two. I have on many occasions allowed patients to give Gopher established commands under my strict guidance. Gopher will almost always look to me to give him a head nod letting him know it is okay.  This ‘special’ patient after many, many visits showed a desire to teach Gopher new tricks, or at least try to. I stayed true to the three primary rules but allowed him to do this. At all times it was under my guidance, but he showed a natural inclination on how to teach a dog new tricks. He was the first patient I have allowed to do this. Would I do it again, maybe, but it would have to be similar to our relationship with this patient. Many of our visitors have given commands, some Gopher knows, some he doesn’t. It is a part of human nature I do not understand. Do you go out and give a stranger an order? No. However people see a dog and want to give it an order. He never did. He was observant, asked first, and followed my instruction. So if another patient were similar in this aspect I would let another patient do this again.

Gifts are a difficult matter and Gopher and I have given gifts, this is where you have to be especially careful. Giving gifts must be equal to all persons, you are not allowed to single a patient out, and this would be going beyond tiptoeing on the line and into the realm of breaching professional distance. We have also received gifts, cards, and crafts. Every one of these is special and has been placed in a special place in our home. Our latest, does not break policies (value greater than $20.00), we find it priceless and are framing it in our home.

When he presented it to Gopher and I, the smile on his face and excitement were contagious. We thanked him for such a wonderful gift. To not accept it would have been hurtful to him, I know gift policies for volunteers are justifiably outlined, but go through the process and thank the patient. If you need to surrender it, pending your facilities policies, surrender it at a later time. Never ever tell the patient directly you are unable to accept, unless it is a financial gift. I am fortunate in that I am able to keep this and other gifts presented to us so far as they have been within policy and reported as well.
Now comes the most difficult part. This patient has meant more to us than we can ever say, he has been an absolute pleasure to visit, and I am not certain if he did more therapy for Gopher and I or we did more therapy for him. His gift to us will remain with us for as long as humanly possible. It will be treasured the entire time. He is fortunately able to go home in the coming weeks. Our relationship is at an end, and there will be no more. This is the part of professional distance I will not bend, and assuredly will not break. I will forever be curious as to how he recovered. I will miss seeing him, but equally pleased that he no longer needs us.  It is a mixed bag of joy and sadness. I do know there will be another patient around the corner and although every patient is different there will be another with this type of bond.  Our time with this young man is coming to an end, our hope is that his health continues to improve and he will not have to face the situations that brought him to this facility again. It is tough to say good bye sometimes. There will however be more. We will continue this journey for as long as Gopher would like to, and the memories of this ‘special’ patient will stay with me. His memory along with the memory of our other ‘special’ patients will remain with us as we continue to visit, and remind us when to bend professional distance.


  1. well said, my friend :) ... nice job!

  2. This is was so interesting to read. I love the gift and I am so glad you were able to keep it. It is understandable to want to know what happens to patients after they live, and to know where the line must be drawn in that can be difficult. I am enjoying getting to know your volunteer work a bit more, and I always look forward to your posts!

    1. Thanks Finn. I am going to try to incorporate some more tips and pointers pieces along with the poignant pieces as well. Glad you enjoyed.