hr. J. Nurs. Said., Vol. 34, No. 5, pp.

346352, 1997
0 1997 Elsevier Science Ltd. All rights reserved
Pergamon Printed in Great Britam
002lh7489/97 Sl7.00+0.00
PI1 : SOO20-7489(97)0002M

Humor in nursing practice : a phenomenologicalstudy

Cheryl Tatano Beck

School of Nursing, University of Connecticut, 231 Glenbrook Road, Storrs, CT 06269-2026,U.S.A.

(Revised 22 April 1996: revised 20 September 1996: accepted 21 October 1996)

Abstract

Humor is an important but underutilized resource in nurse-patient interaction. The multidimensional value of humor in
providing nursing care has recently begun to receive attention. The purpose of this phenomenological study was to describe
the meaning of nurses’ use of humor in their nursing practice. Twenty-one registered nurses enrolled in a graduate nursing
program described in detail an experience they had using humor in providing nursing care. The 21 written descriptions were
analyzed using Colaizzi’s phenomenological method. Five themes emerged in which humor was found to (a) help nursesdeal
effectively with difficult situations and difficult patients, (b) create a senseof cohesivenessbetween nurses and their patients
and also among the nurses themselves, (c) be an effective therapeutic communication technique that helped to decrease
patients’ anxiety, depression, and embarrassment, (d) be planned and routine or be unexpected and spontaneous, and (e)
create lasting effects beyond the immediate moment for both nurses and patients.0 1997 Elsevier Science Ltd. All rights
reserved.

Ke.words: phenomenology ; humor ; qualitative research.

Introduction received minimal attention. Due to the qualitative nat-

The value of humor is multidimensional. Among
the varied benefits of humor are its physiological,
psychological, social, and cognitive ones. Included in
humor’s physiological effects are its stimulation of
the circulatory and respiratory systems, relaxation of
muscles, and increased production of endorphins
(Black, 1984 ; Williams, 1986). Psychologically,
humor helps to decrease stress and anxiety by pro-
viding a safe and acceptable outlet for emotions.
Humor also helps strengthen one’s self-esteem. Soci-
ally, humor has the capability of enhancing inter-
personal relationships. According to Cohen (1990),
laughter is the shortest distance between people. Lines
of communication are opened through humor. Laugh-
ter can enhance feelings of closeness, togetherness,
warmth, and friendliness (Parse, 1993). In the cog-
nitive domain humor facilitates the learning process
by capturing and maintaining attention and increasing
memory (Leiber, 1986).
According to Astedt-Kurki and Liukkonen (1994),
humor is an important but underutilized resource in
nurse-patient interaction. Historically, nurses have
been socialized to maintain a serious demeanor when
providing nursing care (Watson and Emerson, 1988).
Only recently has the value of humor in nursing prac-
tice begun to be addressed in the literature. Most of
these published articles describe the benefits of humor
as a nursing intervention and address different humor
techniques. Humor research in nursing practice has
ure of humor, Bellert (1989) reported that humor
instruments and evaluation tools tend to have low
reliability and validity. Astedt-Kurki and Liukkonen
urge the use of qualitative research to explore such a
complex dimension of human experience as humor.
The purpose of this research was to conduct a
phenomenological study of the meaning of nurses’ use
of humor in their nursing practice.
Review of the literature
The use of humor as a therapeutic nursing inter-
vention has been documented in critical care patients
(Lieber, 1986), in psychiatric patients (Pasquali, 1990),
in persons with Alzheimer’s disease (Buckwalter et al.,
1995), in oncology patients (Bellert, 1989), in aging
adults who are not cognitively impaired (Simon,
1988), and in hospitalized children (Grimm and Pefley,
1990). Some examples follow.
Bellert (1989) has suggested interventions using
humor on an oncology unit such as developing a
library of humorous videos, providing joke books or
humorous story books to patients, their families and
staff, and conducting regular joke-telling sessions.
Ackerman et al. (1994) have developed a model to
incorporate humor into the healthcare setting. The
model consists of developing a humor idea, resource
development, ongoing planning, facilitating humor,
and project evaluation. Their model included two pro-

