Deep in the gallows, you’ll find a long line of nurses waiting to blurt out their sometimes-sticky thoughts. As an ICU nurse, I quickly discovered that the only way I could survive the literal life-or-death scenarios that come with managing serial emergencies is through humor. Laughter—though sometimes considered to be inappropriate, uncomfortable or off-color—is a necessary means for survival. As we takes hits from every direction, fighting adamantly to protect our patients from diseases and discomforts, doctors and diarrhea, we can only do so much before we’ve done all we can. There often comes a point when we must recognize that we cannot save or change or inspire every patient that we encounter. This realization, after fighting like hell while praying toward heaven, is a painful one. There is something about working in these high-stakes conditions every day that leads any of us to turn to the only defense mechanism that seems to combat it: a twisted sense of humor. The dark kind. The sort of stuff that only other nurses laugh at, and will earn you dirty looks and horrified gasps out in the real world. Yet it is not at the expense of our patients—it is for the sake of ourselves. When a team of nurses is having the kind of day where death and destruction are running rampant across the unit, don’t be surprised when somebody blurts out the occasional poop joke. We nurses are an oddball bunch. From hospitals to home care, schools to corporate offices, we push uphill through a mountain of challenges to provide care, comfort and safety to patients of every kind. We are all too often praised as being angels and heroes, guardians and gatekeepers—if that isn’t pressure, I’m not sure what is. On the flip side, all it can take is one poorly perceived experience on a particularly crappy day for us to be labeled as lazy, stupid, incompetent and unkind. Through laughter, we can overcome physical exhaustion. Through humor, we can chase away our stray tears. Through ball-busting and occasional roasting, we can add color to an otherwise darkened day. When something goes wrong for a patient, ranging from mildly inconvenient to horribly earth-shattering, it is the nurse who is yelled at, complained to, turned to, cried on and sometimes, even peed on. It is during these moments—the ones that make nursing so damn difficult but so worthwhile—that we should take a millisecond to stop and remind ourselves, amid the mess and the madness: So many could never do what we do. So few can claim to witness one life end or another begin. So little is known or understood about how we are ripped apart, cut from the inside and made to bleed on account of total strangers—because we are nurses.