Don’t You Know How Serious This Is?

It had been a rough delivery. Even though it wasn’t a high-risk pregnancy, things –  as things often do — had gotten complicated along the way.  Nine grueling hours later, we had a tiny but tenacious little girl in an incubator, and Mom still in surgery.

The new Dad, standing with his wife’s sister, stood outside the nursery, staring at his infant daughter.  They were both overwrought and tense, nervous and overwhelmed.  Somehow they’d gotten on the topic of diapers and poop (perhaps not surprising!) and were joking about the million of pounds of poop that the new baby would generate.  You can imagine the conversation — and if you work in or around the nursery, I’m sure you’ve heard this conversation a million times before!

The Mom’s mother (and new Grandmother) came up to join them at the window, overheard the conversation, and went ballistic.  “How can you joke at a time like this? Don’t you know how serious things are?”

How often do our patients hear that question?  Using humor to address stress, terror, anxiety, fear, overwhelm — all experiences that new Dad and his wife’s sister were going through –is often a natural, instinctive reaction.  Deflecting some attention away from the things that are scaring us allows us to function.  Therapeutic humor — even if it’s jokes about a million pounds of baby poop — is a coping mechanism that almost anyone can access.

Yet there are a lot of times when the family and friends of our patients try to keep therapeutic humor out of the conversation.  Serious times, the logic seems to be, call for a serious demeanor.  And if our patients aren’t serious enough, well, these ‘well-wishers’ will make sure to make them stop laughing and get with the program.

Our patients need safe spaces, in which to express what they’re feeling.  If they’re using humor to manifest that expression, GREAT! There’s no rule that says you have to be funny while pondering pancreatic cancer, but if you can, you might as well laugh.

How do we provide safe spaces for our patients? Specifically, how do we let them know it’s okay to laugh, even when other people in thier lives are telling them this is the last time they should even be thinking about laughing?

There are three ways:

One: Provide an Example

The best way to let patients know that therapeutic humor is acceptable in any given setting is to use therapeutic humor yourself.  A simple joke can ‘give permission’ to your patients to share their own joke or funny thoughts.  Additionally, you’re self-identifying as a non-judgmental person who will understand if your patient needs to laugh to keep from crying.

Two: Frame it as Stress Relief

While relatively few patients or their family members will have heard of therapeutic humor, almost everyone has heard of stress relief.  Let the most critical, demanding family members know that reducing stress can help improve the outcome of the situation.  Add to that the fact that laughter is one of the easiest ways to reduce stress.  Since everyone wants a positive outcome here, they should surely be supportive of stress reduction efforts.

Three: Shoo, Shoo, Shoo

Creating safe spaces may mean physically removing negative people from your patient’s surroundings.  Send them home, if possible, or at least out for a coffee while you check vitals/perform a test/prep the patient for a procedure/ready the room for a roommate.  Depending on your facilities rules, this can be easier in some places than in others.  However, a few minutes ‘away’ can do a world of good for your patients.