The professionalism of nurses at an Ottawa area hospital has been called into question via the appearance of their uniforms. As a part of the new service excellence plan being implemented at The Ottawa Hospital, a new dress code policy has been introduced which prevents nursing staff from wearing any scrub uniforms which have the depiction of cartoon characters or patterns on them (Appendix). Recently, The Ottawa Hospital has been working to change its image into that of an explicitly professional institution by providing “Service Excellence” to its patients (Bourgon, 2011). This policy has been implemented in response to a belief by management that nursing staff are not easily identifiable as care providers. The nursing staff argues that excellence will not be achieved due to low morale of staff and that the patient will benefit more from friendly, happy staff than those who have been angered by management. Nurses also express a concern of increased “White Coat Syndrome” due to the sterility and starkness that somber scrubs married with lab coats would bring to their patients. The articulation of this issue has raised a question; Does a nurse’s outward appearance influence their level of professionalism?
When working with the public, first impressions serve to convey significant messages. At The Ottawa Hospital, the nurses’ professionalism is being questioned due to the first impression they present (Appendix). Management is suggesting that they appear less professional should their scrubs depict cartoon characters and/or prints. On the other hand, nursing staff are concerned that staff morale will decrease and therefore negatively impact the care being provided to the public should they be subjected to this new dress code policy. It is only fair to acknowledge that one’s perceptions should only be based on what a person knows rather than how they look. However, in reality, most people form opinions about those they encounter based mainly on appearance. The purpose of this paper is to prove that a nurse’s outward appearance has an impact on the level of professionalism perceived by patients and their families.
A nurse’s outward appearance has an impact on the level of professionalism perceived by patients and their families because nurses represent their profession through appearance, behaviour and communication. Most patients have expressed that they believe a nurse to be more competent if they were clean cut and dressed appropriately (Thomas, Ehret, Ellis, Colon-Shoop, Linton, & Metz, 2010).
A nurse’s outward appearance has an impact on the level of professionalism perceived by patients and their families because the nurse’s professional uniform is a key identifier for these individuals during treatment (Cite). The nurse’s uniform helps patients and family members differentiate nursing staff from physicians, healthcare technicians and support staff. According to Bednarski and Rosenberg (2008), patients and families say it is important to know who to approach when they had concerns and to be able to identify nurses and differentiate them from other health care staff. For this reason, nurses, along with other healthcare professionals, should be subject to wearing coordinated colours in order to allow patients to have a more satisfactory experience and to be able to communicate easier with the designated staff member they choose.
A nurse’s outward appearance has an impact on the level of professionalism perceived by patients and their families because patients often associate appearance with trustworthiness and ability. If nurses dress too casually, patients may question their professionalism and attention to detail. The first impression should be positive, communicating a message to others about the self. Initially, it communicates how the nurse feels and respects the self. Projecting a positive image communicates that the nurse cares about herself or himself; therefore, the impression is that he or she will “take good care of me.” While the primary concern of the nurse may not be about projecting a positive image, first impressions are an important foundation in building a trusting relationship in a society that values physical appearance (Cite).
How nurses dress has a bigger impact than most realize. The way a nurse dresses either adds to or detracts from their professional image and therefore has a definite impact on how those they serve see them. The reasons for this impact are that patients beliefs regarding competence are base on first impressions, comfort in asking questions and identifying nursing staff are limited due to the current dress codes in most hospitals and a poor appearance can hinder how successful the therapeutic relationship between the nurse and client proves to be. It is possible that the dress code requirements of the past for nurses acknowledged this issues and determined what was need to improve quality of care. It has been said that our profession is a cyclical one; perhaps the time has come to return to a uniform for nursing staff which is immediately recognized by all.
Bednarski, D., & Rosenberg, P. (2008). Nurses’ uniforms and perceptions of nurse
professionalism. Nephrology Nursing Journal, (35)2, 169.
Bourgon, L. (2011, February 6). Goodbye, Snoopy: New dress code infuriates nurses at The
Ottawa Hospital. Ottawa Citizen. Retrieved from http://www2.canada.com/ottawacitizen/ story.html?id=2d77f14c-04e3-49e2-90a6-b8bc7beea215.
College of Nurses of Ontario [CNO]. (2009). Professional Standards, Revised 2002. Retrieved
College of Nurses of Ontario [CNO]. (2009). Therapeutic Nurse-Client Relationship, Revised
2006. Retrieved from http://www.cno.org/Global/docs/prac/41033_Therapeutic.pdf
McIntyre, M., & McDonald, C. (2010). Nursing Issues: A Call to Political Action. In McIntyre,
M., & McDonald, C. (3rd Ed.), Realities of Canadian nursing: Professional, practice and power issues. (p. 3-16). Philadelphia: Lippincott Williams & Wilkins.
McIntyre, M., & McDonald, C. (2010). Issues in Contemporary Nursing Leadership. In
McIntyre, M., & McDonald, C. (3rd Ed.), Realities of Canadian nursing: Professional, practice and power issues. (p. 56-67). Philadelphia: Lippincott Williams & Wilkins.
Registered Nurses; Association of Ontario [RNAO], (2006). Establishing Therapeutic
Relationships. Retrieved from http://www.rnao.org/Storage/15/936_BPG_TR_Rev06.pdf.
Spragley, F., & Francis, K. (2006). Nurses’ uniforms: Professional symbol or outdated relic?.
Nursing Management, (37)10, 55 – 58.
Thomas, C.M., Ehret, A., Ellis, B., Colon-Shoop, S, Linton, J., & Metz, S. (2010). Perception of
nurse caring, skills and knowledge based on appearance. Journal of Nursing
Administration, 40(11), 489 – 497.
Wocial, L., Albert, N.M., Fettes, S., Birch, S., Howey, K., Jie, N., & Trochelman, K. (2010).
Impact of pediatric nurses’ uniforms on perceptions of nurse professionalism. Pediatric Nursing, (36)6, 320 – 326.