Humor in Health Care

There has been plenty of discussion about Kelley Johnson’s monologue and comments from The View. I just took a look at the response from the President of the American Nurses Association, who said, “Nurses don’t wear costumes; they save lives.” and its true, you won’t ever see a nurse wearing joker teeth welcoming a patient.

I am grateful to all the people who have stood up for nurses by responding, supporting, and making us feel like the honorable, trusted, and caring profession that we are. I am also thankful to Pamela Cipriano for her quote above, because that has encouraged me to take a lighter approach in this blog article. Everything doesn’t always have to be heavy or philosophical or serious, right?

While I understand what Pamela meant by “Nurses don’t wear costumes,” I will share that I did wear a costume once, when I was a staff nurse on an adolescent unit. It was Halloween and most of the nurses dressed in costumes that day. I was taking care of a particular 14-year-old boy who needed a new IV placed. In all my costumed glory, I went in and put an IV in this adolescent’s arm. His dad sat by the bedside as I did so. And his dad was a VP of the hospital. I never knew if that patient’s father was amused by my costume or annoyed thinking I wasn’t taking my job seriously. He didn’t say anything to me about it.

I sometimes think back to that experience, especially around Halloween, and wonder when it’s ok to infuse humor into health care. I sometimes use humor with patients I see for diabetes education, but then again those visits are not life or death situations. Hospital staff where I work still dress up every year, but I have never worn a costume to work again.

Personally, I like and appreciate humor. But when I’m the patient I do expect health care professionals to use it appropriately. I remember when I was a patient in room # e111, a joke that I didn’t “get” was sort of an issue I didn’t want on my mind. I’ve noticed in the Diabetes Online Community that people often discuss with frustration the jokes that are told about diabetes. Sometimes funny things happen to nurses at work, and those times (and memories) can help us get through tough jobs. In fact, humor can be one way nurses take care of themselves. Are there ways we can use humor to help people heal?

How do you use humor in health care? Or what funny thing that has happened while you were working in a health care setting? What did you learn from the experience?

Physicians become more like nurses!

I was so excited to see this article today! My first thought was, “Wow! They are finally teaching physicians to be more like nurses!” These principles are the very same ones I learned in nursing school twenty years ago. Did you? Do we still use them in nursing? Healthcare has evolved over those twenty years, and I must admit I have not been in a bedside nursing role for most of them. So I can’t really say if nurses in hospitals are using effective communication skills, patient-centered language and the like. In diabetes education (a multidisciplinary specialty) we are still pushing for improvements in these areas.

And patients are demanding this change! Patients are being asked (required?) to be more “engaged” in their health care, and many want to be. We are evolving into a health care system of connections, and away from the assembly-line, “do what you’re told” mentality. If this is ever going to be effective, we all have to play ball – nurses, physicians, patients, and everyone else.

Let’s do this!!

Language in Nursing Practice

I have found myself on a journey that I can no longer avoid. In 1992 I gave an inservice on language to a group of staff nurses on a pediatric unit in a large, teaching hospital. I was then a student in an MSN program (Pediatric Clinical Nurse Specialist Track). The focus of my talk was refraining from calling patients by their diagnosis (the “appy” in room 3 or the “sickler” in room 25, etc.).

I have since chosen a career in diabetes education and management, and twenty years later I am amazed at how often I see and hear the word “diabetic.” I was giving an inservice (on diabetes) to nurses who provide staff education and was amazed at how many negative and judgmental words I heard. Open up any journal, book, magazine, blog, and it’s impossible to avoid seeing this kind of language.

The health care system has been trying to evolve for years (giving some credit here), from one that is paternalistic, controlling, and about healing the sick, to one that is accepting, supportive, patient-centered and about preventing disease. From one that is about the provider to one that is about the patient. But we are not there yet. And our language is, in my opinion, one of our biggest barriers. We need to talk the talk before we can walk the talk.

Words that come to mind include “compliance,” “must,” “should,” “have to,” “need to,” “I want you to…,” non-compliant,” any word that labels a patient (diabetic, asthmatic, leukemic, sickler, and so on), “control,” “good/bad,” and many more that I can’t think of at the moment.

I truly believe that words matter. Even the most caring nurses use words/phrases that hurt – mainly because they “grew up” using them, and often because it’s just faster and easier to use them. But patients deserve to hear words that build them up (strength-based) and put them at the center of their care (patient-centered). Patients deserve to be thought of, approached, and addressed as human beings with a lot more to them than a disease, illness, infection, procedure, or what have you. And it’s true for conversations about patients as well (for instance, at the nurses station or during report).

Those of you who work in health care settings probably (undoubtedly) hear these and more words/phrases every day. You may even have become immune to them. Can I ask a big favor? Can you pay close attention in the upcoming days/weeks, and jot down any judging, negative words/phrases you hear? Could you then come back to this blog and post the words in the comments section? Thanks for your help with this little project! I would also love to hear your thoughts on how we can change the language that is used in health care.