Canadian researchers have revealed that a bit of humour can play a crucial role in healthcare settings, even when patients are terminally ill.
Dr Ruth Dean co-author of the study and a nurse researcher from the University of Manitoba carried out the study in the palliative care unit, spending 200 hours observing and informally interacting with care providers, patients and family members and carrying out semi-structured interviews with 15 healthcare staff, including nurses, doctors, a social worker and physiotherapist.
The team concluded that humour played an essential role in promoting team relationships and adding a human dimension to the care and support that staff provided to seriously ill patients and their families.
Her colleague Joanne Major from the Health Sciences Centre in Winnipeg spent 72 hours in an intensive care unit, observing and carrying out semi-structured interviews with 15 nurses.
"Some people feel that humour is trivial and unprofessional in healthcare settings, but this study shows that it is neither," said Dr Dean.
They found that humour helped the staff to cope with, and sometimes distance themselves, from difficult situations.
"When you've had the most stressful day and you're ready to cry, sometimes it's easier to bring out humour and take it in the other direction instead of bawling on somebody's shoulder," said an interviewee.
Humour also helped them to bond with other healthcare professionals and provide mutual support, shared laughter nurtured a sense of community.
"If you have those fun moments and that connectedness even the worst hell can happen" said one healthcare professional who worked with terminally ill patients. "
They used humour to reduce tension when things don't go as well as they could do.
Humour not only helped them to connect with patients and make them feel cared for as individuals, but also to reduce patients' embarrassment with the indignity of needing help with toileting and other highly personal functions.
When a patient suffered an episode of incontinence she reported that she found the nurse's matter of fact humour - "what goes in must come out" - made her feel less distressed.
Then there was the satisfaction that staff felt when they saw a patient smile.
"Despite major differences between the work of the intensive care and palliative care units, they are both areas where serious illness, high anxiety and patient and family distress are prevalent and staff are placed in emotionally demanding situations" said Dr Dean.
The study appears in the April issue of the UK-based Journal of Clinical Nursing.