Good afternoon, everybody. Thanks for being here. I know it's the last day of session. And first and foremost, I really stink behind a podium. I never stand still. So if I wander, you will hear me, I assure you. But I may wander, which is going to really upset the rest of the world with all the taping and all the things that are going on. But I assure you, you'll hear me. And that's the most important part. We do a lot with critical events. And in order to actually introduce us a little better, we have a little video to start this off. And trust me, a video with music. And it was a big challenge. And I thank both our moderators for assisting with this. Because some of the things that go on, and we've had this, we actually traverse the country and give different presentations. This is going to give you a little better insight to who really we are as a crisis response canine group. ["Don't You Cry"] You seem so strong. My arms will hold you, keep you safe and warm. This bond between us can't be broken. I will be here. Don't you cry. Because you'll be in my heart. Yes, you'll be in my heart. From this day on, now, and forever more. You'll be in my heart, no matter what they say. You'll be here in my heart, always. Why can't they understand the way we feel? They just don't trust what they can't explain. I know we're different, but deep inside us, we're not that different at all. And you'll be in my heart. Yes, you'll be in my heart. From this day on, now, and forever more. Don't listen to them, because what do they know? We need each other to have to hold. They'll see in time, I know. When destiny calls you, you must be strong. I may not be with you, but you've got to hold on. They'll see in time, I know. We'll show them together, because you'll be in my heart. Believe me, you'll be in my heart. I'll be there from this day on, now, and forever more. Ooh, you'll be in my heart. You'll be here in my heart. They'll see. I'll be with you. You'll be here in my heart. I'll be there always. Always. I'll be with you. I'll be there for you always. Always and always. Just look over your shoulder. What's unique about that video is I would say 90% of them, we were called out to an event, as you saw, Uvalde, that one classroom. For those who may not know, unfortunately, the one classroom was all taken from us. The group that you saw were those who were survivors. There were 11 children who survived that. And we continue to this day to react and interact with them. We've helped them get emotional support dogs. We've helped them in a number of different ways. What Mary's going to do now is talk to you about specifically how it relates to clinicians and their care. And I'll go back a little later on and tell you about my background and how I got involved with this and how it actually morphed into what we're doing nationally now. So Mary, if you would. Good afternoon, everyone. First of all, thank you for having us. It's truly an honor and a privilege to be able to present to this really prestigious group. And you can see, as a nurse, I do a lot of volunteering in my spare time. And as you can see, this is really truly my favorite nonprofit that I work with. It is so fulfilling and rewarding to be able to go into these communities who have been so affected by such traumatic events and to bring the comfort and the healing presence of a canine and the handlers. So it also translates, which I'm going to talk a little bit about and introduce our concepts on why it's so important with our health care colleagues for us to have this type of intervention in this program for our health care colleagues. So we're going to just go through just some of the negative impacts that we're all very familiar with, but just to center us on our conversation about why this is so important. We're going to talk about that. We're going to talk about a model that John has led the development of this particular model over the course of years. It really started long before COVID when we noticed the impact on our health care colleagues of stress and repeated traumatic incidents and how he has really taken this model and developed it to where it is really very much sought after in our area. And I think we're in over 26 hospitals that we work with currently with our teams across the country. And then he's going to speak to you about how you can access these same resources and take advantage of them. So we know clinician burnout is the hot topic. Everywhere you look, every journal is talking about clinician burnout. We know as providers, as clinicians, that we're subject every day to ongoing stressors of the job. It's continuous. We knew that it existed before COVID. And after COVID hit, it only exacerbated really the feelings of that isolation, the stress, and really taking on so much that we were unfamiliar with. We know what happens when we are repeatedly exposed to stress. It can create burnout. And we know that that causes us really to lose our passion for why we became the clinicians or the health care individuals that we did. We came to work every day with this passion and this mission. And after this, we're finding that we're tending to lose that, and we're experiencing burnout. And here you can see some of the symptoms that we know we see in ourselves. And we're asking our colleagues to reach out. I'm a data person. John always laughs. He really will go into the model very thoroughly. I'm from my background. I'm a data scientist, so I love to bring statistics. And no matter where you look, it's pretty much all the same across the board. We know that across all disciplines, especially with providers, they're experiencing burnout. These studies are done every year. They're done by different organizations. But really, the results are coming out and that we're finding that more and more burnout. We also know it exists within nursing, our advanced practice nurses, as well as our nurses at the bedside. And