346
 C. T. Beck/Humor
jects. One project called the “Chuckle Wagon”
focused on patients, while the second project, the
Nursing Humor Resource Center, focused on the staff.
Experts caution that humor can be destructive if it
is used inappropriately. Prior to implementing humor
as a nursing intervention, Cohen (1990) urges nurses
to complete a nursing assessment of patients’ humor.
Her nine-item inventory helps to determine a patient’s
humor style. Bellert (1989) also has created a list of
eight questions to help nurses assess a patient’s values
and practices of humor.
It has been repeatedly documented in the nursing
literature that not only patients but also nurses benefit
from humor. Buckwalter (1991) highlighted the use
of humor as a coping strategy by nurses working in
geropsychiatric settings. Humor techniques to help
oncology nurses cope with their high stress working
environment also have been addressed (Simon, 1989).
Simon identified ways for nurses to incorporate the
positive benefits of humor into their self-care and
stress management behaviors. Examples included
keeping a humor journal, sharing cartoons, using ima-
gery, and conducting a humor self-appraisal.
In reviewing the nursing literature, a dearth of
studies investigating humor in nursing practice was
found. Sumners (1990) surveyed 204 registered nurses
using the Sumners’ Attitude Toward Humor Semantic
Differential Scale. This instrument consisted of 21
bipolar adjective pairs, each measured on a seven-
point scale. The adjective pairs focused on the eval-
uative, potency, and activity factors related to humor.
The final adjective pair, strongly favorable/strongly
unfavorable, was included to assess attitudes towards
humor. Each nurse completed two semantic differ-
ential scales : one for personal life setting and one for
professional life setting. Data analysis revealed that
the nurses held positive attitudes towards humor in
both their professional and personal settings;
however, the nurses were less positive about humor in
the professional work setting. Sumners concluded that
her findings may indicate that a potentially useful
nursing strategy is not being fully utilized by nurses.
The effect of humorous distraction on preoperative
anxiety was studied in a pilot study by Gaberson
(199 1). Fifteen preoperative patients were assigned to
one of three groups: a control group with no treat-
ment, a group who listened to tranquil music, and a
group who listened to a humorous audiotape while
waiting for surgery. The findings indicated that the
humor group reported the lowest levels of anxiety
while the control group reported the highest anxiety,
however, the group differences were not statistically
significant. Due to the small group sizes, Gaberson
recommended further research to follow up on this
identified trend.
Only two qualitative research studies were located
that examined humor in nursing. Astedt-Kurki and
Liukkonen (1994) explored the meaning of humor to
nurses in Finland and its occurrence in nursing care.
Thirty-two nurses were presented with a set of
in nursing practice 341
unstructured, open-ended questions and asked to pro-
vide short essay-type answers. The topics of these
questions focused on (a) a nursing situation where
humor was involved in an interaction between the
nurse and the patient, (b) a situation where the nurse
laughed from the bottom of her/his heart, (c) how the
nurse uses humor in her/his nursing care and (d) what
does humor mean to the nurse, the patient, and the
discipline of nursing. Data analysis was performed by
using content analysis. Themes that emerged included
humor being perceived as an individual and personal
matter, humor being essentially a context-bound
phenomenon, finding humor expression in verbal
communication and in gestures, and humor facilita-
ting a positive nurse-patient relationship. Nurses
shared that humor played a major role in helping them
to cope with job-related stress.
In the second qualitative study located in this litera-
ture review, the use of humor by undergraduate
nursing students was examined. Warner (1991)
explored humor as a coping response for nursing
students during their psychiatric rotation. A content
analysis was conducted on 38 narratives written by
the nursing students describing situations in which
they had experienced humor during their clinical psy-
chiatric rotation. Six categories emerged : novel and
bizarre behaviors, novel and bizarre thoughts, threats
to self-esteem, deficit in role performance, perceived
threats to physical well-being, and wit. These six
categories were antecedents fostering tension in the
nursing students in the form of anxiety, frustration,
fear, and puzzlement. Humor was used by these
nursing students to cope with this stress.
Method
Research question
What is the meaning of nurses’ use of humor in the
clinical practice?
Sample
Twenty-one registered nurses enrolled in a graduate
nursing program in a state university participated in
this qualitative study. Nineteen of the graduate
students were females and two were males. One
student was African American and the remainder were
Caucasian. All the participants were enrolled in a core
course that focused on the exploration of nursing
phenomena. In this course each student chose a con-
cept to analyze over the semester using the hybrid
model of concept development (Schwartz-Barcott and
Kim, 1993).
Procedure
As part of the content of this core course, the gradu-
ate students were introduced to naturalistic inquiry
and various methods of qualitative research. To illus-
348 C. T. Beck/Humor in nursing practice
trate for the students how qualitative data are analy-
zed, the faculty member invited the graduate students
to participate in a phenomenological study on the
concept of humor. The students voluntarily par-
ticipated in this teaching strategy. The graduate
students were asked to anonymously respond in writ-
ing to the following statement: please describe an
experience you had using humor in providing nursing
care. Write all your thoughts, feelings, and per-
ceptions that you can remember about this experience
until you have nothing left to write.
Research design
Phenomenology is an inductive, descriptive
research method whose goal is the discovery of the
meaning of human experiences. Its main objective is
to describe a phenomenon as it is consciously experi-
enced without theories about causes and as free as
possible from unexamined presuppositions and pre-
conceptions (Spiegelberg, 1975).In order to help ach-
ieve this objective the process of bracketing is used
wherein the researcher reawakens his/her pre-
conceptions about the phenomenon under study and
then attempts to hold them deliberately at bay
(Merleau-Ponty, 1956).
into an exhaustive description of the phenomenon
under study.
6. Return to the participants with the exhaustive
description to achieve final validation.
Credibility of thejndings
Credibility, which refers to the confidence one can
have in the truth of the researchfindings, can be estab-
lished by various strategies(Lincoln and Guba, 1985).
In this phenomenological study credibility was
enhanced by the following measures.Before data col-
lection and analysis, the researcher bracketed her
assumptions and preconceptions regarding the
phenomenon under study. The researcher identified
the significant statements and themes by herself and
then used member checks to validate these themes.
Member checks involved reviewing the results of the
data analysis with the nurses who had participated in
the study to ensure that the themes accurately por-
trayed their experiences of humor. The nurses agreed
that the themes that had emerged captured the essence
of their experiences. Numerous quotes from the
nurses’ written descriptions of their humor in nursing
practice were included in the results of this study to
also enhance its credibility.

