An old adage says that “Laughter is the best medicine.” While it’s true that other medicines of all kinds can heal both the body and mind, laughter has a place as well. Using humor while working with your patients can not only help them, but make you and other health care workers feel good in the process.
Working as a care coordinator and registered nurse for the Visiting Nurse Service of New York’s VNSNY CHOICE Health Plans, Alicia Schwartz, MSN, PCC, CCM, RN, spends her days working closely with elderly patients and their loved ones to develop and coordinate home health care plans to address each patient’s needs. Many of these patients have been dealing with multiple health problems for years.
If you think this isn’t the place for humor, you may want to think again.
“Humor can be very helpful in helping [patients] cope with and adapt so they can continue to live safely and independently in their homes, where they feel comfortable and secure,” explains Schwartz. “I believe that humor enhances the nurse-patient relationship and can have a multi-dimensional value in care coordination. Studies show that laughter brings physical benefits and releases endorphins. It also boosts the immune system, improves stamina, and can strengthen breathing. And, of course, there are emotional and social benefits too—like reducing depression or anxiety and helping us feel close with friends and family.”
Maia Aziz, PSW, CLYL, CHP, agrees. As the President-Elect of the Association for Applied and Therapeutic Humor as well as the host of the radio talk show Morning Moments with Maia…Conversations of Love and Laughter, she knows all about using humor. “Emotionally, humor can give perspective, offer momentary distraction to allow patients to catch their breath and carry on. Being able to ‘find the funny’ can allow patients to feel less overwhelmed and powerless and thus, strengthen their resilience,” explains Aziz. “Socially, it can help patients join and bond with nurses and other healthcare professionals, leading them to be more trusting and collaborative. Using humor shows you care about the patient as a person—not just a body with physiology. It personalizes the experience.”
“Nurses who use humor have more motivation, energy, and fun at work,” Aziz adds. “It boosts their resilience as well as their patients’.”
Humor can even be used with hospice care. “The decision to even consider hospice care is not a natural one for most people. So stress levels tend to be heightened,” says Mary Ellen Levine, MSN/Ed, RN, who works as a hospice nurse at the Karen Ann Quinlan Hospice in New Jersey. “Humor has a way of humanizing and demystifying the intent to provide comfort at the end of life, no matter what the age or situation of the client.”
While it’s okay to use humor with your patients, you need to know when and how to use it, as well as what kinds of humor are off-limits.
The Right Time
Knowing when and how to use humor with patients is vitally important. Start by listening to the patients and using careful observation, says Schwartz. She often uses situational humor rather than telling jokes, and she bases it on what is happening at the moment. In one instance, she was working with a patient with arthritis who had severe knee pain. While speaking about the importance of exercise, the patient revealed that she loved to dance.
“And that’s how we laughed our way to progress,” says Schwartz. “During one visit, we danced—all of us in the home: the escort, the aide, and me. We laughed as we danced, and the [patient] discovered that her pain had lessened.” That led to the woman using dance as a form of exercise. “Every time I checked in, we would recall the experience and laugh again,” says Schwartz.
Levine also uses situational humor and will ad lib according to the situation. For example, she says that when she talks with patients and their families about the need to call for assistance during the night—something that they may be uncomfortable with and not expect to have to do—she will say, “And tonight, I’m on call. If you call, you’ll be asked your name, who you are calling about, and your phone number. I will call you back. If you need a visit, I can bring coffee.”
While saying that, she uses a dry delivery. If no one laughs, she can become “all business” again. But if they do laugh, Levine says it often relieves the tension. “My hope is that this leads to more conversation from patients and families,” says Levine. “Often, it leads to more questions in the non-threating environment I am trying to create.”
What kind of humor should you never use? Humor at someone else’s expense, ill-natured humor, or humor laced with profanity. Don’t joke about religion, politics, race, culture, or sex. “Laughter should always be with the patients—never at them or about the seriousness of their conditions. This can be a delicate point. Patients might make jokes themselves about their condition (insider humor) that are not appropriate for others to make,” explains Aziz.
Humor can even help troublesome patients listen to you. “It’s clear that once [people] trust you, they’re more likely to follow your advice,” says Schwartz. “People know we’re here to help, and we know they are going through tough times. Sometimes, it helps to work at it one little laugh at a time.”
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