Professionalism in Nursing? Yes, Please!

Nursing has long been seen by laypeople as a caring and trusting profession, but how does our community define our profession? It seems that there is a lot of variance in thoughts of what actually defines a professional nurse; some nurses envision a white cap and crisp white dress (think: Florence Nightingale) whereas others think of a nurse who has it all together leading the nurses and bossing MDs around (think: Carla from the TV show Scrubs)depicts the epitome of a professional nurse.

Professionalism in Nursing? Yes, Please!

Nurses are seen by the general public as healers, that are thoughtful, kind, and will go above and beyond to help someone, which we are. All of us in our crisp white caps, and sparkly white nurses' uniforms can't possibly be anything other than super spot on nice, friendly, helpful, and never show an ounce of stress, right? (sarcasm intended). Nurses have a whole multitude of responsibilities that the general public can't even comprehend; organizing a PT visit, between their off unit X-ray, their Nutrition consult, and Social Work consult is near impossible, but because they need to see all of those folks to get discharged tomorrow, we will run ourselves ragged getting it done, in between taking care of all of the needs for our other patients. I can't imagine anything more professional than making sure that every aspect of patient care is completed on every shift, and doing so with a positive outlook, and helping out your colleagues.

I recall when I was younger, and had earrings all up and down both ears (nothing outrageous, but it was a bit of extra jewelry for sure), and the door side patient in a double room, who was getting ready to go home, was super needy and rather condescending to me. He was asking me to put on and take off his socks, scratch his feet, read his newspaper to him (all which he was completely capable of doing himself) and I helped out, against my better judgement, as I had a million other things to do for other patients. As I was doing the difficult task of scratching his feet, as only an RN (apparently) can do, I heard the patient in the next bed make a strange noise, so I ran over, and pulled the bedside emergency alarm as I checked for a pulse, when I saw that his eyes were rolled back in his head. Two of my colleagues ran in, as I was doing compressions and we worked together until the code team came, we got a pulse on the patient shortly after he was intubated, and we rushed him to the unit. While I was helping to clean up the aftermath of the code, that other patient seemed to have a new respect for me, and he told me that he thought I was too young and had too many earrings to be a good nurse, but I obviously knew my stuff. After I swallowed my eyeroll, politely said thank you, and got him ready for discharge, I remember thinking to myself that no other patients had ever treated me that way. Do I really look that unprofessional? All of my colleagues respect me, I have been advanced on our clinical ladder, and I am constantly striving to do the best for my patients, isn't that enough to be professional?

Within the nursing community we have the ability to assess ourselves and our own behavior, and decide what should be considered appropriate and professional versus what we should not tolerate in our community. There is a huge variance in what we all think of when we think of 'professionalism in nursing' and that impacts our community as a whole. After some conversations with colleagues from various institutions, it has opened my eyes that professionalism is something we all strive for, however, it is judged differently, so how can we attain it?

Some of the common themes related to professionalism, or that were more an expectation of professionalism were:

  • Dependable: Nurse who comes to work every day on time, and don't use all of their sick time just because they have it. You're scheduled? Unless really sick, they will be there working as scheduled.
  • Attitude: Someone who comes in ready to start the day with a smile and a positive attitude, doesn't complain about the assignment, exudes confidence, and doesn't put anyone down.
  • Team player: Helps others out when they can, including other nurses on the unit, and the staff as a whole (i.e. helping to cover shifts, if needed).

All of those attributes do come to mind when thinking of professionalism, and they are what I look for in my colleagues so that I know on any given day, we are all working together, as hard as we can, putting a positive image of our hospital into each interaction with our patients and families. Knowing that I can depend on my colleagues, and no matter how tough it gets, we will be positive and help each other out in the best interest of the patients, and ourselves, and we will not put each other down because of "rank" or "status" on the unit.

One other point that was brought up, where I am more hesitant to fully support as part of the defining factor of a professional nurse is appearance. Yes, you should wear the uniform for your place of business, whether that's scrubs or business attire, and you should appear clean, and a smile definitely goes a long way! All of that is important to be viewed as a professional. I don't think that we should judge each other for having tattoos, various hairstyles (or lack thereof), or any other forms of self-expression. Why? Well, one big thing that no one seemed to bring up was clinical excellence. Maybe it is just assumed that as nurses we are all competent at our jobs and try to push ourselves to continuously learn, but I don't see that with every nurse, every day. There are some nurses that truly strive for clinical excellence, and will not settle for merely being competent, and I think that is vastly underrated as part of being a professional. I would prefer to see a nurse with pink hair and tattoos that comes into my room confident, with a smile and light conversation, and knows the most recent evidence-based practice to placing an IV to prevent a phlebitis on me, as opposed to someone who may meet the social norms a bit more but cause a raging phlebitis because they lacked fully cleaning my skin.

