The primary objections to gallows and derogatory humor in hospitals are that it indicates a lack of caring, represents an abuse of power and trust, and may compromise medical care. But in my reporting, I found that nurses who use this humor care deeply about their patients and aren’t interested in abusing their power. Their humor serves to rejuvenate them and bond them to their teams, while helping to produce high-quality work. In other words, the benefits to the staff — and to the patients they heal — outweigh occasional wounded feelings.

Nursing, while noble and rewarding, can be a physically and emotionally exhausting career. Many nurses are overloaded with more patients than the safe maximum. They’re on their feet constantly, moving heavy equipment or lifting patients — in an eight-hour shift, a nurse lifts an average of 1.8 tons. Nurses routinely observe tragedies and traumas, and perform futile care on critically ill patients. Yet through it all, they must demonstrate mental composure, physical stamina and alert intelligence, even if they are berated by patients and visitors, bullied by doctors or shaken by their cases.

Doctors and other hospital personnel are also exposed to death and suffering, but nurses may be more susceptible to the lasting emotional impact.