Contemporary policy drivers aim to increase public confidence in the NHS and nursing by enhancing the patient experience through the delivery of compassionate care (Department of Health (DH), 2013; Willis, 2015).
By establishing a link between an unprofessional attitude and poor care delivery the first Francis report (2010) set out recommendations to ensure potential candidates are screened for values such as compassion, integrity and commitment. In April 2015, values-based recruitment (VBR) commenced in the UK, meaning potential students were to be selected on their ability to demonstrate the relevant values required by their prospective role (DH, 2013). The basis of VBR is to select students on their individual values and behaviours, aligned to the NHS Constitution, in addition to considering academic ability and skills (Miller and Bird, 2014; Power and Clews, 2015). Waugh et al (2014) attempted to establish a values-based person specification of prerequisite attributes for student nurses and midwives, which included cheerfulness incorporating a good sense of humour.
Once recruited, nursing students require role models. The Nursing and Midwifery Council's Code (2018) expressly states that all registrants must act as professional role models for future generations by sharing their knowledge, developing students' psychomotor skills and embracing professional values such as warmth, sensitivity, empathy and compassion. Having role models enables nursing students to know what is expected of them, which empowers them to achieve, develop and maintain their professional identity inclusive of attitude and behaviours.
Humour has been linked to many of these professional values, for example, empathy (Scheel, 2017). As a phenomenon, humour has interested philosophers through the ages and been researched in many disciplines.
A recent study I undertook found that pre-registration students experienced tension within themselves and with their role models regarding individual use of humour. The study indicated that knowing when to use their humour is within their values set. Yet the students found themselves in conflict with some of the registered nurses (RN) over when to use humour. This dissonance between the students' judgement of when to use it (planned or opportunistic) within a given situation and their role models' judgement (if contrary) effectively triggered a professional ‘tug-of-war’. This resulted in some students feeling they must abandon parts of themselves, namely their humour, which created a professional and emotional tension for participants.
Part of the conflict seen in the study was the participants' exposure to differing viewpoints about what professionalism is and whether or not professionalism and humour use are mutually exclusive. This is based on personal and professional expectations of humour and those of individual mentors/role models. If the RNs themselves have differing definitions of professionalism, then it would be difficult and confusing for the student to achieve a professional identity based on the group's norms.
The question then needs to be asked: are we professionalising humour out of our students due to differing definitions of humour use?