it also extends to our nurse leaders. We do a lot of work with nurse leaders across our area. We attend retreats. And we're finding that they're experiencing the same level of burnout among our colleagues as well. So we know that there's interventions that need to happen. So the causes, think about your daily job that you're interacting. You're doing the paperwork. It's the bureaucracy. It's the respect. And we know that ever since COVID hit, it seems to be that we have really lost a lot of the civility within health care. We're finding that clinicians are, all of our staff within a health care institution are really subject to a lot of workplace violence and it becomes demoralizing. We know that they're experiencing that every day. And that just adds another layer to everything that they're already trying to deal with. And you can see the list here. I don't need to read it out. But we know that COVID really added an additional layer onto an overburdened health care system and practitioners. So we talk about the symptoms of clinician burnout. And it may be things here, you can see the list. You may see this in yourself. But you may also see it in your colleagues. And it's really important that we reach out to them, that we pay attention to these signs because there is things that are able to be done. So it's very important that we have a role in caring for each other. And this model that John's going to talk about in a minute will show you one of the ways that we found was effective. We started rounding on staff when COVID hit. When everybody left the building, John brought his canines in. And he was there every single day for months. He showed up on weekends. He showed up on holidays. He was on those units where everyone had left and were working remotely. He was in there with the canines. And we started to notice the impact that this had to be able to go in and check on your colleague and say, how are you doing? What's going on today? And when you get to know your colleagues, you know when there's something off or they're having an off day. And it may be something as simple as giving them a little break for this intervention that we're going to be talking about. So we know that there's different ways that people cope with stress and burnout. Some are healthy, that you can see the list here. Some like to go out and exercise. Some like to take up a hobby. But we also know that there's other ones that are more detrimental to our physical and mental health that we're finding that our colleagues are using to cope with the stress and the burnout. So I'm going to turn it over to John now. He's going to share the model that he really has passionately worked on, done a lot of work around this. He's working with some research institutions that he'll talk to you about to really have this model be out there and available to our colleagues. And I can tell you, we round on a weekly basis in one of those healthcare institutions and the impact on the clinicians is just transformational. So I'm going to turn it back to John. Thanks, Mary. Yes, Mary is the intellectual one of the group. I am just the operational one. Little idea about my background, just so you know how I got involved with this. So I'm a retired major from the New Jersey State Police. And I served on a specialized unit in the State Police of New Jersey. They call it the TEAMS unit, Technical Emergency and Mission Specialist. And what that meant was we went to the more difficult jobs, climb bridges, did high angle rescue, anti-terrorism. And quite frankly, I was in a command position after 9-11 and I had sent a number of my personnel to New York and to the outskirts as well. And afterwards, the commanders were told we had to take an employee assistance program. So we did, we put the check in the box because we didn't understand it, we didn't believe it, but we were told we had to go. And I will tell you within three years, two very good friends of mine committed suicide. And I started focusing on like, we need to understand what's going on. I didn't comprehend. And I came from that elite unit idea of badge of honor to be there, not like I can, and I can give you a prime example where we had three officers who were shot, two killed, and we were the responding group. And I remember my commanding officer at the time said, wow, you were part of that, that's really neat. That was his exact terminology to us. It was a badge of honor you were there. We just lost, and we thought we were gonna lose all three. We just lost two of our comrades for sure. And a third one, Rich, who we thought was going to pass away. He did survive and goes across the country now talking. And Rich and I work in collaboration with, what are we gonna do about the wellbeing of our folks? So that's where it all started. I became a critical incident stress management instructor. And I'll be honest with you, I got deployed to Katrina. I had 500 personnel under my command. We went down to Katrina, I had three districts in New Orleans and there was a distrust of authority. There was a distrust of police and no one would talk or converse in any way. It was very combative until they brought canines in. And the next thing I know I'm watching this and I saw people interacting and responding more positively. And again, it was, hey, you have a shepherd, I have a shepherd sort of thing. And they started conversing like that. Part of my master's study, I actually incorporate the animal assisted crisis response and started researching those areas on what we started ended up being the animal assisted interventions. That center picture, I may stop on occasion to let you know, that's Nashville after the shooting they had down in Nashville. And you know what? After an event, a horrible event like that where they lost three children and three adults, it's okay to smile. It's okay to get with each other and understand that we need to continue on. You're not gonna