A good laugh can be very therapeutic. Laughter helps us release tension, neutralizes toxic emotions and can enhance the nurse-patient relationship by building rapport and trust. However, sometimes humor does not readily translate across cultural differences. Instead of the intended laughter, we may unintentionally evoke discomfort, confusion, or even resentment.

Learn to Speak the Language of Humor

Humor is often described as a universal language and anthropologists tell us that no society is entirely devoid of humor. But can the universal language get lost in the translation? Yes. One disparity among cultures is the content of its humor and the situations in which humor is used or considered appropriate.

While the physiological response to the behavior we call laughter is consistent across all cultures, the cognitive aspect or "sense of humor" can be radically different between cultures. Smiles and laughter transcend all cultures, but what we find laughable is influenced by the individual's values, beliefs, and world view, as defined by his or her culture or society. Put simply, different jokes for different folks.

For Nurses Only

For example, let's consider the professional "culture" of nursing. Nurses find absurd situations and surprising patient encounters quite amusing and laughable. However, when we share these stories with our families and non-nurse friends they are often appalled or even disgusted. Our "nursing culture" has given us permission to release our tension (caused by frustration or surprise) through shared laughter. People outside our culture or even student nurses who have not yet been completely acculturated do not understand how we can find some of these things funny. The humor is "lost in the translation."

What's So Funny?

America is known for embracing diversity and has a reputation for celebrating the richness created by sharing cultural experiences. If we want to take advantage of the therapeutic potential of humor, we must first understand more about how humor is used or accepted within the patient's culture.

Because as nurses we care for patients from many different cultures, we should ask ourselves these questions -

· Is there a difference in the kind of humor that emanates from a particular culture or ethnic group?

· Does culture or ethnicity make a difference in the kind of humor that is appreciated?

· Are there similarities or universal topics

for humor that transcend cross-cultural

differences?

· Is there a relationship between a specific culture and its use of humor in times of stress?

· Would the culture of the patient make a difference in the nurse's use of humor - if the nurse were not a member of the patient's culture?

It is always helpful to do a humor assessment with patients before interjecting humor. Observe how patients use humor or ask them -

· What is the last thing you laughed about?

· What type of humor do you enjoy - films, cartoons, jokes, or games?

· What type of humor offends you?

· Are there times when you wouldn't use humor?

Identify the most common cultures in your demographic area and gather pertinent information about their values and beliefs. Assess the role that humor serves in those cultures. Cultural awareness helps you avoid inadvertently offending patients and can build rapport and trust between nurse and patient.

Humor Can Be a Risky Business

Remember, the degree of trust, respect, and rapport that you establish between yourself and your patient will always enhance the kind of humorous exchange that is not only acceptable but therapeutic. If you share the same ethnic or cultural identity as the patient you may have more potential to succeed with your attempts at humor. Humor can be a risky business - even within your own culture. So be careful, be aware, and be informed - and go put smiles on your patients' faces and in their hearts.