Humor in Nursing

You won’t find test items on humor when you sit for your NCLEX. And there probably wasn’t a chapter on telling jokes during your nursing education. Yet humor is one of a nurse’s best tools and an accepted part of nursing practice. Laughter is good for you, your co-workers, and your patients.

Humor is a crucial component of life. Every human is born with a sense of humor, and every culture has its own form of comedy. Mark Twain wrote, “Humor is the great thing, the saving thing after all. The minute it crops up, all our hardnesses yield, all our irritations, and resentments flit away, and a sunny spirit takes their place.”

Humor is healthy!

The benefits of humor—and laughter—are well-documented:

• Oxygen-rich air is inhaled, stimulating the heart, lungs, and muscles.
• Endorphins are released by the brain.
• Soothes the stress response and results in a relaxed mood.
• Improves the immune system.
• Produces natural painkillers.
• Increases ability to cope with difficult situations.
• Helps to connect with others.
• Decreases depression and anxiety.
• Better performance in social situations.

For nurses and other professionals, humor does even more. It can lead to better self-esteem and self-competency. During a stressful shift, it dampens the anxiety response, so you can focus on what needs to be done. This is because humor and laughter stimulate the anterior cingulate cortex, an area of the brain associated with attention and decision-making.

A study at Northwestern University found that people with a good sense of humor were more creative and productive. The study asked three sets of volunteers to watch either a comedy show, a horror movie, or a quantum physics lecture. The group that watched the comedy show were better at solving word association games that relied on creative thinking. Certainly, every nurse benefits from being able to problem solve creatively—and be productive—as part of their daily job.

There are on-the-job benefits, too

A hearty laugh feels great and brings extra benefits when you can laugh at work. Brian Volk-Weiss, CEO of Comedy Dynamics, claims that laughter on the job does several things:

1. Humor improves communication and helps employees connect. Volk-Weiss says, “Except for maybe combat, nothing will bond your organization more than laughing at the same thing.”
2. Employees who laugh and have a good time together are more productive. Absenteeism goes down and collaboration goes up. Stress and boredom levels drop. Happy staff members result in a better morale.
3. When it’s authentic, humor at work builds trust among staff members. Co-workers feel more at ease with each other and because they sense the “real” person behind the job title, they are more open and trusting.
4. When employees are smiling and satisfied, word gets out. The organization tends to attract more high-quality candidates who want to work in a positive environment and the cycle continues.

Certainly, every workday is not full of non-stop laughter. Nursing is a challenging career and many shifts can bring sadness or frustration. But if you’re able to find something to smile about and share with your team, it can lighten the load.

Humor for patients should be therapeutic

For people with medical challenges, “therapeutic humor” can sometimes do as much as the treatment. Along with enhancing the immune system and reducing pain perception, humor can improve digestion and promote better sleep. Using humor as a coping strategy helps patients reframe their illness and treatment; they’re better able to find their way through the process.

Therapeutic humor is defined as “the purposeful and intentional use of humor that is specifically designed to create a positive impact (physical, emotional, cognitive, and/or biochemical) for another person or persons…”

Humor in the healthcare setting is not a continuous stream of one-liners or knock-knock jokes. It must include several principles of nursing:

1. Empathy and compassion for the patient
2. Acceptance of and respect for the patient
3. Sincere and authentic communication with the patient

Research shows that when two people laugh together—even if they’re strangers—they tend to like each other. Even going back to 1949, when DO Hebb published the classic psychology book, “The Organization of Behavior,” science has shown that “neurons that fire together, wire together.”

“But…I’m not funny…”

Not many people are born comedians. Paul Osincup, former president of the Association for Applied and Therapeutic Humor (AATH), wrote in the AMA Journal of Ethics, “Humor is a habit.” He offers a few ways to increase your Humor IQ:

1. Find your favorite kinds of humor. Listen to podcasts, watch funny films or television shows, and hang out with friends who make you laugh. When you find a type of humor you really enjoy, that’s likely going to be your choice to use.
2. Keep a Humor Journal. Every day, write down three things that made you laugh, grin, or even smile a little. There’s always something funny that you notice, so start to pay close attention. Studies show that doing this for just one week leads to an overall better sense of happiness.
3. Follow Funny Folks. Here’s great use of your social media. Find pages or people who make you laugh. You’ll soon find that you’re able to appreciate humor and recognize the triggers that actually make you better at appreciating humor.
4. Let your patients guide the humor. It’s not always up to you to make the first joke. Listen carefully when your patients speak; they can often initiate the humor. One study found that patients make humorous remarks as often as their health care providers…however, the providers only picked up on the patients’ attempts about 36% of the time. Let them be funny first!

Keep it clean…and non-offensive

Inappropriate jokes and sexual comments in the workplace are types of harassment. This conduct shows hostility towards a person’s gender, race, skin color, age, religion or disability. It also causes an offensive work environment and interferes with the person’s ability to focus on work.

The jokes and comments do not necessarily have to be verbal in nature. Emails, posters, flyers and other types of written content can also be construed as offensive and inappropriate.

Examples of inappropriate jokes include the following:

• Negative stereotyping
• Ethnic or racial slurs
• Racial epithets
• Sexually explicit jokes or comments
• Jokes that exhibit hatred toward homosexual or transgendered people
• Jokes mocking a person’s disability
• Comments about one’s age
• ANY jokes about a patient

There’s even an association that promotes it!

In 1987, a nurse founded the Association for Applied and Therapeutic Humor (AATH). It’s an international nonprofit organization that “promotes health and wellness by stimulating a playful discovery, expression, or appreciation of the absurdity or incongruity of life’s situation.” In your nursing career, you will certainly find plenty of absurd or incongruous moments.

The AATH website has a research library, TED Talks and ideas for incorporating humor into work and life. If you’re “serious about humor,” you can become a member to access the library or attend the annual meeting.

It helps in other ways, too

The Centers for Medicare and Medicaid Services (CMS) requires all hospitals that receive CMS reimbursement to survey adult patients to determine their satisfaction with their hospital experience. The HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey is the first national, standardized, publicly reported survey of patients' perspectives of hospital care.

Discharged patients (randomly selected) are asked 20 questions about their stay. The questions cover communication with nurses and doctors, the responsiveness of hospital staff, the cleanliness and quietness of the hospital environment, communication about medicines, discharge information, overall rating of hospital, and would they recommend the hospital. Studies have shown that when communication includes humor, patients giver higher ratings. They are simply more satisfied with their overall experience.

A second benefit of using humor in healthcare is few malpractice lawsuits. When patients feel a connection with their nurses (and other providers) they have greater trust and feel more supported in their diagnosis and care plan. In fact, they are more likely to be compliant with therapy and treatment.

Humor is part of good communication. Doctors with few lawsuits typically spend more time with patients, and are more likely to use humor, talk openly, and clearly express their opinions. It appears that the more likeable a physician is, the less likely they are to get sued. This goes for nurses, too. (However, the humor must be appropriate, or a patient can be offended.)

Get started now!

Take time to get to know your patients. Always be professional and courteous. Once you’ve become acquainted, introduce humor…and let them do the same. Being hospitalized is scary and intimidating. A diagnosis can be life-changing. But when you allow your patients to see your human side—and let them do the same—you are helping them cope and heal.