forget, you'll never forget. I mean, Louisstown taught me an incredible lesson. I spent three hours in one critical and distress debriefing with a hospital staff who ran out of blood, who didn't have enough personnel to assist in what they were doing. They did an incredible job, but we spent three hours to make sure they were good, their wellbeing. That's why I give this Congress such great credit. As much as it's the last day of the session, they cared enough about the wellbeing of their staff to introduce this program. Truth be told, the same thing happened with the EMS National Conference. The one year I did a session like this, and the next year we did a keynote because everybody wanted to know, what are you talking about the wellbeing of your staff and taking care of them? And looking at what we're doing with animals, in particular dogs. These are our canines. We have other people who have other animals who are part of our organization, but we focus on the canines and the interventions and what they're able to bring. The canines we're talking about today are not therapy animals. In order to become part of our organization, you have to be a therapy animal from a nationally recognized organization. And then you come in and you have to go through critical and crisis response training yourself, as well as the canine has to go through crisis response canine training. It's very intense. All three, I have three Rottweilers. All three of my three Rottweilers are working service animals. They are animals that were trained for PTSD. They actually had that certification. Is it for me? Probably somewhat. But truth be told, when I go out to these events, and the first one we actually deployed with, I think it was 2016, was Pulse. We went down to Pulse, and our main objective was to talk to the first responders. I have a first responder background. We first went to the law enforcement. They saw how successful it was because for what they had to go through. And again, you probably are aware of some different event that may have happened near you, or just maybe you watched it, or Uvalde, and some of the things that have happened. Again, the first responder is what they actually encounter when they go in these things. And I'm not talking about the Uvalde, and I saw the... It just came out again. Mary and I were there a day after. I know exactly what happened. I was briefed. I actually met with the people who went in, who had to process those 19 children and those two teachers, and we had to work. We met a gentleman from San Antonio. I'll never forget. He was old school. He went in there, and I will tell you right now, he was almost arrogant, because that's what we do. That's our defense mechanism, whether you're a first responder, whether you're a clinician. And he was telling us, like, I'm used to this. I'm a homicide guy, and everything else. Well, we knew what he was going into. We met with him a couple hours later. A little different when you have 19 of our most vulnerable population taken from us. Real different. And we had to spend an elongated period of time with him. And that's what we learned, and that's why we have our K-9s trained specifically. Again, you'll see this time and time again, because of the critical incident stress management. We're strategic partners with ICISF, International Critical Incident Stress Foundation. And again, the one component we always try to help with is resistance. We want to make sure prior to something happen that maybe you're able to cope with it. Then we push with resilience. Understanding full well, as Mary so aptly said, especially in your professions. You know things are going to happen. Unfortunately, and I'm told in your environments, and it's what we call it. I worked at Atlantic Air for 11 years. I was in charge of emergency management security. You have bad outcomes. That's when somebody has an error with meds. Something happens, and unfortunately, maybe there's a death. And again, the resilience piece of you know these things are going to happen. You know you're going to have traumas. You know you're going to have shootings. You know, unfortunately, as it continues to grow, you're going to have workplace violence. It's almost ridiculous to how it's grown, and people go into a hospital. They might as well think it's a hotel, and they want you to treat them. But then if you don't, they're going to lash out against you. We need to understand what that is and try to help people so they're better equipped to be able to handle that. When we talk about the benefits, you know Mary talked about the clinicians. We looked at certainly the signs of burnout. And again, I can't. She talks about you know your profession. Our job, if you will, is to make sure you maintain the passion you have. My passion for being a trooper, my passion, I wanted to go on a unit that jumped out of helicopters. I had a great passion for that. I'm an old guy. I would still do that tomorrow because that's the passion and love that I had. You didn't get into it thinking, oh my goodness, every day is going to be a challenge. Every day, somebody is going to try to hurt me. Somebody is going to come under the influence. You're going to be trying to save their lives. I couldn't believe how many times I saw people come into our hospital who were literally deceased, and they would hit them with a Narcan, and they saved their lives, and they would try to fight them. And I actually heard the one individual one day say, you took me out of my greatest high. And I wanted so bad to say, you were dead, and that doctor saved your life. But those are the things, unfortunately, that you have to deal with. And you never plan for that when you have that passion for your profession. And we need to make sure we reconnect that with you. And we hope that we'll be able to improve your physical and mental health. And we've proven that. We're working with Ohio State University. We're