They can take your sanity, but they can’t take your humor…or can they?

Shutterstock | Martin Novak

Hospital humor—it’s one of the most “insider” elements of the medical world, and little understood (or appreciated) among visitors. And it’s been called a lot of things, from harmless and cathartic to unacceptable and an enormous breach of trust.

One thing nurses can most certainly agree on: Patients should never, ever catch wind of the “gallows humor” that’s exchanged at their expense. But is it right to punish nurses for sharing a laugh behind doors? Is a nurse’s work simply too heavy if they can’t make light of it, or does a patient’s special circumstances mark them as an immediate “no-go” zone for tomfoolery?

In a recent piece by The Washington Post, this question of “to joke or not to joke?” is tackled in earnest. Find out what the article had to say about hospital humor—the good, the bad and the ugly:

Although patients typically don’t overhear it, a surprising amount of backstage joking goes on in hospitals—and the humor can be dark. Doctors and nurses may refer to dying patients as “circling the drain,” “heading to the ECU” (the eternal care unit) or “approaching room temperature.” Some staff members call the geriatric ward “the departure lounge.” Gunshot wound? “Acute lead poisoning.” Patient death? “Celestial transfer.”

The article points out that while gallows humor may, for example, be excused if exchanged among soldiers at work, medical professionals are subject to more of a “zero-tolerance” policy. Within and outside of the field, there are those who consider this policy a necessity.

“Derogatory and cynical humour as displayed by medical personnel are forms of verbal abuse, disrespect and the dehumanisation of their patients and themselves,” Johns Hopkins University professor emeritus Ronald Berk contended in the journal Medical Education. “Those individuals who are the most vulnerable and powerless in the clinical environment … have become the targets of the abuse.”

But the author of the article, Alexandra Robbins, disagrees. She argues that this gallows humor is not rooted in an abuse of trust or power, and that nurses who exercise it do, in fact, care deeply about their patients:

Their humor serves to rejuvenate them and bond them to their teams, while helping to produce high-quality work. In other words, the benefits to the staff—and to the patients they heal—outweigh occasional wounded feelings.

The article goes on to describe the burden that nurses bear:

Many nurses are overloaded with more patients than the safe maximum. They’re on their feet constantly, moving heavy equipment or lifting patients—in an eight-hour shift, a nurse lifts an average of 1.8 tons. Nurses routinely observe tragedies and traumas, and perform futile care on critically ill patients. Yet through it all, they must demonstrate mental composure, physical stamina and alert intelligence, even if they are berated by patients and visitors, bullied by doctors or shaken by their cases.

Hence, the turn toward something inherently lighter:

Humor has been shown to decrease health-care workers’ anxiety, create a sense of control and boost spirits in difficult moments. This is important because they must get through traumas intact so they can be fresh and focused for the next patient and the next.

While gallows humor may seem crass amid patients who are coping with illness or injury, many nurses depend on it so they aren’t overwhelmed by sadness. 

But all in all?

Humor has a place in hospitals, even if it’s dark, even if it’s derogatory—as long as it isn’t cruel. We ask extraordinary things of our nurses and expect them to face horrors and grotesqueries that we cannot. They should be permitted to resort to whatever nondestructive coping measures they need in order to provide the best possible care, even if those methods might seem unprofessional outside of the health-care setting. Humor is a way for nurses to empower themselves and to unite with one another, determined and defiant, against disease and injury. Above all, it is a way for nurses, who are overworked and underappreciated, to locate hope amid hardship—which is exactly what we need them to do.

Nurses, if you think this is a fascinating topic (like we do), you should definitely head on over to check out the full article here.

Now we know you have an opinion—please do share it with us in the comments section below!