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Departments: A Man's World

Keeping up appearances

Doucette, Jeff RN, MS, CEN, NEA-BC, FACHE

doi: 10.1097/01.NURSE.0000360443.90871.a5
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In Brief

I've noticed a real change in the professionalism I see in nurses…How can I help us clean up our image?

I recently had the opportunity to visit my grandmother in a rehabilitation facility that's known as “one of the best” in the state. I was dismayed when I saw the appearance of the nursing staff. A variety of multicolored and cartoon-festooned scrub tops were coupled with everything from shorts to capri-style sweat pants. While I found the staff to be competent, very attentive, and pleasant, I couldn't get past my initial impression and the seeming lack of professionalism among those caring for my grandmother. In addition, I found it difficult to tell a nurse from a nursing assistant, as few wore ID or name tags. Researchers identified “appearance, behavior, and communication [to] have a cumulative effect on the professional image.”1 Here are some suggestions in each of these areas to improve your self-image and the image of your team.


Like it or not, people judge based on initial appearance. I don't favor strict dress code policies that mandate what employees wear; rather I prefer staff members be sensible about how they choose to dress at work. The problem with this approach is, in the words of Voltaire, “Common sense is not so common.” The general rule of thumb related to appearance is to keep it simple. Uniforms should be appropriate colors and prints for your clinical setting and patient population. Tattoos, piercings, religious symbols, hair, make-up, and other accessories visible to patients should be kept to a minimum and comply with organizational policies and procedures. Most importantly, your clinical role should be prominently displayed for patients, families, and other healthcare providers to see. Having RN, LPN, or other credentials clearly visible has been linked to increased perceptions of safety and professionalism among patients.


How you choose to behave in the work setting says a lot about your character and your professionalism. Patients and their families are always watching, as are coworkers, physicians, and other providers in the unit. It never ceases to amaze me the amount of foul language, inappropriate humor, off-color remarks, and other unprofessional behaviors I witness in nearly every organization I visit. While not always pervasive, these types of behaviors leave a negative impression on those around you. Although every clinician has the need to “vent,” care should be taken to appropriately share frustrations with the right person, in the right place, and at the right time.



Open, honest, sensitive, and direct communications are the standards that each clinician should adhere to while in the unit. Professionalism is judged on how we present ourselves both physically and verbally. Patients should be called by their last name until you're given permission to do otherwise. Nothing is more demeaning to a patient than to be referred to as “honey” or “sweetie,” nor do these terms convey the appropriate level of professionalism. Also, patients should know your name and your role within the organization. The general rules of communication always apply: make eye contact, don't interrupt, seek to understand, and practice active listening. If you're not sure how you rank on communication style, ask a coworker or supervisor to provide you feedback and coaching after observing your interactions with others.

We would all like to think of ourselves as professional in our appearance, behavior, and communication, but like any other aspect of our lives, there's always room for improvement. The best way to boost the perceptions of professionalism in your unit is by role modeling these behaviors and providing proactive feedback and coaching to those around you.


1. LaSala K, Nelson J. What contributes to professionalism? MedSurg Nurs. 2005;14(1):63–67.
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