Data analysis Results

The 21 written descriptions of the nurses’ experi-
ences using humor were analyzed using Colaizzi’s
(1978) phenomenological method. This procedure
entails the following steps:
1. Read all the participants’ descriptions of the
phenomenon under study in order to obtain a feel
for them.
2. Extract from each transcript significant statements
that directly pertain to the phenomenon being
studied.
3. Formulate meanings for each of these significant
statements.
4. Organize the formulated meanings into theme clus-
ters.
5. Integrate the results of the data analysis so far
Analysis of the 21 written descriptions of nurses’
experiences using humor in patient care yielded 108
significant statements. In Table 1 can be found selec-
ted examples of theseextracted significant statements.
The formulated meanings of these significant state-
ments were identified and organized into five clusters
of themes. Examples of two themes along with some
of the formulated meanings subsumed under each of
them are located in Table 2. Excerpts from the written
descriptions are included to illustrate each of the five
themes.
Theme 1. Humor plays a significant role in helping
nurses deal effectively with difJicult situations and dif-

Table 1
Selectedexamples of significant statements regarding nurses’ experiences using humor

. “We cracked up laughing. I guessto relieve our tension and embarrassment over such a statement.”
. “While taking care of an extremely irritable and crabby elderly woman, humor was the best therapeutic approach.”
. “Humor was our way we could communicate and a way that the patient could handle the severity of his situation.”
. “It took a lot of time, effort and diligence to use humor at appropriate times to break down the barriers between the
nursing staff.”
. “Using humor helped a German mother to relax and realize I was a person who had feelings and who cared about her.”
. “We told jokes and enjoyed a couple of moments outside of our usual daily routine.”
. “We all kept our little secret. Nobody blew the whistle on this humorous incident.”
. “After several days of caring for this patient, who had a colostomy, we had developed our own type of humor.”
. “Working on an oncology unit I quickly learned humor could be a very beneficial tool to lift the spirits of an otherwise
very solemn population.”
. “I attempted to use humor to ‘loosen’ everyone up.”
 C. T. Beck/Humor in nursing practice 349

