Humour a Coping Mechanism for Caregivers


Daily Life, Humour, Patients, Way of Life


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Nurses, physicians, and other health care professionals cope daily with the reality and horror of illness, suffering, and death. If you are unable to cope effectively with this, you would experience “a burnout” or more accurately called “a compassion fatigue”. Your compassion and caring may leave you vulnerable to feelings of sympathy for those we serve.

There is a great difference between sympathy and empathy. Both arise from compassion and caring, but they relate to the suffering person in different ways.
Sympathy feels the “other’s pain” as if it were our own; you feel frightened with them, angry with them, depressed with them. As you might imagine, sympathy decreases our effectiveness as caregivers because we lose our objective perspective.

Empathy, on the other hand, employs a “detached concern.” You still express your compassion and caring, but without identifying with the patient’s pain as if it were your own.
Humour is a coping tool that provides you with a similar “detached” perspective.

Caregivers will often use humour as a means of maintaining some distance from the suffering and protecting themselves from a sympathetic response. Christina Maslach, in her book, Burnout: The Cost of Caring, describes how nurses use humor and laughter to cope with the stress and horror they frequently witness. “Sometimes things are so frustrating that to keep from crying, you laugh at a situation that may not be funny. You laugh, but in your heart you know what’s really happening. Nevertheless, you do it because your own needs are important–we’re all human beings and we have to be ourselves”.

Your ability to laugh provides you with a momentary release from the intensity of what otherwise might be overwhelming. You use humour to gain a new perspective and to find a way to function in a situation that could otherwise be intolerable. “Gallows humour” is a type of medical humour usually seen as hostile, inappropriate, or “just plain sick,” by the people who are unfamiliar with healthcare professions. Gallows humour acknowledges the disgusting or intolerable aspects of a situation, and attempts to transform it into something lighthearted and amusing.

When I was working on a Neuro Care Unit at a university hospital, an ambulance brought in a homeless person they had found unconscious in an alley. The man was filthy, his breath reeked of alcohol, and he had lice crawling on his body. It took two of us more than an hour just to clean him up enough for admission. It was difficult work and our senses were overwhelmed with unpleasant sights and smells. I read the intern’s admission note on the way up in the elevator. It said, “Patient carried into E.R. by Army of body lice, who were chanting, “Save our host. Save our host.” I laughed heartily at this amusing picture and suddenly my struggles of the last hours were put into a humorous perspective and I felt a lot less angry and a lot more compassion.
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