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There are a lot of risks to people in healthcare: Needle sticks, back injuries, sprains, strains, exposure to lethal illnesses, assaults from patients or their family members (or even from coworkers or colleagues). The hours are long, the work in intense (physically and mentally), and the pay is often not enough.
These days, “twenty-somethings” have a lot more choices for their career paths, and they’re not choosing healthcare. There are not enough nurse educators to educate the number of nurses that are needed to fill the upcoming vacancies due to retirement of the aging boomers. And at the same time that nurses will be retiring and leaving the field in masse, the largest generation (boomers) will be entering the healthcare system with their aches, pains and illnesses.
How many nurses does it take to screw in a light bulb? Just one, but at the same time she’s passing meds, hanging blood, admitting a patient, greeting families, helping docs, pacifying administrators, juggling paperwork, explaining procedures, deciphering orders, answering lights, discharging a patient, changing an IV, charting notes, and performing CPR.
After one of my presentations, a nurse came up to me and shared that her hospital had a recruiter stationed at the front door. Should an RN come in and sign on to work, the hospital would write them a bonus check of $7000, right then and there. She shook her head and laughed. “The hospital can’t figure out why that same nurse will flee from the building as if it were on fire as soon as her commitment is up. But that $7000 is the only money they (the hospital) will spend on that nurse. No one cares about the employees. We’re just numbers figured into the budget. And if the hospital isn’t making money, the people are expendable.”
Sounds discouraging, doesn’t it? And yet, there are incredible men and women who dedicate their lives to the noble professions in healthcare. For the last 10 years, much of the focus regarding staffing has been recruit, recruit, recruit. Recruiting is a good thing, but studies are finally starting to show that the focus may be better spent on retention. What a concept. Make the work environment so great that the good people you have on board want to stay.
Classic Care Pharmacy in Burlington, Ontario, is a shining example of fun corporate culture. Moe Green, founder of Classic Care Pharmacy started his business 10 years ago with a handful of people. Today he has over 120 employees and services 125 long term care facilities. The corporate culture is fun, and his staff and his customers are raving fans.
While having lunch with two of the team, they told me they hate to miss even a day of work. “There’s something going on everyday, and most of the time its fun!” they said. Apparently the rest of the staff agrees with them. The camaraderie and team spirit is palpable when you walk in the office.
As far as retention goes, people who come on board tend to stay on board. “We don’t brag too loudly to others about how good we have it here,” teased a couple of gals following my after-dinner entertainment. “We don’t want a bunch of other people vying for our jobs!”
From chatting with Moe, two keys to Classic Care’s success became obvious. First, he’s a firm believer in empowering his people. “When issues come up, I let them make decisions. There’s rarely an issue that is life or death.” Engaging his employees in company matters helps them to feel ownership. Once a month he holds a “State of The Union” address where he collects all 125 people and gives them updates on what’s going on and gets their feedback. And all of the executive team have an open door policy.
Second, fun is part of the corporate culture and it begins with the interview process. Moe is looking to hire for attitude and if the interviewee isn’t comfortable with the joking and teasing that goes on with the interview committee, then it’s made clear that this is part of the culture. If he or she feels uncomfortable, then perhaps they would be better off working elsewhere—the company isn’t going to change its culture just because someone doesn’t want to play along. Throughout the year, employees spend time together at potlucks, bar-b-ques, sports and just hanging out. They are an extended family.
The weekly executive meetings usually include gales of laughter. “Sometimes staff will come over and close our door because we’re laughing so loud,” Moe admitted.
What’s the result of all this? It comes as no surprise that Classic Care Pharmacy Ottawa was just named one of The Top 10 Employers in the National Capital Region (based on engagement, leadership and over-all employee satisfaction). This award was not just for healthcare but for businesses across the province. And Classic Care continues to grow at an astounding rate: 30% over 10 months!
When humor is part of the corporate culture, businesses can enjoy tremendous financial success—but that’s not all. George Burns once said, "Do something you love and you'll never have to work a day in your life.”
There a lot of ways to create a positively outrageous work environment—but let’s take a look at humor specifically. There are several factors about humor that make it an ideal tool.