Table 2.
Two theme clusters along with their subsumed formulated meanings

Theme 2. Humor creates a sew of cohesiveness between nurses and patients and also among nurses themselves.
. Sharing a humorous moment helped create a senseof cohesivenessbetween the two units of nursesinvolved in the situation.
. Humor helped to create a bond among the nurses who collaborated with the patient to let her cat spend the night in her
hospital room.
. Through their humor the nurse and patient formed a little bond even though they were not related.
. Humorous moments were viewed as “little secrets” that the nurse and patient shared.
Theme 5. Sharing a humorous experience created lasting effects beyond the immediate moment for both muses and patients.
. The nurse was elated that her humorous intervention had such a positive impact on her patient, This feeling stayed with
her for the rest of the day.
. The nurses laughed about their humorous encounter with the feline night visitor for days after.
. It was such a small moment but the nurse felt good it made this dying man laugh, He had so few moments left. Every time
she thinks of him, she remembers him laughing at her joke
-

jicult patients.. Nurses used humor to break up
extremely tense situations in the clinical area. These
situations could involve nurses and other staff mem-
bers or nurses and patients. Humor helped rid nurses
of frustration, anger, and fear. While caring for
extremely difficult and irritable patients, appropriate
use of humor was found to be an effective approach
that nurses relied on to help them deal with these
demanding patients.
Theme 2. Humor creates a sense of cohesiveness
between nurses and patients and also among nurses
themselves.. Sharing a humorous moment helped cre-
ate a sense of cohesiveness among the parties involved.
This special connection or bond could occur between
nurse and patient and also between nurses themselves.
Humorous moments many times were viewed as “little
secrets” which only the nurse and the patient shared.
The following excerpt from one nurse’s written
description vividly illustrates Themes 1 and 2 in
regards to the meaning of humor in nursing care.
“One of our patients was admitted for medical clear-
ance from a psychiatric facility. The patient had a
female name but by virtue of gender was a male with
distinguishable male characteristics. From the time of
admission the patient’s behavior was time consuming,
noncompliant and attention seeking (i.e., attempting
to climb over bed rails, stand in windows throwing
food, pseudoseizures, and pretending to aspirate).
The patient became either completely vegetative or
belligerent when any male went into her room explain-
ing to the female nurses that she has a phobia and
hatred for all males. At some point during the second
evening of admission she refused to have any males
enter her room and when they did, her behavior esca-
lated to where she would jump over the bed rails and
run through the halls of two nursing units, She then
proceeded down four flights of stairs to a very
secluded area of the basement. All this time, with
nurses and doctors following behind. When she
arrived in the basement, she proceeded to have a
‘seizure’ and we transferred her via body board to
stretcher to bed. After the second occurrence when
she was on the bed, awake and calmed, the staff (at
least 12 people) were visibly exhausted, mentally and
physically. Three of the staff were hurt by the patient’s
pushing and grabbing. Humor broke this extremely
tense situation when I, the nursing supervisor and
only administrator in the hospital at the time, noticed
the front of my shirt was saturated with perspiration
and remarked, ‘We11isn’t this attractive?’ Everyone
immediately laughed and began to joke quietly about
the events of the evening. It helped rid us of frus-
tration, anger and fear, and created a senseof cohes-
ivenessbetween the two units of nursesand the house
staff that were involved in this situation.”
Theme 3. Humor can be used as an efjkctive thera-
peutic communication technique between nurses and
patients and also among nurses.. In extremely stressful
situations humor was one way a nurse and patient
could communicate that enabled the patient to handle
the severity of the situation. Nurses would seek out
some way to connect with their frightened patients and
often humor was the answer. At times when nurses felt
helpless in dealing with patients, they tried humor as a
strategy and it resulted in their being able to effectively
communicate with these patients.
Humor was purposely used as a nursing inter-
vention to decrease patients’ anxiety, depression, and
embarrassment. For example, on an oncology unit
one nurse quickly learned that humor could be a very
beneficial tool to lift the spirits of an otherwise solemn
population. Nurses also used humor as an effective
approach to break down barriers between the nursing
staff.
Theme 3 is portrayed in the following quoted pass-
age :
“I was a staff nurse in a trauma center when a 35-
year-old male came in as an emergency after a gas
grill had exploded. He had moderate to severe 2nd
and 3rd degree burns to his face and upper torso,
I clearly remember the fear that this patient had,
especially because he couldn’t see and did not know
the severity of his injuries. In a situation like this the
nurse can get very caught up in the care at hand,
IV replacement fluids, Foley, tetanus shot, etc., but
underneath all there was a very frightened man that I
