Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

A Narrative Inquiry: How Do Nurses Respond to Patients' Use of Humour?

Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

A Narrative Inquiry: How Do Nurses Respond to Patients' Use of Humour?

Article excerpt

Humour is part of everyday living and working and as such is also an integral part of healthcare. It is used in every culture and in all aspects of life, and human interaction often includes humour to convey messages, is used as part of group bonding, and to improve quality of life. The humorous interaction between patient and nurse has a potential positive impact on the therapeutic relationship (Astedt-Kurki & Isola, 2001; Chinery, 2007; Dean & Major, 2008; Moore, 2008). This research has focussed on the spontaneous use of humour without pre-emption that appears in conversation in the clinical setting.


Humour is a diverse and multi-faceted word used to describe something humans find funny or enter- taining. Humour can also be seen as a social pro- cess and a unique way of communication as well as a personal trait (Chinery, 2007). A reason to use humour in health is described by Astedt-Kurki and Isola (2001, p. 452) 'Humour indicates mental wellbeing and reduces the impact of negative fac- tors and difficulties.' MacMillan online dictionary describes it as 'the quality that makes a situation or entertainment funny' and 'the ability to know when something is funny and to laugh at funny sit- uations' (Humour, 2009). This description shows the many facets of humour as it indicates not only the physical attributes of humour but also the need to be able to interpret something as humorous.

Patient-initiated humour may well be used to alleviate stress or insecurity as well as initiate communication with the nurses (Astedt-Kurki & Liukkonen, 1994). Humour can help the patient cope and adjust to a different and often life limiting situation (Moore, 2008). Humour can support the patient to relay emotion and help maintain their dignity (Astedt-Kurki, Isola, Tammentie, & Kervinen, 2001; Astedt-Kurki & Liukkonen, 1994; Moore, 2008). Patients' might use humour to challenge the nurse and ask ques- tions without undermining the nurse's authority (Mallett, 1993; McCreaddie & Wiggins, 2008). Anger and frustration can be dealt with by using humour. To express discontent in a socially accepted way, humour becomes a healthy coping mechanism (Buxman, 2008). Although the bene- ficial attributes of humour are many, humour can be derogative and hurtful in some situations and caution is needed in the application of humour (McCreaddie & Wiggins, 2008).

Adamle, Ludwick, Zeller, and Winchell (2008) noted the 'missed communication' in their study. They found that patients used humour to com- municate with their nurses but their attempts were missed or ignored by the nurses. During their investigation of nurse's response to, and recogni- tion of patient-initiated humour, they found that although nurses recognised the humorous invita- tion to engage in a dialogue, this was not neces- sarily followed by a conversation (Adamle et al., 2008). Dean and Major expressed the importance of patient-initiated humour as a way for the patient to communicate their anxiety, stress or embarrass- ment. The authors argue that use of humour is not to create a light hearted conversation but an attempt to minimise their feelings of dehumanisation. If the patients attempt to inform the nurses in this 'light hearted' way goes unnoticed, or does not cre- ate a response, this might inhibit the nurse-patient relationship (Dean & Major, 2008).

While working in the clinical setting the pri- mary author noted an obvious difference in patients' behaviour depending on how nurses responded to their humorous antics. Patients seemed more settled in a humorous environment. This observation prompted a literature search and although there is much written about humour in healthcare, little is written about spontaneous humour, or the patients input to the therapeutic relationship. The literature review gave the moti- vation to the research question: How do nurses respond to patients' use of humour?

Aims and oBjectives

The aim of this paper is to report on four Registered Nurses perceptions of patient-initiated humour; how they and nursing colleagues react to patients humour in the clinical environment. …

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