Nursing during a pandemic is no laughing matter…but it was for me.

Photo by Mathias Konrath on Unsplash

Assessing mental health patients over the phone at the VA was always challenging. I worked with the primary care providers, assessing new patients and getting them the right mental health resources.

Little did I know it was going to be taken to another level during the pandemic. It was Covid mental health mayhem: Covid cold calls, suicidal calls, PTSD patients plummeting with increased isolation and hospitalizations. There was increased depression, anxiety, and insomnia (and that was just the RN staff members, LOL!).

I couldn’t control this pandemic, my frustration over anti-vaxxers, the fatigue, fears, or sadness. But what I realized I could control was my daily interactions with the patients. I had to do review the PHQ-9 questionnaire for major depression symptoms and the GAD for anxiety. Once I’d finished the mental health assessments, I’d concentrate on the behavioral activation their results suggested.

Cultivating patient connection through laughter.

Having taken part in research on the therapeutic benefits of humor, one strategy I often used with these patients was to ask them, “What made you laugh today?”

At first, many couldn’t think of anything. So I decided to ask about more specific subjects to stimulate their thinking. I used an easy acronym to remember: STATUS.

  • S – Start
  • T – Talking
  • A – Animals
  • T – Television
  • U – Yourself
  • S – Stories or Sayings

It worked. Sad conversations would often naturally evolve into lighter personal interactions touching on positive things. My patients did not disappoint:

“My wiener dog Buddy keeps me protected and sits on my lap most of the time. I tell him I have chores to do and to get up. He pretends he is deaf as me.” We giggled. Another female patient told me, “When I feel like I can’t go on for the day, I say ‘keep swimming like Dory.’” I loved her creativity in motivating herself using Disney characters even as an adult. Another patient told me he watched old shows like the dentist scene from the Carol Burnett Show. “It’s 10 minutes of nonstop laughter,” he said.

While the laughter could be an outlet for the patient, it was also a way to motivate myself through 18 calls a day. We found connection and strength. By the end of many calls, my patients would tell me that they felt better, and say, “I needed to laugh. I needed this talk.” Laughing became a coping skill and a source of motivation for other behavioral mental health goals.

The science of therapeutic humor.

Laughter boosts immunity, lowers stress hormones, decreases pain, relaxes muscles, prevents heart disease, and increases respiratory activity. Humor increases positive thoughts, decreases anxiety, and relieves stress. In addition, it increases level of alertness, helps coping skills, and decreases depression. With veterans, I find that humor diffuses conflict, increases confidence, and healthily promotes bonding and increased medical compliance. It is an easy intervention for a hard patient population.

Years ago I started my research in humor therapy with a national nonprofit organization, the Association for Applied and Therapeutic Humor (AATH). AATH unites researchers from institutions like Johns Hopkins, Harvard, and the American Institute of Stress with expert practitioners in many fields—including nurses.

Who knew humor and laughter can be researched? I loved it as a science. I learned through studies and practice that the physical, mental, and social benefits of laughter are priceless. I attended Humor Academy and had to complete a work project and a national project. I worked on a presentation called Humor Heals Heroes, teaching nurses, doctors, and patients the history of the use of humor in the military and how it can increase rapport with veterans and elevate their moods. For my national project, “Keep the Boots in Hoots,” I sent humor boxes to active duty service members to increase their morale, including books, comic books, gag gifts, funny hats, and funny games. They were so appreciative at being given something to lighten their deployments.

A way to lighten the nurse’s work, too.

So remember your laughing STATUS with all your patient interactions. I promise that the laughter and lightness you bring to patients will have a lasting effect on both of you. How have you made your patients laugh or be lighter during COVID? I’d like to hear your humor experiences.

By Judy Oliverio, RN, BSN, CRRN, CCM. She is a case manager in a VA homeless program, a USAF veteran, and an AATH member.