had to find someway to connect with without the use
of eye contact. I tried to reassure him verbally and
with touch, but then made a silly comment about what
was he cooking anyway. He obviously used humor as
his strong point in life and with me now using the
350 C. T. Beck/Humor
same, he became more relaxed and let the pain medi-
cation take effect. This was now the way that we could
communicate and a way that he could handle the
severity of his situation. I remember feeling helpless
to help this man until with humor I could really com-
municate with him.”
Theme 4. Humor can be planned and routine or unex-
pected and spontaneous.. Often nurses employed
humor spontaneously with their patients. The nurses
did not purposely plan ahead of time to use humor as
a nursing strategy but as their interactions with their
patients unfolded, humor seemed to be the most
appropriate action. With some patients, trial and error
was used as nurses persevered and tried to com-
municate successfully with their patients. After trying
unsuccessfully to reach their patients, some nurses
attempted to utilize humor. For some nurses humor
as a nursing strategy was part of their routine nursing
care. As one nurse shared, she enjoys laughter and
routinely tries to create a surrounding that is joyful
and supportive.
The quoted passage that follows illustrates one nur-
se’s use of humor as part of her routine care :
“With all my Cesarean delivery patients I try to use a
little bit of humor their first time out of bed to ‘lighten
up’ their attitude and mind. They are usually
extremely tense, stiff and tight, anticipating extreme
pain and afraid to move any body part. When I first
get them up and have them stand, I always tell them
they’ll feel like an old lady at first but each day they’ll
feel younger and younger. Then as they begin to walk,
I tell them to take small steps and that we call it the
‘section shuffle’. I always comment on their Foley
catheter and say, ‘Don’t you wish you had this during
the pregnancy?’ because of the frequent urination
with pregnancy.”
An example of spontaneous use of humor was illus-
trated in the following excerpt from one nurse’s writ-
ten description :
“A male college student was brought to the clinic in an
advanced state of hyperventilation. He was extremely
anxious, unable to relax both his fingers and toes from
a curled position. He was placed sitting up on an
exam table, his eyes were closed, his face flushed, and
he kept saying, ‘I can’t breathe.’ A physician and
two nurses (myself included) were available to initiate
appropriate treatment. I began to talk to the patient
constantly in an attempt to bring about relaxation
and give him a sense of control of his breathing. The
patient would appear to fluctuate between relaxation
and hyperventilation. I considered how I could break
this cycle, as 1 was the one doing the verbal com-
munication and whose voice he was listening to.
Finally, without thought I said, ‘Did you see Murphy
Brown last night on TV? Did you watch her version
of Lamaze breathing? That’s what I want you to do.’
With that, the patient cracked a smile and I knew the
crisis was over. Although it took another 15 minutes
to bring the patient back to completely normal
breathing, I knew that laughter had initiated the
cure.”
Theme 5. Sharing a humorous experience created
lasting effects beyond the immediate moment for both
in nursing practice
nurses and patients.. Nurses repeatedly shared how
lasting the positive effects of humorous interactions
with their patients had on them. Periodically through-
out their shifts, remembering humorous experiences
with their patients brought smiles to the nurses’ faces.
Some humorous interactions were so powerful that
nurses recalled these experiences years later with hap-
piness and satisfaction that their nursing strategy had
been so effective. The following passage illustrates
such a moving humorous interaction.
“We had a patient on our unit who came in for
workup following increased shortness of breath,
cough, and hemoptysis. Diagnostic tests showed can-
cer-the prognosis was poor. He was told he would
probably be dead within a month. He spent about I
week and a half on our unit. Every day he greeted me
with some kind of joke. Whether it was a simple
knock-knock joke or a lengthy anecdote, he always
had a new joke for me. Even after he got his bad news
and had to face the fact that his life was close to
ending he still told a joke a day. I always laughed
appreciatively at the joke but I never told any of my
own until the last day. He was discharged to home
with hospice on a Friday. That morning as I was
helping him get ready I told him a political joke that
he loved. He laughed out loud, grabbed my hand and
squeezed it. It was such a small moment, but I felt
good. I made him laugh. It was a moment that was
happy for him and he had so few moments left. He
died 2 weeks later at home. When I heard that I felt
sad. But every time I think of him I think of him
laughing at my joke-just happy that I finally told
him one.”
In concluding the results section two passages from
other nurses’ written descriptions are shared. Each
excerpt contains illustrations of multiple themes that
emerged from this qualitative study.
Excerpt I
“One morning I was assigned to take care of a patient
who had undergone a coronary artery bypass graft
(CABG) on the previous day. I was to transfer this
patient at 10 o’clock to our stepdown unit, a long
travel which usually takes approximately 15 minutes.
