Laughter is a powerful tool. To do nursing work without it is like going into the toughest fight of your life, and choosing to tie one arm tied behind your back. Self-punishing, self-defeating madness! For the cost of a moment’s enjoyment, laughter grants stress relief. It evokes hope, happiness, optimism, wellness. It bolsters resilience, creativity, and the ability to solve our problems that much better. What do you think? Could you use more of these things?
People – some of them nurses – disparage laughter and humor as somehow the opposite of professionalism. It’s a common misconception that nurses can’t afford. With our work, our stress levels, the stakes we deal with every day: nurses need every tool available. We can’t afford to make it harder.
Taking our responsibilities seriously, doing our very best, doing what’s right – all the various ways to be professional – are all crucially important aspects of nursing, of course. Too many people, some of them nurses, forget that your outer appearance is NOT the same as one’s inner life. BEING professional, THINKING professionally, aren’t the same as LOOKING professional or ACTING the part. A serious facial expression, stiff, stern, and boring: playing the role, stereotypically “professional,” however convincing it all looks.
A brief aside: health care education doesn’t teach how normal thinking works, how people learn, decide, and interact normally. It leaves nurses and other providers handicapped with obsolete tools and obsolete assumptions. It turns out, for example, that fully normal thinking, as completely rational as most of us ever manage, can’t begin keep up with reality. Too much happens, far too fast, and there are far too many decisions to make.
It sounds crazy, I know. Bear with me a little further. Your brain can’t keep up with reality, yet it does the best it can, and it does a tremendous, wonderful job of it for a smallish blob of grey goo. It even grants you great taste and judgement. Consider your choice of reading material! (Hey, this is a post about humor…)
So we can’t keep up with reality, but somehow we manage to live our lives pretty well anyway. How do we pull it off? Decades of research give the beginnings of an answer. Human brains rely on lots of mental short-cuts that we mostly don’t notice as they happen.
These mental short cuts take complicated tasks and replace them with easier ones: estimates, simplifications, etc. It makes the work involved far more manageable, and lets us make decisions far more quickly, fast enough usually to keep with life. Usually the results are good enough for our purposes. Still, we pay in a price: we make lots of little cognitive errors every day. It’s perfectly normal, and universal among humans. People tend to assume that “normal,” “rational,” “sane” thinking is correct, and “mentally ill” thinking incorrect. Actually, we all share frequent thinking errors. People with and without mental illnesses have more in common, cognitively speaking, than we do differences. This topic is far too vast for a blog post. It’s more book-sized, and I offer a great one below for those interested. One example will do, for now.
“What You See is What You Get.”
We usually assume appearances match reality. When it comes to human interactions, it saves us an awful lot of work. If someone looks angry, we assume they are angry. If they look happy, they are happy, and so on. We do it all the time. Often enough, it works just fine. We psych nurses call it affect versus mood: affect is what shows outside, mood what you feel inside. People assume they match, and often they do, but no always, not by a long shot. What psych people call the usual ‘congruence’ between the affect and mood often breaks down. A sad person smiles. A suicidal person says everything is fine, just fine. A serial killers seems harmless. What you see is most definitely not ALWAYS what you get. It’s a short-cut.
Here’s a clinical tip that I’ve found extremely useful more times than I can count. Ready?
It’s often very useful to DECIDE to break down your own congruence, to act in other words. I’ve long ago learned to act happy at work: cheerful, eager to help, pleased to see every patient, lots of pep and jokes and fun and optimism. Folks often ask me how I can keep it up all the time. The honest answer is that I can’t. I’d love to, but I just don’t have it in me: my natural state is far too introverted and cynical. I CAN keep it up at work most of the time. Here’s why I do:
One: it’s contagious. Patients and coworkers perk up too, get a little more optimistic or at least set their problems to the side. They smile more, cooperate more, trust me more, listen to me. They tell me their jokes and funny stories. They’re less apt to yell at me or give me a hard time. It makes work much easier, and much more pleasant. Not bad! There’s more though.
Two: I noticed this phenomena long before I learned that research agrees with me (I love it when that happens!). ACTING happy tends to MAKE YOU MORE HAPPY. Your brain uses lots of feedback loops. Some of them monitor your facial expression, how you act and talk. Far more than seems plausible, your brain adjusts your mood to fit the way you look and act. It’s no silver bullet: you can’t act simply “snap out of” of deep sadness, let alone clinical depression, but it does offer real benefit. I really DO enjoy seeing patients. Some of it’s natural. I’m a born caregiver and teacher. Some of it, though, is a habit I’ve built over time. In Alcoholics Anonymous they say “Fake it Until You Make it.” They figured this truth out long ago. You can help yourself avoid burnout, too.
Three: I often use my affect and persona as a clinical tool. Especially with confused patients, if I act like everything is fine, soon enough they follow my lead. Staff members who don’t know me yet sometimes whisper in my ear,”They’re out of control” and I whisper back,”I know, I’m working on it.” Soon enough all is calm, no more agitation. How much violence, how many psychiatric emergencies and restraints, how much WORK, pain, unpleasantness, and time have I saved this way? LOTS. Honestly, lots. How can I act like I’m on top of it? I’ve learned some confidence based on past from experience.
As an alternative example, what happens when I need to be strict? I can turn off Happy Go Lucky Greg in a heartbeat and offer You Do What I Say Greg: flat, stern, cold. You will go to your room or it will happen anyway in 1, 2, 3… People notice the difference, trust me! I learned long ago to set the line-not-to-be-crossed in my mind, and make it EXTREMELY clear where it lies and which side of it we’re on right now. I promptly switch presentations and ground rules each time someone crosses the line in either direction. Go bad and meet Strict Greg. Back off, and Nice Greg comes back just as quickly, no hard feelings. That’s making the most of carrots and sticks, BEING both as appropriate. I don’t spend time as Strict Greg, and people learn to expect there’s a good reason when I do. That builds more respect, trust, cooperation. People make decisions based on their emotions first, especially when they’re confused or upset. It pays to offfer clear signals that reach people emotionally.
Without sharp contrast, without Nice Greg, Strict Greg would be much less effective. Two sides of one coin, each depends on the other. I trained with social workers to manage a group home full of longterm State Hospital residents before I became a nurse. They taught me that YOU ARE YOUR MOST IMPORTANT CLINICAL TOOL. I had to learn to manage agitation without force, without backup, without needles or restraints, without locked doors. I’m glad to have all those tools available as a Hospital nurse, but I haven’t forgotten which tool to use most: the one that works best. Me! I’ve also not forgotten to keep honing my skills, learning new things, improving myself, keeping all my edges sharp, no rust. Keep the saw sharp, people, or work becomes a sweaty frustrating nightmare. Stay sharp.
We’ve all met nurses who offer one rigid persona, exactly one, all the time. It’s so limiting! It’s like using a hammer for every job: driving nails, putting out fires… I suggest you learn to do better, BE better. Fill your toolbox and learn when, how to use each one best. Laughter and fun are tools that improve your life and give you far more power and influence.
As a parting gift, enjoy this collection of art puns:
I share ’em when I find ’em!
For those interested in learning more about cognitive psychology, here’s a great best-selling book for a general audience:
Amazon offers the book itself and some brief summaries as well.