You’ve got to be kidding!” Have you heard yourself saying these words more often than you used to?
You hear about the latest cutbacks, reorganization or mergers and your first statement of disbelief is: “You’ve got to be kidding.” That reflex response provides a clue for how you can survive the stress and chaos created by managed care. Your sense of humour and an ability to laugh can nurture and protect your body, mind, and spirit during these times of rapid change. “A sense of humor can help you overlook the unattractive, tolerate the unpleasant, cope with the unexpected, and smile through the unbearable.”

I believe that laughter is the canary in the mines of health care reform. Let me explain . Many years ago, before sophisticated monitoring equipment was available, miners would carry a caged canary down into the earth as they searched for ore. Because the canary has a higher oxygen requirement than humans, it provided an accurate gauge of the life sustaining oxygen supply. If the atmosphere became toxic, the canary would die.
In today’s rapidly changing environment of managed care, laughter is our canary. Think about your unit. Do you hear the sweet sounds of laughter? If not, the situation may be too toxic for your health. Laughter is essential for our physical, mental, and spiritual well being. The bible states, “A merry heart does good like a medicine.” How then does this mirthful medicine improve our health, and what can we do to create a work space that is filled with healthy laughter?

Humour Assessment.

Matching your humour interventions with the patient’s preferred humour style is essential if you wish to stimulate laughter and its therapeutic potential. Humour preferences vary tremendously.
You will increase your success of stimulating laughter with patients if you first answer the following questions.

• Has your patient given you any clues that indicate they are receptive to humour?
• Do they attempt to share humour with staff or visitors?
• What is your patients’ ability to perceive and understand humour?
• How does the patient use humour? Is it cynical and sarcastic or absurd and foolish?
• Observe the kind of humour your patient chooses to create. Do they tell jokes, play pranks, or bring playful items into the hospital?
• Are there any humorous topics the patient might consider taboo? Avoid sexual, ethnic and religious humour to decrease chance of offending them.
• Do you find your patient has a preference for a particular type of humour?
• Do they prefer a certain comedy artist?
• Will the humour be perceived as annoying? Will it indicate Caring?

As you embark upon this journey into therapeutic humor, remember you may have to create the map as you go along. Each individual and situation is unique and the terrain will change from day to day. It is important to collect a variety of tools and resources. And most of all, be sure to travel lightly and be prepared to change directions if needed. Most of all, have fun along the way!

Techniques to Create Therapeutic Humour.

• Create a scrapbook of cartoons. Place the cartoons in a photo album with plastic “peel back” pages. This will protect and keep them clean.
• Develop a file of funny jokes, stories, greeting cards, bumper stickers, poems and songs.
• Collect or borrow funny books, videos and audio tapes of comedy routines. These can be found in libraries, humor sections of book stores, mail order catalogs, or at humor conferences. Develop a lending library in your facility.
• Keep a file of local clowns, magicians, storytellers, and puppeteers. Invite them to entertain at your facility, the patients’ home, or for a group function.
• Collect toys, interactive games, noise makers, and squirt guns. Keep them available to play with. If you will be sharing these toys with a patient, keep in mind safety and cleanliness factors
• Create a humor journal or logbook to record funny encounters or humorous discoveries. On days when you really need a laugh, but can’t seem to find anything funny, you will have a collection of amusing stories at your fingertips.
• Establish a bulletin board in your facility to post cartoons, bumper stickers and funny signs. If the display is public you must consider the sensitivities of the audience and be careful to exclude potentially offensive (ageist, sexist, ethnic) material.
• Educate yourself about therapeutic humour. Attend conferences, workshops, and conventions.

Please let me know what kind of skills you use to survive anything?