Self-Care for Nurses

Nurse-humorist Patty Wooten (1996) describes humor as "a quality of perception that enables us to experience joy even when faced with adversity". She reminds us that the environments in which nurses function are particularly stress filled and that we need to remember to protect ourselves to remain balanced and healthy.

Laughter seems to be the perfect antidote to stress. For many years, she has been addressing health care providers, offering her own particular, delightful blend of humor and data about the healing effects of laughter. She presents data about the healing effects of laughter. She presents data about the healing effects o laughter. She presents data about the interrelationship between laughter and lowered serum coritsol, activated T lymphocytes, natural killer cells, and T cells with helper/suppressor receptors. She explains how the growing field of psychoneuroimmunology defines communication links between emotional experience and immune response. In other words, there are messages continually sent back and forth between the nervous system and brain and the immune system. When we are distressed, the messages weaken immune response, whereas when we are relaxed and joyful, our vitality is enhanced.

Humor enables us to feel better for a variety of reasons. Physiologically, humor and laughter produce changes in blood chemistry. In exploring the research, we see that humor stimulates immune function. Furthermore, our cells are continually changing, occasionally forming cancerous cells. When the immune system in strong, it can mobilize natural killer cells to destroy the abnormal ones. Also, the emotions can trigger release of neurotransmitters from brain neurons, which bond in receptor sites on the surface of the immune cell, altering metabolism positively or negatively.

The ground-breaking work of Norman Cousins (1979) awakened health caregivers to the potential therapeutic effects of laughter. Cousins, suffering from a life-threatening illness, practiced laughing and focusing on positive and humorous events to inspire joy, hope, and love. He based this idea on the belief that if negative emotions could destructively affect his health, then perhaps positive emotions could beneficially affect his health. His last decade was devoted to researching this relationship at the University of California, Los Angeles Medical School, Department of Behavioral Medicine, where he established the Humor Research Task Force. This project was able to coordinate and support clinical research on humor throughout the world.

NURSING TIP

Use of Humor

Though humor can be useful in most situations, there are certain times when it would not be helpful or appropriate to attempt to introduce humor. If a person has just received severely distressing news, such as a terminal diagnosis or notification of the death of a loved one, no attempt at humor is appropriate. Similarly, humorous responses can be confusing in serious situations or when important decisions must be made. Humor is inappropriate with individuals who are already challenged to understand, as may occur when communicating with culturally diverse populations, or with individuals who are imbalanced in their psychological orientaion. In general, one must be well attuned to the individuals and the situation to inject humor.

Research further indicates that when we engage in humorous activities and responses, we gain a greater sense of mastery. Though we cannot always control events in the external world, we can learn to relax and release positive chemicals such as endorphins and enkephalins, this having more control over our inner environment.

To have more laughter in oulives, we need to learn to laugh at ourselves more, seek out people with naturally developed sense of humor, read uplifting and humorous material, and stay in touch with our "inner child," the part that know intuitively how to laugh at life's events.

However, we might also keep in mind that what often passes for humor is based on making fun of certain people or groups, which can actually be destructive and hurtful. The use of appropriate humor requires a certain level of professional maturity.

There are times when individual resort to humor to avoid facing painful situations. Humor can be a defense mechanism, covering the deep layers of painful memories or feelings stored beneath the immediate consciousness. Certain individuals develop patterns of injecting humor at tense moments to avoid feeling the immediate pain of the situation. Some people also laugh when anxious or nervous, confusing those in their presence. This response is often a result of pent-up emotion, but it can result in hurt feelings when others are attempting to deal with the gravity of a dire situation. For these individuals, some stress-relieving maneuvers coupled with opportunities to talk about painful situation s can lead to a more appropriate effect over time.

For most of us, we can consider humor as a balm to life's constant challenges. Consider a balanced diet between stressful or negative intake and positive, humorous intake. For example, reading the newspapers regularly and watching daily news in graphic detail can be stressful, activating corticosteroid production, which has an immunosuppressive effect. Consider, instead, the health benefits of reading more humorous material and watching less violent, stressful television.

Remember, we are constantly receiving and processing information. Be sure your energy field has enough laughter and fun to sustain a joyfulness as you undertake a day's work in stress-filled environments. Have you had your laughter fix for the day?

Thus, it is important to relax and remember the lighter side of life, even when life is stressful For example, consider the following entry written by a breast cancer client:

Whatever the prognosis is
For better or for worse,
For updating: see the doctor
For updating: see the nurse.

In another example, written by the mother of a child with cancer, we also see how humor helps people to cope:

Humor is what got all of us through the clinic
visits, the hospital stays, the blood tests, the loss of
hair and weight. There is always something on the
light side if you can look for it. I'm sure people
think "How can he laugh when he has cancer?"
Our human nature is such that we can't feel
terribly bad all the time.

Each of these statements serves to exemplify how people use humor to adapt to the challenges of life. For some, there is more occurring than simply accepting; some people, through maintaining a sense of humor, actually seem to rise above a situation, transforming it for themselves and for everyone around them. This is only one of the many ways in which we can inspire and support each other.