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Send In The Clowns! Part I
From Journal of Nursing Jocularity, Winter 1992, 2(4), pp 46-47.
I got to go to Clown Camp!
Held in LaCrosse, Wisconsin, it was inspiring, informative, EXHAUSTING, and delightful. Anyone may attend, young or old, novice or professional.1 Two hundred clowns from all over gathered for this week-long infusion of study and practice. Each day we had activities from 8a.m. to 10p.m., and we had to choose from over 20 daily classes on various aspects of clowning. I wish I could have taken them all!
Some of the most exciting parts were those focused on the development and education of Caring Clowns - clowns who visit hospitals or nursing homes and practice therapeutic clowning.
Clowns have existed since the beginning of time. They have had different names in different societies, but all have served similar functions. Clowns have been recognized as having an important influence on the health of the community as well as on individuals. In some cultures, such as Hopi & Zuni, they have even participated directly in healing rituals-but that's another article.
As early as the middle ages, the philosopher Syddenham noted:
"The arrival of a good clown does more for the health of the village than twenty asses laden with drugs."
More recently, Norman Cousins upheld this evaluation by acknowledging the importance of faith, hope, confidence, laughter, joy, and festivity to offset the impact of negative emotions and to mobilize the 'will to live'.
Most of us are familiar with the circus or parade clowns and remember them as bold, bumbling, and noisy. In contrast, the caring clown working in a hospital or nursing home is gentle, soft, and empathetic. A good caring clown should be sensitive, be able to read non-verbal body language, and possess good listening skills.
Bedside clowning attempts to distract patients from their problems, help them forget their pain, and offer them an opportunity to watch or participate in some silliness. The goal is to afford the patient momentary release from personal burdens, to inspire joy, and to stimulate the will to live.
The court jester who served Queen Elizabeth I was described as:
" . . .a master of his faculty . . . He told the Queen . . . more of her faults than most of her chaplains and cured her melancholy better than all her physicians."2
Sharing in the belief that humor has healing capabilities, we find the caring clowns - a group of present-day jesters who use their clowning to help people in our modern courts of medicine.
Richard Snowberg and Janet Tucker are instructors for the "Caring Clown" program at Clown Camp and are active in their local hospitals and communities. (Richard has recently published a book on the subject3 and is also director of Clown Camp) These two people have inspired me and guided me in developing better skills and a more polished clown bedside manner.
Should you decide to try therapeutic clowning, remember these tips:
- You must look sharp and clean, even if you are a hobo clown.
- Your costume should communicate fun and fantasy. It should not be threatening in any way.
- Because the audience is small (1-3 people), you may individualize your performance according to who is present.
- Therapeutic clowning asks nothing of the audience, so plan your routines to not depend on the patient's verbal or physical response- perform so that they may simply observe you and be entertained. (While the stage clown measures success by audience laughter or applause, the caring clown's reward is a smile, a tender "thank you", or even tears.)
In establishing a new relationship with a hospital or nursing home, you should first go to the facility in street clothes and meet with the appropriate staff (Child Development Specialist or Nursing Supervisor) to obtain permission and establish guidelines. Hospitals may have no guidelines regarding entertainers visiting patients, so it is helpful to prepare your own guidelines to offer when you first meet. This will help to convince them of your professionalism and your serious intent to work within the system rather than invade and perhaps upset it. Ask them if there is anything you may have overlooked and would they care to add to your guidelines. Some hospitals may require a more extensive approval system before allowing clown visits.
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Your guideline list might include: All visits will be approved and scheduled prior to arrival. Clown visits will occur between 9a.m. and 8p.m. and will avoid meal times. Clowns will check in at nursing station, obtain approval or suggestions for patient visits, and request staff to accompany clown to the patient's room on the first visit. Clowns will ask (from the doorway) for patient's permission before entering his or her room. Clowns will not move patient or manipulate hospital equipment -- staff will be called if necessary. Clowns will not wear gloves; and will wash hands prior to exiting room. All gifts will be approved by nursing staff before being given. Visits will be limited to 10 minutes, unless nurse permits longer visits. After visits are complete, clowns will check at nursing station to obtain other requests or notify staff of leaving the facility.
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Your proposal of these guidelines (and adherence to them) will show your respect for the seriousness of the medical setting and help you gain the trust of the hospital community.
Clowning visitation programs exist in hundreds of hospitals throughout the United States. Perhaps the most well-known (via an article in LIFE Magazine, August 1990) is The Big Apple Circus Clown Care Unit in New York City.4 Under the guidance of founder/director Michael Christensen, this group continues to grow and presently provides 30 clowns who regularly visit eight area hospitals. Since its inception in 1986, the Big Apple Care Unit has been a model for many others around the country.
Other caring clown programs include:
- St. James Hospital Clown Connection (Chicago Hgts. IL),
- Clowns on Call (LaCrosse WI),
- St Lukes Hospital Clown Connection (Cedar Springs IA), and
- in the Ottumwa Regional Health Center (IA).
There are certainly more clown visiting programs than I have mentioned. (If you know of one, please tell me about it so I can add it to my growing list.)
In this issue we noted some of the history of caring clowns and some hospital guidelines. Next month, we'll interview several active caring clowns to get their personal perspectives and advice and offer some practical activities and interactions for bedside use.
As that medieval professor of surgery, Henri de Mondeville, wrote in the 1200's:
"Let the surgeon take care to regulate the whole regimen of the patient's life for joy and happiness . . . allowing his relatives and special friends [& Caring Clowns!] to cheer him."5
Patty Wooten, RN, CCRN, will be a keynote speaker at JNJ's Humor Skills for the Health Professional conference May 14-16, 1993 in St. Louis, Missouri. The conference will also feature Patty's Nancy Nurse performance, and a workshop on "Clowning in the Hospital" featuring world famous Ringling Brothers and Barnum and Bailey clown Kenny Ahern.
References
- Clown Camp; c/o University of Wisconsin at LaCrosse,
1725 State St., LaCrosse WI 54601. - Doran, D. (1858).
The History of Court Fools. London, England: Richard Bently, p.229. - Snowberg, Richard. (1992).
The Caring Clowns. LaCrosse WI: Visual Magic. - The Big Apple Circus Clown Care Unit;
35 W.35th St., 9th floor; New York, NY 10001. - Walsh, James J. (1928).
Laughter & Health. New York NY: Appleton & Co. pp.147-148.
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.
