LOST: Sense of humour

Bridget Leach has been a nurse for over 30 years. She currently work in falls prevention but was also a ward nurse and ward sister for many years.

LOST: Sense of humour OWNER: NHS Reward for return: happier, healthy & retainable workforce.

The above may seem flippant but a simple google of the term ‘Do hospital managers have a sense of humour?’ returned a myriad of articles including academic research.

Some of the articles were what I would consider odd; for example; a member of hospital staff doing tricks with disappearing scarves while …”the surgeons began cutting away dead flesh …” to a ‘humour cart’ containing, amongst other things, ‘funny props’; I know plenty of hospital staff who, in certain circumstances, would consider a bedpan on the head and a proctoscope a funny prop so who knows?

As I read further however I became acutely aware that we have in fact mislaid something that not only benefits staff by improving their working environments but can assist staff and patients alike in ways such as easing stressful situations, treating each other as fellow human beings with the wealth of emotions that we possess and showing our humanity and vulnerability.

A study by Canadian researchers back in 2008 concluded that “ … combined with scientific skill and compassion, humor offers a humanizing dimension in healthcare that is too valuable to be overlooked..”  (Humor plays an important role in healthcare even when patients are terminally ill. Science Daily 2008).

What is humour? It certainly isn’t just funny walks (well, it can be in falls clinic to be fair) or risqué jokes.

The dictionary definition lists humour as

1. The quality of being amusing or comic, especially as expressed in literature or speech
2. A mood or state of mind ( an inclination or whim – surely whim is one of our very best words)
3. Or of course the medical humours of blood, phlegm, yellow bile (choler) and black bile (melancholy)

How do we use humour in our daily work and why can it be viewed as unprofessional to be laughing whilst in the hospital environment.

The hospital environment can be stressful with limited staff dealing with extremely ill patients, unprecedented demand on services and limited resources. Where is the humour in that?

Humour, when used sensitively (and therein lies the key to this most useful of communication tools) can ease tension in a situation.

It can also be used to express frustration without resorting to anger, direct insults or aggression.

1. Where would you hide a £10 note from an orthopaedic surgeon? (Answer below)

Humour can help us connect with our patients as fellow humans and individuals and can be used to diffuse situations where patients may become embarrassed.

What is crucial, in my view, is experience. One cannot hop out on your first day as a qualified clinician and display your rapier wit or balloon modelling skills.

Being able to read people both work colleagues and patients and their families and assess the situation you are in will allow you to gauge when humour may be appropriate and when it is not.

It is blatantly apparent though in today’s NHS that humour can be viewed by some (and often those without significant clinical experience) as a person not taking their role seriously and being unprofessional, the onus being that we do not have / should not have time to laugh.

I believe we should make time and that the time humour actually requires is all around us.

A terminally ill lady told me once, after I had been told off for giggling about something near her bed, that I ( and my equally hysterical colleague) had made her feel normal for a while.

Involving patients in pranks to set up other colleagues can be fun and a good way of alleviating the boredom of the hospital day.

Please don’t immediately put this down and run off to send some poor unsuspecting nurse for a long weight or a medical student for a fallopian tube but let’s try and lighten up a bit; be nicer to each other, create relationships, tease each other and learn about each other. Our patients are human too and even when they’re feeling really ill might want to share an observation or a joke.

Oh and PLEASE bring back the hospital show!

There are a generation of consultants who have never had to sit cringing whilst watching a junior doctor mimic a much noted habit.

So many songs that with simple word changes become hospital anthems.

The sense of community and shared laughter at these events has few equals.

1. Question: ‘Where would you hide a £10 note from an orthopaedic surgeon?’ Answer: In the medical notes