Do Tattoos Reflect Professionalism?

Your medical scrubs and lab coats aren’t the only part of your look that your patients are paying attention to. Tattoos can be a significant part of one’s appearance, which makes it hard not to wonder what effect they have on patients’ perceptions of their caretakers. This article from looks at how tattoos relate to professionalism and what some hospitals are doing about it.

If you have an opinion on this topic, leave a comment when you’re done reading.

Do Tattoos Reflect Professionalism?
By Debra Wood, RN, contributor at

Art and beauty may lie in the eyes of the beholder, but some hospitals are requiring nurses to cover all tattoos and other body art in case patients don’t find them beautiful or professional.

“They are concerned about what consumers will think, and whether they want people to care for them with visible tattoos or body piercings,” said Myrna Armstrong, RN, EdD, FAAN, professor and RN-BSN director at Texas Tech University Health Sciences Center, whose research interest is body art: tattooing, body piercing and branding.

There is no current research that clearly identifies patients’ perceptions of nurses with body art, but there appears to be generational differences. General indications suggest that older adults frown on tattoos and young people are more supportive, Armstrong said. She added that 25 percent of 18 to 30 year olds have tattoos and 32 to 50 percent have body piercings, somewhere other than an earlobe.

Nurses are currently required to cover up their tattoos at many leading hospitals, such as St. Mark’s Hospital in Salt Lake City; Florida Hospital Memorial System in Ormond Beach, Florida; Children’s Health System in Birmingham, Alabama; and Cleveland Clinic in Ohio.

“When you walk into a room as a stranger, you have to build rapport and a sense of trust,” says Nancy M. Albert, Ph.D., RN, director of nursing research and innovation at the Cleveland Clinic. “A tattoo or piercing is another sign of a cultural difference or being hip. The perception is not professional.”

Albert added that walking in with a tattoo gives the impression the nurse is not taking the position seriously. She said nurses at the clinic have not voiced opposition to the policy.

That’s not the case at the Seton Family of Hospitals in Austin, Texas, which is considering a dress code that requires nurses to cover body art. Some nurses object.

“We are moving to a policy that addresses professional appearance and demeanor,” said Yvonne VanDyke, RN, MSN, vice president for nursing education, nursing practice and research at Seton. “The core of what this is about is decreasing anxiety the patient or families might have in the patient?nurse interaction.”

VanDyke acknowledges that body art and piercings are popular, yet patients may not view it the same way as the person with the tattoo. Seton is discussing the proposed policies with staff and hopes to implement or phase in a policy starting in January 2009.

Armstrong said that many nurses have tattoos in locations that are not on display, but in some settings, such as working with adolescents or on a mental-health unit, a visible tattoo might help in establishing relationships with clients.

Nurses working in facilities that ban visible body art may wear long sleeves to cover tattoos. But if it is on the face or hands, they may need to wear a bandage. Armstrong expects nurses with visible tattoos likely would not be hired in the first place.

Although external, Armstrong said that people get body art for to feel special or unique. She said there is still a backlash?internal reasons toward women with tattoos.

“People who have them have made the decision for themselves,” Armstrong said.

In addition to requiring nurses to cover tattoos and piercings, the Seton system plans to introduce standard colored uniforms for nurses as part of the dress code, so that patients, visitors, physicians and staff can identify them more easily.
Which color is ultimately chosen might also rest on the public’s perception of which is more professional.

Albert has researched patients’ responses to different uniforms. Nurses at the Cleveland Clinic wear white and, Albert said, most are happy with it. Her research showed that patients age 45 and older thought white was more professional. Older patients, age 70 to 100 years, also believed that fitted, white uniforms reflected professionalism more than scrubs.

Seton officials have not made a decision yet about the proposed dress code.

“We want to make sure nurses’ ability to carry out their role is not compromised by a patients’ anxiety or lack of confidence in them,” VanDyke said. “This will help the nurse in many ways.” ■

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