Patty Wooten presents ... 
Keep 'Em in Stitches:
Robin Walters and her clown program.
From Journal of Nursing Jocularity, Spring 1994, 4(1), pp 46-47.Imagine you are 14 years old.
School is boring,
you don't believe your parents care about you,
friends are pressuring you to use drugs,
and you may have been exposed to AIDS through unprotected sex.
Your head is pounding.
Your stomach's in knots.
You're anxious.
You've got STRESS!
Where can you get help?
Maybe the school nurse.
You arrive at her office. She greets you wearing a thunderbolt through her head. You smile, relax a little, and wonder if she really is a nurse. She asks you questions and begins her examination.
Everything is quite normal until she tests your reflexes with that little hammer and it makes a crashing sound. Taken by surprise again, you smile and realize that this person is not like the other serious adults in your life. She obviously likes to play and have fun. She asks you about your life, your problems, and your concerns. Perhaps because she's different than other adults, perhaps because she's willing to take a risk, somehow you trust her. You tell her the truth.
Who is this nurse with the unusual bedside manner? Well, she is unusual and has worked at a variety of bedsides. Her name is Robin Walter. She lives in Baltimore. She's a nurse entrepreneur who believes that humor is an essential skill for effective nursing care. Walter is the humor writer for Spectrum, a monthly nursing publication in the Baltimore and DC area. She produces workshops through her latest business venture, "Bedside Manners." These workshops help health care professionals learn practical techniques to lighten the bedside atmosphere with humor and magic.
Walter came to this special focus of nursing practice through a rather circuitous route. She began her professional career as a communications specialist with a degree in broadcast journalism. She held positions in television and photojournalism. Then, in a career shift, she moved into child care administration.
When Walter realized she needed a career with flexibility, stability, and variety, nursing naturally came up. She changed fields again, and became a nurse. Her clinical experience includes a cardiac research unit, an adolescent psych unit, and a maximum security state prison.
Walter wanted to use her professional expertise to empower patients. In 1990 she started a business called, "Health and Medical Information." Upon request from patients, she would complete a literature search and provide that patient with a packet of information about their illness and treatment questions.
But she missed direct nursing care. So she joined Baltimore Medical Systems Incorporated, a non-profit health organization that targets its services to under-served populations.
Walter then became a school nurse at an inner-city middle-school in Baltimore. This city was rated as the number one teen pregnancy location in the United States, and has reported that AIDS is the leading killer of students, rather than accidents. Walter took the job as a school nurse to satisfy her need for challenge and to finance her humor and health information business. She also decided to also use humor to lighten up the school nurse role. Humor promotes her bond with the students and improves her therapeutic potential.
Every high school student in the Baltimore educational system must, before graduating, have provided at least seventy hours of community service. To help students meet this requirement, each school creates mini-seminars to prepare students for this work. Students who will cook in a homeless shelter take a cooking seminar. Students who will help clean up a neighborhood take an environmental seminar. Because students responded so well to Walter's humor, she was asked to teach a workshop on clowning. These students would then provide entertainment at community nursing homes.
Walter decided to teach the clowning class and asked the teachers to refer the kids with behavior problems to her. She had a good reason. A literature search Walter had done on creativity turned up research by Ruth Noller in the Journal of Creative Behavior. This study reported that ninety percent of all children under five years old tested as highly creative. Then, two years later, only ten percent of these same children tested as highly creative. And after one more year, only TWO percent of the group was highly creative. This study bothered her. She agreed with the researchers' hypothesis that perhaps the children's creativity had been damaged by the regimentation of our educational system.
About two percent of her middle school students have strong behavioral problems. She thought an environment that would support and encourage creativity might help these kids. Clowning could be such a vehicle. Walter's class was so popular, she created a condition for enrollment. To remain in her class, the students had to maintain acceptable behavior in their other classrooms. She wasn't told which kids had behavioral problems. But she could see from their performances who was highly creative.
After a few weeks, she took the students into a nursing home to entertain. The residents really loved the performance. The students loved performing. Clowning was such a success that the school decided to keep the program as part of community service preparation, and also added it as an extracurricular activity provided by the drama department. Clowning was scheduled as a preschool program, to entice the kids to come to school, and maybe even stay to attend their regular classes.
The local television station filmed the original nursing home visit. This, along with the school's expansion of the program, documented the success of Walter's activities. She then was able to raise five thousand dollars in grant money from the Able Foundation, the Baltimore City School Fund for Excellence in Education, and the Journal of Nursing Jocularity to continue to fund the program.
Walter is also in the middle of writing two books. One is called Beyond Amenities: 100 Ways to Really Empower Your Patients. Many of these ways use humor. The other is Mirth, Magic, and Mending, where she shares specific patient-care techniques which nurses can use to meet patient goals and enhance nursing outcomes.
Walter realizes the power of humor and has the courage to implement her vision. She will be a presenter at the Journal of Nursing Jocularity's "Humor Skills for Health Professionals" conference scheduled for June 3 to 5, 1994 in Anaheim, California. Her session, called "Funny Money," will explain how to write a grant proposal and where to get funds for both low-cost and high-cost humor programs.
This will be an opportunity for all of us to learn from another successful nurse-humorist about using humor to enhance our nursing practice. Walter's ideas and creativity have affected the lives of many students. She is living proof that humor can be effectively integrated into traditional nursing roles. She is an inspiration for each of us.
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This article was originally published in "Jest for the Health of It", a regular feature in the Journal of Nursing Jocularity.
Feature columnist Patty Wooten, BSN, is also a past President of the American Association for Therapeutic Humor, author of two books related to humor, and a national speaker presenting on the benefits of humor.