working with Sigma Theta Tau. Yeah, that Sigma thing. I'm giving a presentation, and so I got to get that down. But we're working in collaboration with them, the Association of Nursing Leadership, because now we're taking this model. We're seeing how well represented it is and how successful it is. And again, I got to be honest with you. I don't know where you're at, but I always put the organizational benefits. You have less turnover. They actually will use us, whether it's Jefferson, Temple, and the other 26 hospitals, as part of their recruiting to show that they've made an investment in their people, that it's a little more than just the normal. And I'll explain what we do in going around and establishing that baseline it was talked about. And again, you talk about increased patient satisfaction. You know how that happens? Engagement scores are going up. I spoke to a president last week. I won't tell you which hospital. He was like, hey, I'm so glad you're here because our engagement scores went up and our HCAP scores went up. And to me, I'm the operational guy. I'm not the data guy. And I'm like, yeah, that's not why I'm here. But that's a benefit to your organization. And we've seen that time and time again. And obviously, it helps increase the work environment, the workplace environment. Now, again, when you look at this, it's nothing new. As I started to look at this, and you can look at this and research yourself, it goes back to 800 BC, when the Grecians actually were using it for modality. Then we looked at it, and I found that they used it in the 1800s for psychiatric interventions using canines. I always love when I interact with nurses because Florence Nightingale, I mean, the queen of nursing, I guess, used to use animals in the same way. Sigmund Freud, Boris Levinson, and how he would bring canine, or they would bring canines in during sessions to help people relax, lower their blood pressure so that he could interact with them. World War II is where you really start to see they start to use it from a standpoint of an organization, if you will, the military organization. And even in the 40s, when there was a big fire in Boston, 400 people lost their lives. And many of them were military, and they started using the animal sick crisis model at that event, not only with first responders, but also those who were serving, obviously, as in the community trying to aid. And again, for anyone who's here, and I love when people come to this, and afterwards, we'll say, is there any questions at the end? And nobody else has a question. Then we'll start walking. Everybody will grab us out in the hallway. People came just because you have a dog. What is this about? And I got to be honest with you. The only reason I didn't bring a dog, and I'll probably get yelled at by these two moderators. I have two dogs that are out and they're doing obedience competition. The other one's doing the run around the ring competition. And I had a female who's going to bring with you. She's in heat. I ain't bringing a female in heat. So for anyone who has a dog, you understand. You understand the bond. You understand, you know, the significance of that. When you get home, they're not going to ask you what's for dinner. They may want to eat, but they're not going to harp on things. They're there for you. The same thing applies. We've taken that same process, and we're now including it in some of the environments that you work in. And we obviously have increased the positive, emotional, psychological, and the social interactions that occur. Again, you look at it overall sense. This is not just the clinician aspect we were looking at before. Again, certainly the burnout aspect, the social isolation. And obviously you're going to talk about the loneliness, the depression. There's some of the things you feel. We don't want to accept that. We don't want to acknowledge it, but the anxiety that you may have. And these are the things that we see. And again, it improves your quality of life. When anyone ever comes to, when we talk about things and the challenges you have, we look at, all right, what is the quality of life aspect and where are we progressing? And again, we talked about the lowered levels of epinephrine, the cortisol, the increased levels of endorphins. And I talked to you already about the lower blood pressure. What had happened was we had this program, as Mary said, and it was literally, I know this because usually Mary will bring it up. It was 156 days straight. And I can be real candid with you because I don't know anybody in the audience, and I'm sure there may be an administrator somewhere. During that time, during COVID, you never saw them. I'll never forget the one day that someone very high up, may have been the president and CEO, came to the IC unit. And there was a myriad of people who were suffering from COVID. Respiratory issues, we had deaths. And the person came in to the unit and said, have all the nurses come to me in the front area so that I can talk to them. And I'm thinking, yeah, I think somebody missed the point here. Because you've got patients who need them and they're servicing those patients. And again, I have such a profound respect. And normally I say my nurses, and sometimes I get in trouble. It's not an HR thing. It's this. I spent, for those who may remember Camden in the New Jersey area, it was the most dangerous city for two years straight. And I had three deployments there. During that time, two of my guys got shot pretty bad. And the nurses at Cooper Hospital saved their lives. You better know I'm going to save my nurses because God bless them. The nurses, the doctors saved their lives. So I always had a profound respect. I never thought in a million years, I don't like hospitals. Next thing you know, I retire from the state police. I'm in charge of security and emergency management at a hospital for 11 years. That's the respect