“Every time you find humour in a difficult situation, you win” – Snoopy
Black humour – It’s something we are introduced to early in our nursing careers. It is often muttered in tea rooms, at ward Christmas parties or during a post-shift debrief. An outsider listening in might be appalled at what they hear – these are remarks not voiced in polite circles or in public. But dark humour can have positive as well as negative aspects.
Nurses have a few handy traits in our toolbox of skills that allow us to function professionally. First, we are inherent empaths. We feel the pain and misery that our patients experience. Yet we are also thick-skinned. Images, smells and verbal un-pleasantries are deflected by this armour. This protection, to a certain extent, allows us to emotionally deal with the daily tragedies, and minimise the chance of vicarious trauma settling in. But we have another device in our toolbox to employ – black humour.
Black humour is taking a morbid experience and expressing it via a jest. We nurses hear, see, smell and emotionally absorb circumstances that are inherently ghastly. We laugh against fear; however, another outlet may be required. Sometimes the situation is expressed through an emotion, like crying. But often we use macabre humour to express raw grief.
This isn’t meant to demean our patients, but is an expression of a coping mechanism against taboo topics. This allows us to smile and laugh and then muster the emotional stamina to move onto the next patient.
Black humour transmutes a distressing event. It transforms a physically or emotionally exhausting incident into a diversion that makes us smile and laugh. This lets us express painful thoughts more easily.
Gallows humour allows us to bond and share experiences with our colleagues witnessing the same dire situations. It is a natural human instinct that helps to manage our own mounting stress with a snarky comment. Incidentally, a 2017 study published in the journal Cognitive Processing stated that people who appreciate black humour “may have higher IQs, show lower aggression, and resist negative feelings more effectively than people who turn up their noses at it.”
But black humour can be taken too far, and from outside hospital walls can be interpreted as cruel and inappropriate. Derogatory comments may be considered as a lack of caring, insensitivity, or an abuse of power and trust between the nurse and patient. People can use grim humour to promote an agenda that is ageist, racist, homophobic or sexist. The danger lies with black humour stereotypes that devalue a patient or worse, dehumanises them. As nurses and midwives, we need to take the person out of the humour and focus on the truth of the circumstances. Otherwise, it can destroy empathy and distort objectivity.
We must remember that our patients are likely experiencing fear, anxiety, and vulnerability. In our profession, we must be aware that our comments, even if innocently expressed, may be interpreted by the public as offensive or even scandalous.
For example, I once had a colleague use the tragic death of a young person as the reason to make a dark humour joke – they were quickly shut down.
Black humour may be acceptable in certain situations, but nurses need to develop their judgement that recognises that it has both a time and a place. Mindful of professional ethics, I would argue that this shows we are human and trying to cope as best we know how. Macabre humour allows us to cope expertly when we witness tragic events and allows us to care for our patients with empathy. Importantly, this allows us to maintain a semblance of control over the endless suffering that we encounter. And ultimately, laughter is still the best medicine.