1. Hunt, Loretta

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Why did the stand-up comic have to sit down? Because taking care of patients had worn her out.


Planted on a broken commode in a hospital utility closet at the beginning of a mandatory double shift, the weary Ivy Push tries to muddle through a stack of unfinished paperwork. And she has a little chat with her audience. In a pidgin English native to the Hawaiian Islands, she skewers callous superiors and demanding patients, complains about long hours and having too few days off. Of course, hospital food isn't spared. "It's like Halloween food," she says. "'And what are you supposed to be?'"


Ivy Push is the alter ego of Hob Osterlund, MS, RN, CHTP, who created her in 1997 and has toured the country preaching the power of levity to her overworked, underpaid, and under-appreciated peers. Osterlund has found a distinctive way for nurses to be heard.


It all started because a comedian friend had failed to act on Osterlund's suggestion that she create a funny character who could speak to and for the nursing masses. So Osterlund, a clinical nurse specialist in pain and palliative care for the Queen's Medical Center in Honolulu, Hawaii, took matters into her own hands.


"One day as I was driving to work," she recalls, "this character, Ivy Push, started coming up with lines." And Osterlund knew she was onto something when she discovered that her colleagues at the hospital were overflowing with suggestions.

FIGURE. Hob Osterlun... - Click to enlarge in new windowFIGURE. Hob Osterlund practicing laugh therapy at the bedside with patient Joseph Hanwright.

Ivy Push's debut came a few months later at a Christmas party. Word quickly spread around the islands about the strong-minded staff nurse from the (fictional) Waikiki General Hospital who dished out her own brand of "sit-down" comedy. (As Ivy Push says, "Nurses are too tired to stand up any-more unless there's blood or fire, because so much is being asked of them.") Ivy soon received invitations to appear at health care conventions across the country. Her first video, Ivy Push: Live in Honolulu, was made in 1998.


"The first Ivy Push recording was really meant to mirror nursing to nurses," says Osterlund. "I wanted nurses to see that someone understood them and their stresses, and do it so we could laugh at it and not be victims."


The taping of Osterlund's second live performance, When Ivy Push Comes to Shove, was underwritten by a grant from the Lloyd Symington Foundation, which supports cancer care. (You can find out more about Ivy Push and order copies of those shows at


Ivy's audience.

"Nurses are absolutely extraordinary audiences," says Osterlund. "They are so ready to laugh and are so generous in their response. Nurses have a common perspective, so if someone gets up to represent them in a way that's really authentic, they appreciate it."


And although one might think that patients wouldn't find a nurse making fun of their less-than-attractive behavior to be that funny, Osterlund's humor has elicited praise from the other side of the bed as well.


"One of the most gratifying things for me is when patients tell me how much they enjoyed the show," says Osterlund. "It's really about patients and nurses and doctors and the whole health care absurdity. The humor is meant to be uplifting and uniting, rather than divisive and demoralizing."


In the beginning.

Osterlund's road to nursing wasn't a straight one. After receiving a bachelor's degree in wildlife biology from the University of California at Berkeley, she moved to Oregon, ostensibly to continue her studies, but she ended up instead in the nursing program at Linn-Benton Community College. There was no adviser in her field in the graduate program she wanted to enter, but the community college had a nursing course. "I knew immediately that that was for me," she says. "My mother was a nurse. It was definitely in my blood."


Osterlund also believes it was destiny that led her to Hawaii, where six generations ago her family had arrived to serve as missionaries, only to become teachers instead. While attending the University of Hawaii, Osterlund was nearly asked to leave the nursing program because of comments she had made to a patient; she was accused of displaying "an inappropriate sense of humor."


"In those days, it wasn't okay for nurses to laugh with patients," she says. "It was considered too intimate."


Years later, Osterlund was invited to speak at her alma mater, an indicator of changing trends. "I think somewhere between the 1970s and 1980s," she says, "there was a big [move] from maintaining a cold professional distance to sharing warmth and compassion. People are now encouraged to sit and hold hands and to listen carefully."


Osterlund also believes it was an "ancestral supporting hand" that led her to the Queen's Medical Center-her great-great-grandfather had served on the board of trustees. Today, Osterlund works three 12-hour days as a clinical nurse specialist, and she moonlights as Ivy Push to spread her pearls of wisdom.


The Chuckle Channel.

Osterlund's efforts have also led to the return of the Chuckle Channel, an in-hospital TV show that brings "clean, nonviolent, family-level comedy" to hospital patients.


"I developed the concept about 20 years ago," she says. But budget cuts and the rising costs of licenses to air the programming led to the channel's demise. "Now, in-hospital TV stations just show talking heads doing 'you and your diabetes,'" she says. "Or scrolling telephone extensions." The idea, she says, was to "use a resource that was already there, so hospitals didn't have to spend even a little bit of money to create the programming."


Relaunched during Nurses Week at Queen's Medical Center, the Chuckle Channel included the two Ivy Push specials, as well as material donated by local comedians Andy Bumatai and Rap Replinger in conjunction with local TV station KGMB9. The result was four hours of comedy at the patients' fingertips.

FIGURE. Ivy Push cha... - Click to enlarge in new windowFIGURE. Ivy Push chats with her audience while sitting on a broken commode in a hospital utility closet.

Osterlund's goal is to create a template that will enable any hospital to offer the Chuckle Channel to its patients. She predicts that in the years to come, 24 hours of fresh comedy, which could include films and works in other media, will be available to patients in hospitals across the country.


Osterlund, along with her accomplice Ivy Push, sees just as much benefit in a good giggle for nurses. "We know it stimulates the immune system," she says. "We know it causes a whole circulatory and respiratory uplift, and on top of that, it just makes you feel better. The ills of society are washing up on the shores of hospitals, and nurses are dealing with it all the time. I don't know how far we can get with dealing with it unless we laugh about it."