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A playful touch: Nurse uses humor to put patients at ease

Monday May 6, 2013
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The patient was talking to her nurse practitioner as I prepped her flu shot, which she was not happy about receiving. "Sally" was staying at our 24/7 medical respite care center so we could address her out-of-control diabetes. Once patients are under our roof, we try to squeeze in as much preventive care as possible. But Sally was having none of it.

Then I unleashed the flatulence machine. Initially, I sounded the machine solely for the benefit of Emily, the nurse practitioner working with Sally. But when I saw Sally exchange a look with Emily and roll her eyes, I knew I was on to something. Suddenly the power dynamic had changed. It wasnít two white coats "ganging up" on a patient, but rather a patient and a nurse practitioner sharing a conspiratorial moment at the expense of a rude nurse.

Then came the reveal. I pulled the machine out of my pocket, and Sallyís entire mood changed. She laughed — hard. Emily and I were laughing too. All three of us were in on a joke together, and the power dynamic had shifted again. I handed her the machine and she pressed the button with great amusement. A few toots later, she was vaccinated. "Are you done?" she asked incredulously. "I didnít even feel it."

I am a nurse at a healthcare program for the homeless by day and a comic actress by night. Laughter, in my book, is exactly what the doctor — or nurse — should order. But my day job is quite different from my night job.

As I see it, using humor in nursing is not about telling jokes or performing. It is about looking for the comical in the daily rituals of caregiving. Itís about shifting perspective and power dynamics. Itís about creating those private jokes with patients that bring you closer, and being undaunted by the prospect of falling on your face if the joke tanks. Because, honestly, thereís no such thing as failure in humor, which at its most fundamental level seeks to connect with another person, to share a moment.

I start out with a bit of an advantage: I am 4-foot-9 and sport indigo hair. When I distribute medication, I have to climb onto a custom-built box to see over the counter. I play up the absurdity of my diminutiveness by arriving at the station looking stern, putting down the box, then making a big deal of hauling my frame atop it. If a patient calls me "Shorty," I snap back: "Thatís Nurse Shorty to you!"

I like to fashion puppets out of rubber gloves; wear a clown nose; use funny accents; and enter my patientsí rooms in odd ways, sometimes leading with my knees, sometimes my hips and sometimes walking backwards. Iíve been known to peek into a room, pretend Iím scared, then run away. I once worked half a shift on roller skates.

Despite my near constant playfulness, Iím always careful to convey that I am a skilled nurse first and foremost. I introduce humor slowly, conservatively, dipping my toe into the water to make sure the temperature is OK before taking the plunge. Some people wish for more serious interaction with their caregivers, while others yearn for more lighthearted discourse. I always allow the patients to set the tone, an important part of granting them autonomy and ensuring their dignity.

I believe every nurse is capable of sharing a chuckle or two with patients. Here are a few tips on how to get started:

• Begin by simply smiling, which will make you feel happier and more relaxed, and put you in the mindset for humor. It also will make you seem more approachable.

• Joke with your co-workers. When patients see you having fun with your colleagues, theyíll know this is a safe place for humor and theyíll want to join in.

• Do not be afraid of "failure." There is no such thing as being unsuccessful at humor. Itís all moving you toward creating that precious patient-caregiver — and human-human — bond. •


Michelle Whitaker, RN, works for Boston Health Care for the Homeless Programís Barbara McInnis House, a medical respite care facility.Write to editor@nurse.com or post a comment below.