Bedside manner advice for physicians is coming from an unlikely source: hospital clowns. New research from Tel Aviv University in Israel and the Ramat Gan-based Israel Center for Medical Simulation identified 40 skills medical clowns use to bring joy to difficult situations.
Hospital clowns have been found to "help patients, their parents, the medical team and the achievement of therapeutic goals. In fact, through various communication skills, clowns enable patients to overcome crises and move towards healing," researchers said.
These trained professionals can turn frowns upside down with their lighthearted antics and humor, but their skills are not meant only for people in makeup. Researchers identified seven characteristics physicians and adopt to their bedside manners to improve patient outcomes:
- Distraction: "Diverting a patient's attention from a negative emotion breaks the [patient's] cycle of negativity." A distraction can change the atmosphere and the mindset of the patient.
- Anchoring: Clowns use objects in the room as icebreakers to make a connection and even create inside jokes.
- Empowerment: Patients can feel powerless, and clowns help restore a sense of control and autonomy with simple questions. "The first question we ask is, 'Can we come in?'" Zachary Steel, program director for Los Angeles-based University of Southern California's Comic+Care, told WebMD. "If the patient says no, we go away. That's not happening with physicians and nurses. Empowerment is at the center of our work."
- Empathy: The fast-paced environment physicians and nurses work in can make it difficult to connect with patients, but an easy tool clowns use to build connection and understanding is using the first-person plural: we. Clowns provide validation, support and relief with phrases such as, "We're in this together, and we'll get through it!"
- Exaggeration: Exaggerating patient frustrations invites them to laugh and reexamine the situation from a different perspective, according to the Israeli researchers.
- Partnership: Clowns become advocates by partnering with children. For example, if a child says she cannot do chemotherapy anymore, the clown might say, "I will come with you and tell them how much it hurts. We will tell them to try it themselves!" Partnering with the patient legitimizes the difficulty and can give them the strength to endure.
- Laughter: Laughter has been scientifically shown to reduce stress hormones, increase oxygen uptake, improve immune function, raise pain thresholds and activate areas of the brain that produce feelings of connection and joy. The act of laughing can also physically stimulate the heart, lungs and muscles.