I had and the passion I had to protect those who actually serve and protect and save others. So when we put this whole model together, we were looking at that. And I saw the incredibly positive results during COVID. As Mary so aptly said, literally, I would walk around on Mother's Day when everyone else's home, when you would never see an administrator, when people were still working, I would bring the canines in and work with them. We talked about the baseline. Mary talked about that. And she was with me the one day we met a nurse that we knew and we interacted with many times over. And that's why it's so important. It's not just a therapy animal comes in. We don't even visit patients unless you, the nurse or doctor tell us, Hey, could you visit them? You know, the first time I did that, because normally I would say, no, we're here for the staff was when the nurses came to me and God bless him was temple. And they said, would you please visit this patient? I should listen. We're here for you. If you need a therapy. No, they said, listen, this is a little different. This is one of our own, one of our nurses. And unfortunately, um, she did lose her life and they knew that that was, she was going to succumb to what her problems were. And we went in and saw her and the smile. It brought her lifting her spirits, you know, just for that short duration. We said, okay, if there's no isolation issues, we listened to the doctors and nurses and we will go in and interact, but we're there for staff. And that's the most important thing. And we saw that time and time again, and we had a baseline and we saw this woman the one day and we said, Hey, are you okay? And she was like, yes, of course I am. You know full well, how you doing today? I'm good. And you know full well, it's nonsense. We took the extra time, went in, interacted with her and we found out she has some significant issues to the point where she was going home at night and her husband and even her two kids were like, you can't come in the house. You need to get changed outside. You need to shower in the outside shower before you come in. I mean, what the heck is that your own family here? She works with us all day. And then she has that a shout out. I'm trying to be a little humorous as well. I got to tell you, I love my nurses and I'll never forget, you know, you know, Morgan, I know here I'm going to get in trouble and I'm going with it. I never knew what explosive diarrhea was until I helped the nurse one day because I put on PPE all the time and I would put on the N95 or whatever we needed. I would go into that room. And the one day Morgan was going in and nobody was around to help her and she said, Hey, I got to change this guy and everything else. And she goes, be careful. He's had explosive diarrhea every time. I'm like, all right, whatever, whatever. What is that? I'm a trained killer. Yeah. Well, guess what? I didn't realize what that was, but she didn't tell me was when you rolled them over the other side, it happens again. And the nurse, I love her to death Morgan. And you know who she is. She was so nice to put me in the operative place where I would actually understate it clearly. Well, my point is this, you do that every single day. You're going through that every single day. And to this day, I will tell you those nurses, those doctors, Jim Eakins, Frank, you know, Jim, you had the one doctor. I don't even know if you remember, she's standing in green scrubs and she's got a mask on and she's going like this scared to death of dogs. But the one day she needed something. And she's like, you know what, can I, can I get near him? And again, our dogs are extremely well-trained. If Frank and, and, and, you know, some of the other moderators get us to Orlando, I promise you I'll bring dogs, not in heat, but I'll bring dogs. But with that said, that is where the model started. And then we continued on. We have probably 98 teams across the country. I'm not going to tell you where every place where you're at. What I will tell you is same with ICISF. I gave a keynote speech to international critical and stress foundation. And I tell folks, if you have the appropriate dog that has trained properly, that can go through our assessment, perhaps you could be part of that team. I can't even begin to tell you, Mary will tell you afterwards as well. How many nurses are part of our group? Some like Mary don't have a dog. Mary went with me with Baltimore. When we lost our three firefighters in the Baltimore fires, she went to Uvalde with me. She went to Nashville with me. She was incredible in the role that she played. She too is a critical and stress management instructor. But the role that she played going to Vanderbilt, going to some of the hospitals that we go to after the fact, you know, meeting with staff, meeting with a doctor who is the pediatrician for 19 kids who now he had to identify them. Yeah. So we actually interact and it's so incredibly important that we have folks like yourself participate with this program. So again, understand where we're at, how we select our teams. You know, that's not only just people who have canines and it's not just a dog as we go. Unfortunately, we're going to be having a big symposium in Atlantic city in April because everywhere you go, you jump on a plane and everybody has a service animal, but we're trying to address that because, you know, I was in El Paso when you had that shooting. And the next thing you know, some guy shows up with a dog and he said, it's a therapy animal. And then it tried to bite kids. We are very critical about it. And unless you go through specific training and are recognized as a working service animal, you're not part of our group. And it's tough. And the criteria that the handlers have to go through is equally as challenging, but extremely rewarding in what we're able to do. We spoke about COVID two of my greatest nurses are, I love Trudy