It had not been Jenny T’s best day ever. After discovering that she — along with many of her colleagues — were being downsized out of a job, she’d gone out with some friends. They’d had a few drinks, but Jenny wasn’t behind the wheel when they headed home. That didn’t help her much — she’d spent most of the night in the ER, being ‘reassembled’, after the car she was riding in was involved in an accident. We tried to reach her husband, and when we finally did, it turned out he was at his girlfriend’s house and he wasn’t in a big old hurry to come see her — seeing as the girlfriend still had a job and all, he figured it was as good a time as any to jump ship.
What, she asked Linda, her ER nurse, was she going to do?
Linda, a RN with a great deal of experience, had taken in the whole sad tale. She listened, thought about it, and said, “I think you better write this all down and sell it to a country music singer. You’ll make a million dollars.”
Jenny stared at her for a moment, and then burst out laughing. “I guess maybe!” she said. “Now, I’ve got a plan!”
Sometimes it is difficult to tell whether humor is appropriate in a given situation. Many times, nurses adopt the “When in doubt, leave it out” approach, but this can be very limiting and leave patients unable to capitalize on some of the many benefits of humor. Instead, you want to figure out if the use of humor is a safe BET — and to do that, you need to consider the Bond, Environment, and Timing of the joke.
The Bond represents those areas where we have a point of commonality with our patients — a pediatric nurse who is also a patient, for example, can relate to their patient’s parents in a way that someone who is not a parent perhaps could not. The more you know about your patient, obviously, the easier it is to find a place where that common ground exists, but you can discover a bond fairly quickly.
“Jenny was wearing a Alan Jackson T-shirt when she first came in,” Linda explained. “That’s why I used the country music joke.”
Being aware of the environment also helps determine if humor is appropriate. There’s a saying that there’s a time and a place for everything, and environment is all about the place. For humor to be effective, you need your patient to be in a place where they’re able to hear and be receptive to what you’re saying. When Jenny had first come into the ER, still in shock from the evening’s events, it was not the place to introduce humor. Later, as she was in recovery and waiting to be discharged, where things were calmer and quieter, the situation was different. As health care workers, we must always be aware of our patient’s comfort level with the surroundings. The more familiar and comfortable the patient is with their surroundings, the more effective humor will be.
Bear in mind, too, that some patients will use humor as a way to process their own discomfort with new surroundings or procedures.
Timing is perhaps the most difficult element in using humor. Comedians spend countless hours trying to perfect their comic timing; some consider it a gift you either have or you don’t. For the purposes of nursing intravention, you don’t need Seinfeld-perfect comic precision; common sense will get you close enough. Refrain from using humor during moments of crisis, or when it’s vitally important that communication be clearly understood.
When humor can be used to support a patient, to put a bit of light into a dark moment, or to reframe a situation to allow the patient to see it from another angle, without devaluing or invalidating their experiences, that’s a good thing. With practice, you’ll be able to determine when these times are.
And sometimes, you slip in a puddle on the floor and land on your butt right in front of the patient, covered in things you’d rather not think about. Then you don’t even have to worry about the timing: all you can do is laugh!
