Health care professionals often face stress due to the enormous responsibility for the lives of patients, high workload, and constant communication with different people. Humor is one of the most convenient and quick methods to reduce stress and calm down; however, jokes cannot always be appropriate. The line between humor and insult in healthcare is incredibly delicate as issues of illness, death, or patient fears are inappropriate for jokes. For this reason, the use of humor y by healthcare providers to deal with stress is ethical only if it carries light messages and is respectful of the subject of the joke.
The use of derogatory and cynical humor, or “black” humor, is common in hospital settings as many doctors and nurses believe it helps them deal with stress. However, this type of humor is unethical as it can be offensive to patients who are the subject of jokes, their families, and colleagues who do not accept this type of joke. The use of such humor is illustrated in the case of Aultman and Meyers (2020) when two medical students ridiculed a patient. In that case, the cynical humor was most reflected in a colleague who heard the joke and found it unethical.
For a nurse who has constant interaction with both the patient and the doctors, doctors’ cynical jokes also have a significant impact. First, a nurse who is more familiar with the patient’s personality can perceive jokes of her or his colleagues as an insult, and conflict can arise between healthcare professionals. In addition, even if the nurse does not speak out against the joke, she or he can lose respect or trust in a colleague, which hinders their team’s work.
At the same time, the derogatory humor of the nurses themselves demonstrates that they are not familiar with the patient’s case or have not established quality communication with him or her (Aultman & Meyers, 2020). Consequently, the relationship with the patient is low and needs improvement. In addition, according to Aultman and Meyers (2020), the demeaning humor of healthcare workers can be caused by a mismatch between their views of medicine and the reality of high-stress work. For this reason, cynical jokes can signal to a nurse that her or his colleague is uncomfortable or fearful behind and hide these feelings behind humiliating humor and that he or she needs help with those fears. Thus, cynical and demeaning humor affects all areas of communication and relationships of the nurse from the negative side.
Moreover, cynical humor violates the professional code of healthcare professionals and can have legal consequences in addition to being unethical. The unethical nature of cynical humor is manifested because it humiliates human dignity and prevents people from seeing the good in others (Aultman & Meyers, 2020). In other words, medical professionals put themselves above their patients and show disrespect to them by using cynical jokes about their patients. Besides, the Code of Ethics for all healthcare professionals has an article about equal and respectful treatment of patients by staff; therefore, cynical jokes are a violation of professional duties. A more serious problem occurs if such a joke is heard by patients or their families as it offends their feelings and shows the unprofessionalism of a hospital employee. Moreover, while there are no clear rules in federal law that health professionals prohibit disrespectful behavior, their words may violate other laws. For example, Aultman and Meyers (2020) talk about the case when the health care team yelled: “Code Madea” walking into a black patient’s room, which has a reference to the film Diary of a Mad Black Woman. Although the joke was based on the woman’s exaggerated concerns, she might have seen the phrase as racist if she had heard it. This joke could be condemned as one that violates the XIV Amendment of the US Constitution, and the patient could sue the person who uses it for discrimination. Although the fact that a joke is mean and intentional is challenging to record, this act can have legal consequences or at least a career one if the patient files a complaint with the hospital administration.
An alternative to derogatory and cynical humor to cope with stress is also humor but its light and respectful version. Aultman and Meyers (2020) call such jokes “gallows humor” and demonstrate that they differ significantly from cynical jokes. This kind of humor also helps health professionals relieve stress, but it cannot offend anyone. In addition, Aultman and Meyers (2020) argue that looking at a patient’s case in more detail allows nurses and doctors to avoid the possibility of a cynical joke. Empathy for the patient helps prevent misconceptions about his or her behavior and understand fears or other factors that cause it. Therefore, a closer examination of the patient’s case is an alternative to cynical jokes, albeit more complex.
I also believe that the alternative to cynical stress-relieving jokes is to discuss the positive aspects of the patients and their behavior. For example, instead of talking about the patient’s habit of asking a lot of questions, a nurse can highlight his or her ability to listen and notice details. A nurse can also focus on patients’ pleasant appearance or their ability to be polite to the staff instead of talking about their needs or manifestations of the disease that are difficult to manage. Thus, instead of ridiculing the negative qualities of patients, the staff can discuss nice small details of their patients to improve their own perception subconsciously.
Although, in this case, the main issue is the use of humor by the medical staff within the inner circle, this topic also raises the issue of joking with the patient. For example, is it ethical to joke with patients about their health problems or causes of illness, even if the joke does not have an evil connotation? Even though humor can be used by nurses and doctors to build trust with patients, in many cases, they cannot get the joke out of anxiety or lack of knowledge in medicine. Such situations can cause additional concerns in patients or make the relationship with staff members more awkward. Consequently, the ethical issue of the appropriateness of jokes during conversations with patients is not entirely clear.
In conclusion, using humor to reduce stress does not justify making fun of patients, but it is appropriate if the jokes are light and respectful. Medical professionals cannot make cynical jokes about other people’s problems as it does not help their interactions with patients or their relations with colleagues who find jokes inappropriate. Such behavior can lead to work conflicts and patient complaints, but even without these consequences, seeing negative traits in the patient is an inadequate reaction for a person who should show empathy and care. However, humor that displays serious health problems in light and respectful manner is a suitable option for stress reduction, and healthcare providers can use it along with other methods.
Aultman, J.M. & Meyers, E. (2020). Does using humor to cope with stress justify making fun of patients? (2020). AMA Journal of Ethics, 22(7), E576-582. Web.