to the left and Jeannie to the right. My, my goodness. There was the only thing that was tough with them is I'd literally get a call like two 30 in the morning. We had a bad night. Can you come in? Which meant I had to be there at four because they wanted to hit that shift and get the ongoing shift. But again, I told you before, you know, we have 26 hospitals that we're actually active in. You see 30 or 15 systems, multiple hospitals, and some of the systems we're going national. We're working. As I said, with Sigma, I'll just cut the other two words out Sigma. And we're working with Ohio state to actually bring it to where we're going. We're working with North Carolina, North Carolina university. We're being acknowledged nationwide now and what we've been able to achieve working with people like yourself and moving this forward. That, that group there, what an incredible group, that group there is temple. And they are a, that's a, that's a, a challenging facility, I will tell you that. That is after one night where they had 21 traumas. And we went in there and we actually interacted with them. We had some diffusing. A debriefing is perhaps maybe like 48, 72 hours out. Diffusing is when it just happened. And I'll actually touch on that in a little bit with some of the events that we've had. I'm gonna be honest with you. I mean, Mary knows this, she's the only one who knows this. Somebody I know very well, it's not New Jersey, but an associated place. I will be going back. We leave tomorrow and on Thursday, I have to meet with the family and some of the others because another police officer took his own life. The same thing happens, unfortunately, with medical staff. It's happened on multiple occasions and we get called in. So again, it's the matter of what we can achieve, what the individual can achieve, and the success of the teams and what we've actually constructed with some of the healthcare systems we're talking about. When you talk about a critical incident, when you do a debriefing, when you do a diffusing, did several last week at different hospitals. This is what I'm talking about. Certainly anytime you have death and serious injury, obviously mass violence, when you have active shooter events, we don't respond ad hoc. We don't like all of a sudden show up. That's what's happening all too frequently. I know one group, they need to be there so they can get a photo. I used to be part of a group, Las Vegas, you know the shooting in Las Vegas, how many people lost their lives in Las Vegas? Literally, we're on our way out to meet family members. The person who was in charge of that organization says to the five of us, make sure you get pictures of people crying so I can put up my PowerPoint. I was done, absolutely done. That's not what it's about. We're there to help folks serve as that bridge to recovery if we can. You will never forget. I told you about the police officers who got shot and killed. I was a sniper on that job. My view for six hours was John McLaughlin, who I knew extremely well, half of his head was taken from him because of a blast of a rifle. That was my view for six hours. Think I'm forgetting that? Not hardly. Happened in the 90s. I can tell you exactly what it looks like to this day. Those, that's what happens to us. That's an injury though. We call, like some people call PTSD. Not everything's a disorder, just so you understand. When people go through these events, it's more like PTSD. It's an injury. Oh heck, I'm shoveling and I slip and I injured my knee. That's an injury. Same thing happens with your mind. And all too frequently you forget that, that your mind is the same. And you'll have some incredibly diverse reactions. They're normal, normal reactions. I've been to police officers. We had an event where three children were killed in a car accident and the police officers respond. And the one police officer, we were talking openly and we're having a debriefing. And he said, I can't sleep. Normal reaction. How long is it? Now, if you start to go three, four, five weeks out and you're still actually challenged by that, then you have to go to a therapist or someone obviously of a higher level because now it's going towards a disorder. But most of the time, they're just PTSI. They're injuries. Your mind just is looking at it going, wait a minute, that's not right. Yeah, no kidding. And you're having a reasonable reaction to an incredibly abnormal event. So that's what we're talking about. Certainly disasters, you saw Surfside. We had gone down there. We were actually assigned to the pile. I was no further away from the pile, if you will, to that back wall. So literally as they came off the pile, we would interact with people who you didn't know it, but they were finding body parts. They were finding other things. And again, we were trying to help them make sense of that. And sometimes all is it needed, whether it was that or whether it's an event at a hospital or wherever the event may be, sometimes it's just that five minutes to decompress. There's a picture that I'm not going to go back to, but one of the folks was from Israel, the Israelis. I have spent time in Israel for different reasons. And we were talking about that. And I was talking about with a gentleman. One of the other gentlemen from Israel was there and he was with my dog. He came to me, he was on the ground and he was petting him and I was just letting him go. I'm just letting him relax. He came over to me afterwards and he goes, hey, I just want to thank you. I want to thank you so much for letting me do that. And of course, what do you say? Like, hey, I want to thank you for what you're doing. He goes, you don't understand. That gave me the resilience I needed to go back to the pile because I had had it. I had lost it. I couldn't do it anymore. And he said, just that five minutes with him just helped me, if you will. From resilience to recovery to move forward