The patient was comfortable and stable. His mood
was calm, actually very matter of fact and solemn.
Upon transferring to the other unit, we passed a cou-
ple of windows. Myself, the patient and the trans-
porter all commented on what a beautiful day it was.
The sun was shining. It looked warm and inviting. As
we were passing a doorway leading to outside, I got
the urge to ask the patient if he wanted a breath of
fresh air. His eyes beamed, he stated, ‘I’d love it.’ We
wheeled his stretcher halfway out the door and just
stood there for a few moments, absorbing the sun-
shine and fresh air. We laughed at the spontaneity of
our actions and joked about what others would say if
they saw us there with a patient’s stretcher out the
doorway. The transporter, a friendly guy, told a few
jokes and we enjoyed a couple of moments outside of
our usual daily procedure. I noticed a difference in
the patient’s affect. I felt we had done something
special for him. I could see that he was now smiling
and more cheerful. The rest of the transfer went as it
usually did and without incident. But we had our
‘little secret.’ Later that day this patient’s wife stopped
 C. T. Beck/Humor
by our unit and asked to speak with me. She said her
husband was elated and in great spirits. He had asked
her to make a special trip back to the intensive care
to thank me. I now, too, was elated that my inter-
vention had such a positive impact on my patient.”
Excerpt 2
“A woman was in her late 40s and recovering from a
respiratory, flu-like illness. She was very overweight
which complicated and slowed her recuperation. She
had become discouraged and was becoming
depressed,MS M. had been in the hospital for several
weeks, She lived alone with her Siamesecat. This cat
meant the world to her. He provided companionship,
humor and caring. Someonein her circle of friends or
family must have been concerned about her low mood
and decided to brighten her up. It turned out that her
cat spent a night with her in the hospital, hidden
under the blankets. The night nurse discovered him
but didn’t let the cat out of the bag! We all saw the
humor in the situation and also the outcome of a
change in her mood. She kept him all night and we
discreetly managed to get him out and returned to her
home in the morning. It was a rather comical and fun
experience. MS M. was a much happier person after
her little visit from her pet. It also helped to create a
bond with the nurses who collaborated with her and
shared this adventure. We laughed about it for days.
We knew she appreciated our tolerance of his visit.
Nobody blew the whistle on the incident and it pro-
vided her with a little excitement and fun. She reco-
vered very quickly thereafter. Her mood improved.
And we were none the worse for our encounter with
the night visitor.”
Discussion
The value of incorporating humor into nursing
practice not only for patients but also for nurses
emerged repeatedly in the themes of this phenom-
enological study which confirmed findings of earlier
qualitative studies. Just as in Astedt-Kurki and
Liukkonen’s (1994) and Warner’s (199 1) research, the
nurses in this current study also shared how essential
humor was in helping them cope with difficult patients
and situations. Theme 3, which focused on using
humor as an effective therapeutic communication
technique, supported Astedt-Kurki and Liukkonen’s
finding that humor facilitated a positive nurse-patient
relationship. In Parse’s (1993) study she reported that
laughter enhanced feelings of togetherness and close-
ness A similar finding emerged in Theme 2 which
involved humor creating a sense of cohesiveness not
only between nurse and patient but also among the
nurses themselves.
The immediate, beneficial effects of humor in
nursing practice have already been addressed in the
literature (Buckwalter, 1991 ; Simon, 1989). Emerging
from this current qualitative study, however, was the
discovery in Theme 5 that sharing a humorous inter-
action also created lasting effects beyond the immedi-
ate moments for both nurses and their patients.
The results of this phenomenological study have
in nursing practice 351
implications for nursing administrators, nurse edu-
cators, and nurse researchers. In efforts to decrease
the rate of nurses’ burnout and to increase the nursing
staffs morale, nursing administrators can promote an
atmosphere where laughter and humor are valued.
Humorous dimensions of nurses’ personalities can be
encouraged to emerge. Continuing education pro-
grams on implementing therapeutic humor can be
offered. Inclusion of humor in nursing curricula needs
to gain the attention of nurse educators in order for
nursing students to be socialized to view humor as a
valuable resource in nurse-patient interactions and in
interactions among nurses themselves.
ln regards to areas for further research, both quali-
tative and quantitative studies are needed. The current
phenomenological study focused on the nurses’ per-
spective of humor. A follow-up qualitative study can
examine the meaning of humor in nursing care from
the patient’s perspective. Quantitative studies can
investigate such questions as: does humor help to
prevent burnout in nurses? Which humorous inter-
ventions are most effective with specific types of pat-
ients? In health care settings, what barriers affect
nurses’ use of humor in patient care? What factors
facilitate humorous nursing interventions in health
care settings?
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