Paul McGhee, PhD
The Humor-in-Hospital Movement
Chances are that you have never been in a hospital with a "humor program." The very idea of humor in hospitals may even strike you as an oxymoron (like "giant shrimp," "smart bombs," "military intelligence," etc.). If ever there were two things that don't go together, it's humor and hospitals. After all, hospitals are places for the very sick.
The last decade, however, has witnessed a (slowly building) international revolution in health care, as more and more hospitals become convinced of the therapeutic power of humor. The humor-in-hospitals movement has also gained support because of the trend toward depersonalization in hospitals in recent years, as focus has shifted away from the person and toward application of the latest technology. Patients now want a more personalized relationship with caregivers, and humor helps establish it.
Patients generally arrive at hospitals in a state of stress and anxiety, are placed in a strange environment, submitted to degrading and embarrassing procedures by people they don't know, have their independence and sense of control removed, and don't always get the kind of explanations that they would like. Humor provides a means of establishing a more personal relationship with hospital staff, easing tensions and anxiety, and helping patients cope. The nurse who maintains a high level of competence, but also has a "light touch," has an extra means of saying, "I care."
Many nurses and hospital administrators are concerned that patients will perceive them as unprofessional, and as unconcerned about their health problems if they show a sense of humor while interacting with patients. There is evidence, however, that patients welcome the opportunity for humor and laughter during their hospital stay.
The figures in brackets indicate the percentage of patients in one study who agreed with the following statements: 1) "Nurses should laugh more often with patients" [80%], 2) "Nurses should try to get their patients to laugh" [83%], 3) "Laughing helps me get through difficult times" [83%]. The following statements generated strong disagreement by the same patients: 1) "Nurses who laugh with patients are unprofessional" [94%], 2) "Nurses who laugh are insensitive to patients who are suffering" [91%], 3) "Laughter does not belong in a rehabilitation hospital" [89%].1
Types of Hospital Humor Programs
The best known approach to bringing humor and laughter to hospital settings is the use of clowns. Many hospitals now have volunteer clowns who visit patients in their rooms in order to boost their spirits and distract them from their anxieties and concerns. The Big Apple Circus Clown Care Unit was initiated in New York in 1986, and has spawned many comparable clown units across the U.S. and around the world (e.g., the Fondation ThÇodora in France). At present clowns are the only approach I know of being used to bring humor to patients in European hospitals.
The power of clowns is evident in the following example provided by a clown from the Big Apple Circus. An 11-year-old boy had been doused with gasoline and set on fire by an older boy.
"He was conscious, but in terrible pain with major burns over more than half of his body. I went right into emergency with him. When the surgeons began cutting away dead flesh, I began telling funny stories and promising circus tickets and making scarves appear and disappear--anything to keep his mind off the agony. Pretty soon he was rolling his eyes in amazement and finally I got him laughing behind his medical mask. It was incredible. He was staring death in the face--and he was having fun!"2
Another common American approach to building a lighter touch into hospitals is to create a "humor cart." This is a cart which can be wheeled into patients' rooms, and which contains funny audio and video tapes, books of cartoons, games, funny props, etc. Several hundred hospitals around the U.S. now have humor carts. Volunteers from the community often take responsibility for these programs.
A few American hospitals have entire rooms devoted to fun and humor for ambulatory patients. These rooms are given such names as "The Lively Room," "The Living Room," or simply "The Humor Room." Sunnyview Rehabilitation Hospital, in Schenectady, New York even has a full-time humor coordinator, whose job is to be sure humor is made available to all of those patients who want it.
One of the first humor rooms was established at St. Joseph's Hospital in Houston. Representatives of this program have expressed their belief that the program leads to shorter hospital stays for many patients. The head nurse observed that some patients are able to reduce their pain and nausea medications following a visit to the humor room.
I know of one hospital which has a humor program built into its pediatrics department. The hospital recently was short of beds for adults, so a 70-year-old cancer patient was forced to stay in pediatrics for nearly a week. While he came in depressed, he had such a good time during his stay that when he was later re-admitted to the hospital, he specifically asked for a room in pediatrics.
One of the most effective means of making the therapeutic benefits of humor available to patients is through the daily interaction with hospital staff. Nurses and other staff members can have a powerful impact on patients' mood by bringing an occasional laugh to patients as they do their jobs. For a detailed discussion of guidelines for appropriate and inappropriate uses of humor by nurses and others in hospital settings, see a recent article in RN Magazine.3
[Excerpt from Dr. McGhee's book, Health, Healing and the Amuse System: Humor as Survival Training. Published by Kendall/Hunt, 1999. To order a copy by e-mail, see www.kendallhunt.com. Click on orders. ISBN number is 7872-5797-4.]
1) A friend of mind says he's tried every diet imaginable, but nothing has worked. Now, he says, "I'm on a new seafood diet. Every time I _________, I eat it."
CLUE: Every time he looks at food, he eats it.
2) When do doctors get most annoyed? When they're out of ___________.
CLUE: Who do doctors treat?
3) What do you call a cow that's just delivered its offspring? ____________.
CLUE: What kind of coffee do you drink if you're concerned about the harmful effects of coffee?
1. Schmitt, N. Patients' perception of laughter in a rehabilitation hospital. Rehabilitation Nursing, 1990, 15 (No. 3), 143-146.
2. Darrach, B. Send in the clowns. Life Magazine. 1990, 13(10), 76-85.
3. McGhee, P.E. Rx: Laughter. RN Magazine, July, 1998, 50-53.
Answers to Pun Fun
1. see food (seafood)
2. patients (patience)