and go back in. So that's what we do. Obviously, if you have any workplace violence or injuries, medical errors, anytime. I didn't skip over it. I left it last. Anytime there's an event with a child. Anytime our most vulnerable population is impacted, obviously we have to go there and we have to serve those folks. We've talked about it many times, those three main areas of focus. I say them to you because those are the areas you should be focused on yourself. Everybody has a model now. Every hospital I go to has a different term. We all have to come up with our own acronym. That's great. Enjoy. I don't care what you call it. Just understand the core fundamentals of critical and distress management are the resistance piece. You can read what that is, the resilience piece, and hopefully that process of recovery. And again, understand this as well. And this is mostly for my brothers and sisters in law enforcement. Just so you know, I do a lot of work, as you saw, with the military as well. My daughter's a lieutenant in the Navy. My son's a major in the Marine Corps. And my son's best friend is actually SEAL Team Six. I won't tell you his name. He just calls and tells me, because he's like, I'm his adopted father because they went to the Naval Academy. Hey, Dad, I'm going on a business trip. Yeah, okay, whatever. Business trip. But understand this. When you do critical and distress debriefings, it's not a critique. We don't go in. I remember one time at Atlantic Care, one of the bosses was like, we need to find out what came in. So bring the dog in and we're gonna, This isn't an operational critique. That's not why we're here. We're worried about the well-being of our people, making sure they're okay to continue. That's what it's all about. He and I didn't see eye to eye and it didn't end well. But you know what? We stuck to the principles. Same thing. We don't just self-deploy and pop in. You make sure that there's a purpose that you're part of a process. Surfside, everywhere we go, we work with the incident command. Our people have to take incident command courses. There's only a couple of them. They're easy. For those who may be considering, it's like, oh my God, I gotta take all this? Yeah, you do. Because when you go to Surfside and all of a sudden FEMA says, hey, you're gonna be working with us right out of incident command, you need to understand what the hell they're talking about. And they respect greatly that we have a general understanding of what's going on. And again, as you can tell, I am not the intellectual. I am certainly not a psychotherapist. We are gonna talk openly and we're gonna talk in general terms about how the mind is reacting normally to those abnormal events. Again, when you look at critical and distress debriefing, it was actually started in the 80s as much as it was taken from what they did, like we said, in World War II from the military. And they adopted it for those in first responders, EMS, obviously law enforcement and the like, fire as well. And we started talking about how, and I work with Dr. Mitchell, Dr. Everly, who are the ones who were created through ICISF. And we actually forged that whole healthcare model. We're actually putting together a curriculum in that regard. And again, part of that, as we said, was the debriefing aspect. We talked about the 24 to 72 hours. And the biggest thing here is you read all these things. I'm just gonna say this to you. Look at those things. Let me ask you one thing, like I said, you yourselves, obviously it's rhetorical. Who's your go-to person? When things are really bad, who's your go-to person? Because I gotta tell you, and I'll be upfront and honest with you, it wasn't my wife. And I told my wife that and she was not happy. It was the people I work with. They get it, they understand it. And I hear that nonsense about work, husband, work, wife. I don't care about that silliness. Who is your go-to person? Make sure you know who your go-to person is. You need that, especially when events are going to occur. And in your profession, they're going to occur. And you're gonna be impacted. Every single person is impacted. I won't tell you where, but I will tell you that one place we went, we met with medical examiners. I don't know if there's medical examiners here. They were certainly a unique group, but they were bothered equally as much. And when they opened up, they had the same challenges as every single other person. It's just that they had built up these walls and it's like, ain't gonna work. I remember the one doctor, literally, I had Axel, my one dog, sitting next to me. He's 120 pound Rottweiler. And all of a sudden, I see the doctor petting him and interacting with him. I'm like, all right, and I hate to say it this way to you, but I'm like, I got him. I know now that he's ready to talk. And he did. And boy, did he have some significant challenges. But he needed to understand that himself. That's all it is. But you can see that the number of positive things there, your go-to person. And again, as you progress, I'm gonna say this because everybody's looking at facility dogs or whatever you wanna call them. We get a lot of contact information from across the country. We're looking to actually codify that in the months to come because everybody wants their own dog. That'll backfire. I mean, don't get me wrong. I shouldn't say there could be successes. I've never seen one. One hospital system right near us got two dogs. They tried to copy everything we did. The two ladies got them. They started going to the hospital and the dogs just did not work out. Problem is Baltimore. We went to Injun 14. They had lost one of their loved ones. They asked me to go there to do a debriefing. I didn't know the family was gonna be there, but I went in to do the debriefing. Hold on, we gotta put our therapy dog away. I'm good, my dog's trained. My dog could care less. My dog normally sits up on the