Professional Documents
Culture Documents
The synthesis of art and science is lived by the nurse in the nursing act
Josephine G Paterson
McCreaddie (2008) advised that humour A perceptive nurse should acknowledge this
is inappropriate in psychological crises and fear and help to reduce the feeling by discussing
emergency situations. Williams et al (2009) it with the patient and informing him or her
advised against the use of humour following recent about the forthcoming surgery. Humour can be
abdominal or brain surgery and with symptoms a useful coping strategy during what can often
such as nausea and vomiting. Humour is personal, be a vulnerable time in a persons life (Moore
so sensitive areas that could compromise an 2008). For example, adjusting to life following
individuals morals and/or ethics should be a stroke and its many potential biopsychosocial
avoided, for example ethnicity, politics, sex and implications can be overwhelming for the patient
religion (McCreaddie 2008, 2010). and his or her family. Using humour to raise the
patients spirits can offer a distraction and may
ensure that a positive and encouraging approach is
Physiological and psychological benefits adopted (Pryor 2010).
Physiological Killick (2010, 2011) described an initiative that
Being in a healthcare setting can induce physical used improvised drama and humour. Funshops
and psychological stress. Graham (2010) were run in five centres 18 staff members and
summarised some of the positive physical 44 individuals with dementia took part in various
effects of laughter, such as improving immune, exercises and sketches. The aim was to relax
cardiovascular and respiratory function; people, giving them the opportunity to express
neutralising stress hormones and increasing the their thoughts and feelings, and to laugh. This
relaxation response; assisting with pain relief; initiative offered the participants some respite
lowering blood glucose levels after a meal; and from their difficulties and created a sense of
releasing endorphins, serotonin and dopamine. community by connecting with people.
The release of dopamine can promote positive
thinking and creativity, and reduce depression
(Old 2012). Social effects of humour
Using humour to invoke laughter can lower Humour can assist bonding on a personal level and
serum cortisol levels while increasing the number can be applied to clinical practice. Pryor (2010)
of T-cells and natural killer cells in the immune considered that an inclusive form of humour
system, thereby reducing stress levels (Old 2012). one that actively encourages patients to interact
The physical act of laughing can relax muscles with and support one another can result in a
and provide an effective internal massage to the camaraderie and beneficial peer support. This
digestive tract, as well as enhancing blood supply may be especially helpful for those patients who
to vital organs, including the liver, kidneys, are new to the clinical environment. Creating
spleen, pancreas and adrenal glands (Old 2012). an atmosphere in which patients feel safe and
Some patients may benefit from laughter yoga comfortable is something that nurses may take
this therapy combines laughter exercises and for granted, however, it can be beneficial to their
yogic breathing. While this is a more formalised health and wellbeing. Pryor (2010) explained that
approach in as much as the laugh may be forced, humour and laughter help to create a light hearted
the ethos is that the body will reap positive benefits atmosphere, which encourages patients to be
in terms of health and wellbeing because it cannot positive and happy. This is particularly relevant
distinguish between fake and genuine laughter in certain settings, for example keeping patients
(MacDonald 2004). spirits up can enhance the rehabilitation process
(Pryor 2010).
Psychological Using humour can also assist in promoting
Humour can be used as a coping mechanism health to groups who are difficult to engage with
during stressful situations (Tanay et al 2013). (Foster 2012). Oliffe et al (2009) described how
Reducing stress and anxiety through humour humour was used at prostate cancer support groups
and laughter can enable emotions to be released to introduce sensitive cancer-related issues such as
and increase a persons ability to cope, enhance urinary incontinence, erectile dysfunction and death.
memory, and increase self-esteem, optimism and However, it should be noted that while this form
vigour (Moore 2008, Oliffe et al 2009). of humour can create male banter that is valued
Davis-Evans (2013) considered how humour can by many, sometimes such an approach may inhibit
be assessed to identify any underlying messages those who have shared personal information or an
in patients undergoing surgery. Patients may hide experience only to feel belittled or embarrassed.
behind the facade of humour and use it effectively Caution with levity is therefore essential
to open up by making a joke about being scared. to prevent compromising a patients future
and happiness, resulting in a more open and closer and requirements, for example 30 minutes of
relationship with members of the healthcare team. comedy daily. By connecting with patients and
In such an enhanced working environment, the getting to know what may make them laugh,
team can work more effectively and may be humour could offer respite and diversion from
happier and more motivated to achieve positive personal anxiety, fear and, in some cases, the
patient outcomes (Tanay et al 2013). monotony of being a patient.
Recommendations Conclusion
Service providers could develop a bank of There can be a tendency to trivialise humour,
humour resources, which could include items however it has several benefits for patients and
such as humorous DVDs or books. Such resources nurses. While it is subtly interwoven in many
could be useful when a patient feels challenged nursing interactions, nurses should consider how
or anxious, or requires some diversion, and this overlooked resource could be used in a more
could be used individually or in a group setting structured and specific manner for patients. Service
(MacDonald 2004). The development of an providers need to recognise that humour and
appropriately located humorous file or bulletin laughter are important and relevant in contemporary
board could also be considered for clinical nursing. Humour and laughter are natural
staff (Chinery 2007). The development and expressions of emotion, which offer a genuineness
implementation of laughter sessions or funshops and authenticity, promoting a more human, mutual
may also be considered for appropriate areas, such and intimate connection between nurses and
as day centres (Graham 2010, Killick 2010, 2011). patients. When used effectively, humour can lead to a
The use of humour prescriptions may be more individualised, holistic and personal approach,
considered this would involve prescribing which may result in patient care being more
humour for patients that is tailored to their needs comforting and ultimately more compassionate NS
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