Humor is recognized as a healthy coping mechanism. There are a lot of unhealthy ways people deal with their stress—eating, drinking, smoking and drugs, to name a few. Professionals in healthcare need a lot of tools to cope, and I encourage people to include a variety in their coping tool belt, such as meditation, visualization, exercise, massage and muscle relaxation. But humor doesn’t require additional equipment and space, it doesn’t cost anything to implement, and you don’t have to be coordinated. It can be done practically anywhere at almost any time.
Stress robs healthcare institutions of a lot of money from their bottom line. Stress related issues and illnesses such as headaches, muscle aches, fatigue, obesity, heart disease and exacerbations of chronic illnesses such as arthritis, diabetes, and ulcers cost employers in terms of decreased productivity, lost work days, and utilization of health care plans partially funded by the employer.
In addition, studies have shown that nurses who are stressed out and burned out are much more likely to commit errors which result in longer patient stays and even death. (Have I got your attention, yet?)
Sign of nursing burnout: Every time you make a patient’s bed, you have an overwhelming desire to lie down in it.
Psychologically, humor is an emotional outlet for anxiety; it diminishes tension, and allows people to vent in a socially acceptable way. And yet both staff and patients are frequently discouraged from using humor. Staff hear comments from their supervisors like, “What do you think we’re paying you for around here?” or “You’re having entirely too much fun at work!” Patients hear things like, “You must not know how sick you really are or you wouldn’t be cracking jokes.” Allen Klein, author of “The Healing Power of Humor,” found that patients wanted their caregivers to use more humor and that they wanted permission to use more humor themselves.
When staff is given permission to use humor and have more fun, everybody wins. An infusion nurse told me about the fun and caring attitude at her infusion center. “Our patients love us so much, that they hate to enter hospice or leave the area, because they won’t see us anymore. One patient drives 90 minutes to our center while he could get care closer to his home.” For the institution which is willing to allow some fun, this can add dollars to their bottom line.
Socially, humor strengthens bond and rapport. This might be between caregiver and patient or between caregiver and coworkers. It lessens the hierarchy between individuals. So many institutions today are focused on recruitment, but the best recruitment tool I’ve ever seen is a bunch of happy employees. There’s a lot of truth to “bad news travels fast.” Employees who are unhappy will tell everybody they know how miserable their lives are. This is not something you want potential patients and recruits to hear. And happy employees will also share the good news about their employer.
It’s no coincidence that Scripps Hospital in San Diego is rated among Fortune’s Top 100 Places to Work and also has an employee turnover rate well below the national average. The other day when I was accompanying my husband on his doctor’s visit, we spied a new putting green between the two parking garages. It turns out rather than just have dead space between the two buildings where nothing would grow, a creative employee came up with the idea of a putting green for doctors, staff and even patients to use during breaks and down time (and they’ll even supply you with a putter!).
 A nurse once told me about her clinic and how they used cartoons to build rapport with their patients. It started out when one of the staff collected and laminated cartoons and then put them in a basket in the waiting room. Patients were encouraged to look through them and even take home a cartoon if they liked it. To the surprise of clinic staff, patients started bringing in their contributions to add to the basket. It became an interactive exercise for all to enjoy.
When it comes to communication, humor helps get peoples attention. Are you trying to get a patient to read educational literature? Are you attempting to get staff to read a memo? If you can include a little humor, people will stick with the task longer.
Laurie Paulson, a registered dietician, once showed me a humorous prop she used when teaching patients about weight loss. It was a soft rubber representation of five pounds of fat. Pretty disgusting, actually. Plopping that down in front of a patient got a laugh—and the patient’s attention. She could then give them serious information that could help them get healthier—and they listened!
An important point in humor and communication is about listening beyond the laughter. Many times people will try to convey a serious topic in the guise of a joke. It’s a safety net. If you don’t respond the way they hope you would respond, they can still save face by saying, “I was only kidding.”
Once while taking care of a patient going for an orchiectomy (removing the testicles due to a disease), I asked him to explain the surgery to me as he understood it. The patient laughed and said, “Sounds like the doc is going to change me from a rooster to a hen.” Things are always funnier when they’re happening to someone else. And I sensed this guy didn’t really find this as funny as he let on. I hung around for a few minutes and in no time, he was asking me questions about his sexuality after the surgery. Listen beyond the laughter.
