A Dose of Humor Keeps You From Losing Your Patients

by Ronald P. Culberson, MSW, CSP
Director or Everything! – FUNsulting, etc.

Humor is not an intervention that is measured by Medicare or the Joint Commission on Accreditation of Healthcare Organizations surveys. Yet it can be one of the most effective treatments we can offer patients. The following two contrasting experiences show the power of the humor difference.

My friend Jim Ball was accompanying his daughter for her pre-surgical visit with the orthopedic surgeon. When Jim asked the doctor how long her knee surgery would take, the surgeon replied, “They tell me it's a short procedure. I wouldn't know since this is my first one. Don't worry though, we keep a manual in the operating room – I can always refer to that if I need to.”

After glancing at the wall to make sure the surgeon actually had a medical degree, Jim started laughing. A wink from the physician assured him that his daughter was in good hands.

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After months of neck pain and numbness in my arm, my family physician ordered a consultation with an orthopedist who in turn ordered a nerve induction test. In case you are not familiar with this barbaric procedure, it involved sending electric current through the nerves in my arm to make sure they had not been damaged by swelling in the discs of my neck.

When I arrived for the test, the doctor introduced himself and asked how I was doing. I said I was a bit nervous but that I had worn rubber-soled sneakers to ground the electricity. The doctor looked at me with a look only a teenager's parent would understand. Not only did he basically ignore me, he refused to acknowledge my brilliant use of humor. Needless to say, that made me more nervous.

Humor can be a welcome touch of humanness amidst the metal bedpan atmosphere of a hospital, clinic or doctor's office. Patients do not come to these places because they feel good nor because they want to be there. Yet they can be casually treated as a chart number, a diagnosis or an insurance plan. A dose of humor can provide the warmth of a heartfelt smile in an otherwise impersonal situation.

Consider these three ways in which you might bring a little more humor into your patient care repertoire.

Humorize the Environment. The patient care environment is not typically designed for fun. Patients are tense, regulations control procedures and caseloads are high. Still, there are ways to make the environment more fun without compromising the need for quality, sterility or professionalism. Think about those routine experiences your patients encounter and how you might make them more fun:

• Place large cartoons or signs on the ceiling for patients who must lie on any kind of exam table. My internist has a note on the wall of his exam room that says, “My view is worse”. The only time a patient sees this note is when he or she is the recipient of a rectal exam!

• Put a cartoon bulletin board in every exam room or waiting area. Invite your patients to contribute to them. One of my favorite cartoons shows a patient struggling to close his hospital gown. The nurse says to him, “Don't worry, it covers more than Medicare!”

• Create a supply of humorous materials to give patients while they are in your hospital. This could include books, magazines, audio tapes, etc.

• Decorate bland patient care areas with posters or funny signs. On the door to one hospital's maternity unit was a sign that said, “Push, push, push!”

Punch up Procedures. Most procedures are invasive and uncomfortable. Most patients know this in advance and build up anxiety ahead of time which can make the procedure much more difficult. Consider what you can do to help them relax. Here are a few ideas:

• Have tape players with tapes of clean comedians available for patients who have extended waiting periods during procedures like chemotherapy, GI exams or when giving blood. A little Bill Cosby or Jerry Seinfeld could go a long way to relax patients

• Prior to procedures such as MRI's, biopsies or surgeries, allow patients to watch funny videos to relax them and take their minds off of the procedure.

• Attach funny signs, posters or instructions to the equipment used in procedures. For instance, a sign on the side of an MRI machine that said, “Torpedo Tube #1” would be a great way to relax patients.

• Include humor in pre-procedure instructions. With all the disclaimers such as “there is a risk of death in this procedure”, patients are not necessarily comforted by the preparatory paperwork. Consider adding a few lines of humor to make the serious information go down a bit better. An instruction like “Passing Gas is not only socially acceptable in our colonoscopy room, it's encouraged!” would make us all feel a bit better!

Have FUN with Patient Interactions. If you are my nurse or doctor, I want to know that you are stress free, competent, personable and FUN. Healthcare is personal and healthcare staff should make this personal interaction comfortable. Consider ways to include humor in your interactions with patients.

• Ask about humor. In your initial assessment, determine if humor is important to and welcomed by the patient. If it is, it gives you permission to incorporate it in your work. If it's not, you that may be a clue that the patient has fears or anxieties about their visit.

• Decorate yourself! Pediatric nurses have the best uniforms in healthcare. That's because they try to make themselves look less threatening to their young patients. The same rule applies in adult care. Dr. George Russell, a physician in Boulder, CO, wears a red clown nose and funny hat when he visits patients. He also uses jokes to see if patients are paying attention and to gauge their mental state. The patients find it reassuring that their doctor has a sense of humor.

• Share a joke, cartoon or funny quote with patients. My mother's nurse was trying to reassure her about an upcoming colonoscopy. As she left the room, she said, “Don't worry darlin, everything will work out in the end.” My mother and I burst out laughing.

You probably didn't learn about humor in medical or nursing school but research shows that it is a therapeutic intervention. Give your patients the gift of laughter as a way to enhance the care in your patient care.

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Copyright 2005 by Ron Culberson. Reprinted with permission. Ron Culberson, Director of Everything! at FUNsulting, etc., is a speaker, humorist, author of Is Your Glass Laugh Full? and former hospice social worker whose mission is to work with organizations that want their people to lighten up by using humor to minimize stress and maximize effectiveness. He is a Certified Speaking Professional (CSP), the highest earned award from the National Speakers Association, and is one of less than 7% of speakers worldwide who have received this designation. He has provided entertaining and informative programs to over 70,000 people in more than 600 associations, government agencies, non-profit organizations and Fortune 500 companies. Reach Ron at www.Funsulting.com