By Jeni Miller
While healthcare professionals frequently work in high-stress conditions, there are times when they can lighten the mood, provide comfort, or defuse an escalating situation despite the circumstances. One method for case managers to consider is using humor in care.
“Humor takes the stress away from a lot of what we do, for the people we work with and the staff,” said Michelle Cornelius, LMSW, EdM, vice president of memory care for Cogir Management USA. “It’s important to remember it’s OK to use humor because in a serious situation, sometimes we just have to laugh.”
Research has shown how humor can help enhance a patient’s health by reducing their level of stress hormones, strengthening their immune system, lowering blood pressure, and even alleviating pain and inflammation.1
When to Use Humor
Case managers and other providers may be concerned about if and when humor might ever be appropriate, or they may have conflicting feelings about it. Providers tell jokes and use humor among themselves, but doing so when caring for a patient is different, as its goal is to strengthen the relationship between patient and case manager.
“As long as the patient understands humor, then it’s OK to use,” Cornelius says. “Of course, sarcasm is hard to read, so we don’t use sarcasm. It’s also important to ensure you are never making fun of the person — instead, humor should focus on the situation.”
Cornelius also explains humor is an excellent tool for “humanizing” both the patient and the case manager, which carries the extra benefit of allowing the patient to relax in what might otherwise be a stressful situation.
“Humor helps us to remember we’re working with people,” Cornelius notes. “They are not just patients. Using humor helps us to have a more natural relationship and still maintain professional boundaries. Not all professionals have considered this, but when you’re trained on clinicals, and not really bedside humor, it’s easy to get caught up in the day-to-day of things rather than human side of healthcare.”
Additionally, a case manager might choose to use humor not only with a patient, but with a patient’s family to ease tensions and connect more deeply, remembering this patient is a loved and cherished member of their family.
“Sometimes, we need to help lighten the mood. In those situations, it’s great to use humor in a way that does not downplay a situation but rather helps the patient and their family to remember that ‘this, too, shall pass,’” Cornelius says. “It also gives the family a chance to connect and laugh a little.”
Cornelius recalls a situation with a family who struggling after their loved one, who had repeatedly expressed to Cornelius that they were ready to die, had passed away.
“The [patient] was not suicidal — just ready to go — but she was pretty physically healthy, and so the family was having a hard time. It seemed like an appropriate opportunity to just say, ‘I don’t know who called her today, but she’s been waiting for this.’ It really helped lighten the mood,” she notes.
Learning to Use Humor
Taking the right steps and learning to use humor appropriately is necessary for case managers and other providers who want to help care for patients in this way.
“[Case managers] first need to make sure that the person they are talking to understands the language and words being used,” Cornelius explains. “I forget often, and in healthcare we all forget that people don’t always understand our terminology and jargon. You also want to ensure that the humor is inclusive, and not degrading or demeaning. It transfers, as long as it’s respectful and shows that you understand their point of view, that whatever you’re joking about includes them.”
Cornelius shares a few tips to keep in mind when considering using humor:
- Know the person and their situation. You can joke in certain ways with some people, while others may find that particular humor offensive.
- Remember the levity of a situation. While humor can be great for a brief moment, be careful if it is a serious situation.
- Learning how to use humor through improvisation techniques can be helpful. Research how to use the “Yes, and…” tool to help use humor in the spur of the moment. Tools like these are designed to be funny while not making fun.
Of course, there are people who may not care for humor in their healthcare, so it is best to be an attentive listener, fully present in the moment, and ready to take the patient’s lead on whether humor is appropriate.
When working with patients or residents with dementia, or even in care situations that can be awkward for the patient, humor can help provide a distraction.
“Humor can also be great, and works so well during care when, for instance, a person doesn’t want to take a shower,” Cornelius says. “It helps keep the conversation rolling. I know sometimes we want to tell people what we’re doing as we do it, but sometimes people don’t want to focus on that. In those situations, distracting with humor can be helpful, perhaps saying something like, ‘Who ever thought we would be in this situation?’ These are things that you can use again and again in care.”
Humor “destresses situations, especially when there is potential for physical or verbal aggression,” Cornelius adds. “It allows us the ability to resolve a situation before it goes any further.”
Improved Patient and Family Care
Studies have shown humor at the bedside can improve patient outcomes and satisfaction — and, of course, also enhance the patient’s relationship with their nurse, physician, or case manager.1 When a patient interacts with a case manager who seems to see their humanity and interacts with them as a valued person, it can improve the patient’s experience. For a hospital’s bottom line, those improved patient satisfaction surveys and scores can be meaningful.
“Overall, humor can improve quality of life, and it helps remind healthcare professionals that we’re working with people, that not everything has to be so serious,” Cornelius notes. “For family caregivers, it helps them remember to keep some perspective in the situation.”
Cornelius recalls an experience she had with the wife of a patient who had dementia. “Her husband one day put on her raincoat and refused to take it off,” Cornelius says. “This coat was three sizes too small for him, and his wife was in tears wondering, ‘What are people going to think?’ It was very upsetting for her that he’d done that. Listening to her story, I said, ‘You know, that had to look really funny.’ Then she was able to see the situation from a different perspective. She started laughing about how it looked, and that little piece helped her redefine the situation.”
Because people are different and may have varied levels of comfort in using humor in patient care, it is important to remember humor is just one of many tools case managers can use when caring for patients. However, they should know it is OK to use humor appropriately, that there is a time and a place for this powerful tool that has both physical and mental benefits for the patient and the case manager.
“In general, I think professionals are hesitant to use humor, partially because they think it’s a serious situation, and also partially because they may not know how to use humor,” Cornelius notes. “But you can practice with families and in other parts of life, practice lightening mood with friends.”
Humor is one of the greatest tools we have because “to be able to laugh about some of these things is critical,” Cornelius adds. “You know the saying: ‘If you don’t laugh, you’re going to cry.’ We have to laugh when we can.”
REFERENCE
- Osincup P. How to use humor in clinical settings. AMA J Ethics 2020;22:E588-E595.
While healthcare professionals frequently work in high-stress conditions, there are times when they can lighten the mood, provide comfort, or defuse an escalating situation despite the circumstances. One method for case managers to consider is using humor in care.
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