Humor promotes creativity, and in a day of shrinking budgets and resources who couldn’t benefit from a little more creativity? Chris, a nurse at a small hospital wrote that on April Fool’s Day he took five rolls of colored plastic wrap and made the charge nurse’s car look like a giant Easter Basket. He also wrote, “Did you know that you can take a measuring hat for the toilet, turn it upside down, and it looks just like a Domino's Pizza sign on the top of a car?” Staff members who have this creativity know how to make resources stretch!
You may be thinking to yourself, “This sounds like good stuff but Karyn, I’m not funny! Can you help me be funny?”
 The answer to this question is yes. And, you would be better served if I showed you how to see funny, instead of how to be funny. The latter will serve you in a limited number of circumstances, but the former—to see funny—will serve you almost anywhere at almost anytime.
The first step is to start assuming there is something humorous going on somewhere that you may be overlooking. Just by raising your awareness, you are increasing the likelihood of discovering humor around you. It’s kind of like buying a red car. You take it out on the highway and all of the sudden you notice that there are tons of red cars on the highway. Why didn’t you notice them before? You hadn’t raised your awareness. They were there all along, they just didn’t catch your attention. And by raising your humor awareness, you’re going to start noticing things that have been there all along, they just didn’t catch your attention.
Anyone who has read patient charts over a period of time knows how funny unintentional humor can be. A nurse manager at a nursing home recently told me one she read on a resident’s chart: Patient fell in November and has been going downhill ever since. A staff member in medical records spied where a doctor had charted: Patient deserves colonoscopy. (We might think such a thing, but would we really put it in writing?!)
Seek humor from others. My friend and colleague in humor, nurse Leslie Gibson, told of a home health patient who wanted to give her a gift for taking care of him. She explained that she couldn’t accept any gifts but that if he really wanted to do something special for her, the next time she visited him she wanted a joke. Not only did she get the gift of humor the next time she arrived, but the patient received a gift as well. Because he was looking for examples of humor during the week, his attitude was vastly improved because of his outlook.
Tell stories. Most people can’t remember the punchline of a joke, but almost everyone has a story to tell. If you can’t think of a funny story, try to think back on an embarrassing moment. We’ve all had them. And most adult humor comes from pain and discomfort—it just takes a little time to emotionally disconnect before we find it funny.
One morning while I was hurrying down the hallway to circulate for the next C-section, I saw a tall young man in scrubs looking somewhat lost. “Must be the soon-to-be father,” I thought. Out loud I asked, “Are you looking for the C-section?” He nodded. “Well, you can’t go into the operating room without a mask! Follow me.” Silently he followed me to the sink, where I first showed him how to wash his hands, and then handed him a mask. “Here,” I instructed him. “You take these two strings and tie them like this . . . and these two strings and tie them—like so!” He nodded slowly, then replied, “I prefer to tie mine like this,” and after demonstrating, he extended his hand. “I’m the new pediatrician, Dr. McHardy.” I smiled back, shook his hand enthusiastically, and said, “And I’m Nancy Roberts, the OR supervisor.” It was two weeks before he discovered that I’m NOT Nancy Roberts! Moral of the story: Never let them see you sweat!
Manipulate your environment. If you keep fun things in your work space you increase the likelihood of having fun. When I toured the worksite at classic Care Pharmacy, all the cubicles were decorated with cartoons, toys, and one even had a diorama of the reality show, Survivor! I bestow a magic wand to all of my clients for those days when people make impossible demands. Years later, clients are still waving those wands, decreasing their stress with a laugh!
There are resources to help healthcare professionals “see funny.” (See table) I highly recommend you use humor proactively, starting today. Humor by chance garners benefits, but humor choice provides results. And that’s no joke!
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I’ve spent the last couple of decades studying humor (seriously!) and I’ve come to the conclusion that for most adults, humor comes from pain and discomfort. We’re not laughing about having a great hair day or a sexy figure or more money than we can possibly spend. We’re laughing about the things that drive us crazy.
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