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ID badges: What's really in a name?

Starr, Kristopher T. JD, MSN, RN, CEN, CPEN

doi: 10.1097/01.NURSE.0000453001.87277.04
Department: LEGAL MATTERS
Free

Kristopher T. Starr is an Attorney at Law, Ferry, Joseph & Pearce, P.A., Wilmington, Del.; Nurse Manager, Wilmington Emergency Department, Christiana Care Health System, Wilmington, Del.; Adjunct Nursing Faculty, Excelsior College, Albany, N.Y.; and Supplemental Nursing Faculty, University of Delaware, Newark, Del. Mr. Starr is also a member of the Nursing2014 editorial board.

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A RECURRING THEME in some healthcare institutions—and further up the food chain to include not only healthcare executives, but regulators and legislative bodies—is the fight over the practitioner ID badge. Some states, seeking the safety of uniformity or for various other reasons, have required healthcare employees in state-licensed institutions (hospitals, rehab facilities, skilled nursing facilities, and so on) to wear ID badges that include their full name and a current photo. The Commonwealth of Pennsylvania, for example, is very exacting about ID badge requirements. In fact, 28 Pa. Code Ch. 53 is strict enough to require that ID badge photos be updated every 4 years. This statute represents the more stringent side of the work world; that is, requiring the employee's full name, title, facility or agency, and photo for identification.

Other states have acted in similar fashion. North Carolina also requires the full name and title to appear on the ID badge of any employee in a healthcare facility. The exclusion in this state is that badges need not be worn in the practitioner's private office if his or her name can be readily obtained; for example, if the practitioner's license to practice is prominently displayed in the office.1

Out West, our friends in California require the full name of the healthcare provider in at least 18-point type unless the provider is in a private practice or office and the license is prominently displayed.2

A brief, and I mean brief, survey of states reviewed by legislative research in Connecticut also identified mandatory name and title badge laws or regulations in these additional states: Massachusetts, Georgia, New York, Rhode Island, Oregon, Illinois, and Minnesota.3 When we include Pennsylvania, North Carolina, and California, we arrive at the conclusion that 10 states have some mandatory name identification requirement, with the more stringent regulations applying to licensed healthcare facilities. The fact that an ID badge name requirement has become codified in one-fifth of U.S. jurisdictions suggests that some impetus pushed legislatures to enact such laws, but it's not entirely clear what the precipitating factors were. My educated guesses for such laws include patient-safety concerns, the validity of licensure, practitioner verification issues, and the need to facilitate reporting of less-than-positive experiences patients may have had with the healthcare system and/or its practitioners.

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How private are you really?

The concern raised by many a nurse focuses on the safety of the practitioner in the current electronic age, where a simple Google search of one's name can yield quite a bit of personal information, including where people live, particulars about their age, ethnicity, and marital status, and what they do for fun (hello, Facebook). You, the reader, should try looking yourself up. Or, look me up—you can easily find out where I work, what attorneys I work with, my reported cases, my parents' 50th wedding anniversary announcement, a few pics of me (quite dashing), and assorted other stuff. Fortunately, I don't see anything out there questioning my nursing skills (yet), but the search uncovers varying reports of my legal exploits. Point is, we can all be easily found, which leads to the question at issue: “Should RNs be required to wear ID badges that disclose their full name?” My answer is simply this: It's inevitable.

Several of the laws that codify the full name requirement arose, I suspect, from patients' perceived right to know who's caring for them and to have a mechanism to report perceived substandard experience or practice. I alluded to this point earlier. The reality is that the Health Insurance Portability and Accountability Act of 1996 and later amendments grant any person access to his or her personal healthcare record. An objection to having your full name on your ID badge is somewhat tempered by the fact that John Q. Public can leave your care, walk down to medical records, demand his medical record, and find your full name attached to the medical record manually or electronically.

While I understand the safety concerns of staff RNs who've been stalked, hounded, harassed, even assaulted and worse by former patients, the simple fact remains that patients who come under your care at any point can easily, if not eventually, get their hands on your full name.

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So, pick your battles

A wise colleague of mine (okay, the editor-in-chief of this very journal) once advised, “pick your hills to die on...and make certain it's for the cause you really want.” Her point is well taken on this issue. In my view, it makes little sense to fight for a singular moment of partial anonymity when the reality is, you're very easily discovered.

So, if your employer requires full name and title and photo on your ID badge as a condition of your employment or as part of your professional uniform, don't launch that courageous battle of resistance before checking state law and Board of Nursing regulations on ID badges. Even if no law is on the books, consider the inevitability of your names' full disclosure.

Until next time, keep it legal.

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REFERENCES

1. N.C.G.S. §90-640(b).
2. Ca. B.P.C. §680(a).
3. Dube N. Health care provider identification badges. Office of Legislative Research. Report No. 2010-R-0062. Hartford, Connecticut; 2010. http://www.cga.ct.gov/2010/rpt/2010-R-0062.htm.
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