stage and all you people are like, oh my God, look at him. He doesn't move. That's what he's told to do. This dog was so vicious, the shepherd they had. Problem is this. It becomes environmentally protective. Schools, I've seen school teachers who have dogs and it's like, this is great for the kids and everything else. The dog becomes protective of the environment and you have to be very careful of that. And when we retested that dog, we have something called Seabark. You can look it up. It's actually a system you use. It failed miserably and we're like, you gotta get this dog away from kids because we don't know how reactive it may be. So be very cautious. What's nice, even the FBI who was coming to our symposium, their dogs went to nothing but events. Our dogs go to everything. And you'll see that in short practice. We talk about, hey, where do our dogs go? Comfort animals, everything else. We talked about CISM a lot. Like I said, we're strategic partners with ICISF. This is some contact information. You know, yell at us afterwards. I know there's contact information. I'm letting you all take your phones and get it if you want. I'm giving you two seconds and I'm just beating a drum while you're doing it. But again, there's other things, there's other organizations we could actually direct you to as well. I talked about comfort teams. We integrate them as well. You don't become a deployment team unless you're able to actually go forward and go visit libraries, visit kids, go to other places. We go to hospitals every day of the week near us. And we have those 26 hospitals that are available that we go every single day. That young lady there with her arms crossed, great photo. I have to tell you that morning, she lost a young one. They asked us to come in, she was absolutely devastated. Victim again, most vulnerable population, a very young, less than six months old. We actually interacted with her and yes, she's smiling under the mask. And yes, it's okay, life will continue. We just need to make sure she's okay and we continue to see her all the time. Same with that young lady in the middle. She's a trauma nurse at Temple. Again, these are what we see on regular basis. This is part of our baseline, but in these cases, this is when we went and we responded and met with people we had seen before. Actually, I had forgotten that upper right is actually the kids that survived. I'll give you a quick story. I only have like a couple minutes left, but when I was there, the Texas Critical Injury Stress Team came to me, the Texas Rangers, and they said, listen, the kids, the 11 survivors, several of them won't talk. One in particular, David, cute kid, will not talk at all. Won't even talk at home with his parents. We met at a church. There was a church service going on and they knew they were going to go. It was going to be bifurcated. They were going to take the adults and put them in one section and take the kids into another. And they said, will you take, they literally said, will you take a run at them? And I said, listen, I'll do my best. So when he came there, I gave David Axel. And I said, listen, I want you to do me a favor. I want you to take Axel and I want you to have him meet the other 10 kids. So he went over, didn't speak, starts talking. And now the other kids are like, what's his name? I don't know. How much does he weigh? So he came back to me. What's his name? Axel, okay. How much does he weigh? 120 pounds, okay. How do you train him? How do you train him? I made him a stakeholder. All of a sudden he starts talking. Swear to God, what an incredible turnaround. About 10, 15 minutes later, I'm there and I'm inside the room and somebody had answered the knock on the door. They said, hey, the Texas Ranger wants to talk to you. I go to the door, I'm like, hey, what's up? And he goes, how you making out with that kid? I said, hey, remember that kid that wouldn't talk? He goes, yeah. He won't shut the up. And what happened was, just so you know, his teacher, she's gonna be at our luncheon next, well, her husband will be at our luncheon. She took three kids, including David, and held them in front of her and had her head shot with the rifle in Uvalde. All those kids saw that. So we started working with him and we continue to work with him. And like I said to you, some of them, we got emotional support dogs and we're helping them that way as well. You can see Surfside, lower right, that's Vanderbilt Hospital in that other picture. I will tell you that, you know, as we conclude, just understand you need to take care of yourselves. I am so grateful, I truly am. And I hope that we were able to come forward and profess what you wanted. I say, and I'm not discounting the young lady, but Dr. O'Connell knows what we did and knows how we go on across the country and talk about the wellbeing of the people working in your environments. And the challenges that you have every day, as Mary spoke to, especially with her data. Understand that there's things out there available for you. Please take advantage of that. I don't care what your acronym is. And then obviously consider the use of canines. I've done a lot of work on it. I learned a hard way through people that I had to lose. And again, as I said to you, I'm going to be going home and the people who asked for me to meet are the family. We do a lot with families now. It was the family who asked if I could actually meet with them when I returned from their husband who committed suicide. Take care of each other. That's one of the biggest things. With that said, I'm going to have another quick music. It's okay to get up and dance if you'd like. I saw a couple of you like rocking and rolling in your seats and then maybe we'll have a couple of minutes for questions.

crisis response

canine support

emotional recovery

clinician burnout

animal-assisted interventions

trauma resilience

stress management

healthcare support