New Zealand nurses use of humour in surgical nursing practice

Humour is a tool that can build rapport, establish communication and enable a therapeutic relationship: all of which are essential skills for nurses. For nurses to use humour in their practice they need to know when it is appropriate and when it could be beneficial for patients. However, much of the literature on nursing humour focusses on when not to use humour or provides contradictory messages about the use of humour. This is problematic as with little guidance, nurses may be hesitant to deploy humour with patients, potentially missing important opportunities to deliver more effective care.  The lack of evidence-based guidance about use of humour for nurses was a key driver for this study. Furthermore, with even less research in the surgical care setting, a stressful environment for patients and staff, the need to explore how and when humour is used in surgical nursing practice was important.  A qualitative descriptive methodology was used to explore how registered nursing working in a surgical environment decide when and how to use humour within nurse-patient interactions, and the use of humour during nurse-patient communication is assessed. Data collection was carried out in two surgical wards within a single site tertiary hospital in New Zealand. Nine registered nurses participated in group or individual interviews that were conducted using an interview guide incorporating semi-structured questions. Data were analysed thematically.  Findings demonstrate the humour is a significant feature of practice for surgical nurses with its use being purposeful and undertaken after careful consideration and assessment. Within three themes (assessing openness, building a connection, protection against vulnerability), humour was described as enabling nurses to quickly connect with patients and establish a therapeutic relationship. Humour facilitates communication, even under difficult circumstances, and provides an outlet for the perceived physical and emotional vulnerability experienced by both patients and nurses within the surgical environment.  Humour forms an integral part of surgical nursing practice. This thesis challenges surgical nurses to place an emphasis on raising the profile of humour in practice and develop skills to assess when to use, and when not to use humour. This will require the development of specific educational and professional strategies.