I am clearly biased as a nurse, but I have also been a patient, and I have seen some amazing nurses, and some nurses that really need to learn more about professionalism, but how can we role model professionalism when we all have different ideas of what it means and entails? Is there anything that you think should also be a part of the definition of professionalism in nursing, or that should be removed?

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Bridgid Joseph

About Bridgid Joseph, BSN, MSN, APRN, CNS

Clinical Nurse Specialist, Emergency Cardiovascular; from US Specialty: Surgery,Critical Care,Transplant,Neuro

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I agree that the knowledge or clinical excellence of the nurse is of utmost importance. Any profession has expected "norms" of professional appearance. Nursing isn't any different. It is important that we meet these standards of professionalism in regards to our appearance. In my career these norms are not difficult...cleanliness, hair pulled back or up, solid shoes, and sometimes certain colors. I live in the southern United States. No mention is made of tattoos, earrings, or hairstyles. I work with people who have pink hair, tatts, etc. You can be an individual and still have a professional appearance.

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The only thing that bugs me about appearance is long hair. I used to have hair down past my shoulders - and I wore it up, every shift, every day, when I was a civilian. If there's a 'dress and appearance code' at a facility, I think the one essential thing it should have is that long hair should be up.

I don't care if your hair is six shades of green and you have sleeve tattoos. I just don't want your hair hanging near me. :) It's like docs who don't tuck their neckties. Eeeew. :blink:

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Specializes in Surgery,Critical Care,Transplant,Neuro.

I've seen hair (from RNs and MDs) touching patients and grazing open wounds and it totally skeeves me out: YOU don't want MRSA hair and THEY don't need anything else crawling around in that festering wound!! :)

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Specializes in Surgery,Critical Care,Transplant,Neuro.
You can be an individual and still have a professional appearance.

I love this!!!!

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The way people groom, dress and conduct themselves is very, very important. Whether it's right or not people will make all kinds of assumptions about a nurse and her practice just based on the way she presents herself.

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I'm going to go way out on a limb here and further DeeAngel's assertion. It fine and well to say, "don't judge a book by it's cover" in regard to professional appearances-sounds good, right? However, people have always done, and will continue to do, just that! It's analagous to making assumptions of someone's overall intelligence or level of education based upon how they communicate in either spoken or written contexts. I also ask, does this lowered bar apply equally to other professions? What would you think of retaining a personal trial attorney with dreadlocks, full sleeve tattoos, gauged earlobes, and multiple facial piercings? I maintain that appearances do matter and far more than people are willing to acknowledge. This most definitely reflects upon professionalism and the instillation of confidence to our patients. To suggest otherwise is perhaps, more politically correct, but certainly disingenuous.

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I'm going to go way out on a limb here and further DeeAngel's assertion. It fine and well to say, "don't judge a book by it's cover" in regard to professional appearances-sounds good, right? However, people have always done, and will continue to do, just that! It's analagous to making assumptions of someone's overall intelligence or level of education based upon how they communicate in either spoken or written contexts. I also ask, does this lowered bar apply equally to other professions? What would you think of retaining a personal trial attorney with dreadlocks, full sleeve tattoos, gauged earlobes, and multiple facial piercings? I maintain that appearances do matter and far more than people are willing to acknowledge. This most definitely reflects upon professionalism and the instillation of confidence to our patients. To suggest otherwise is perhaps, more politically correct, but certainly disingenuous.

Funny, dreadlocks might even impress me if focused intelligence is the first thing that came out of his mouth.

On the flip side, a conventional haircut on someone who appears distracted begins a sentence with umm while rifling through their files is going to lower my confidence.

We have a few seconds to make an impression, both of our knowledge and our focus. The moment you make, or don't make, eye contact and begin to speak is going to set the perception that will stick, positively or negatively. A conventional appearance can increase tolerance of an otherwise imperfect 1st impression so it isn't a bad idea for someone starting out and still working on their routine.

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Appearance says alot about you,here tattoos & coloured hair is associated with karaoke dancers and musicians. Very short and tight uniforms will earn you disrespect from patients,you might even be summoned to the nurses' council.

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I think local culture should be accounted for as well. I live and work in a liberal west coast town, where tattoos and piercings are pretty much de rigueur. I work in an exclusive facility with a very affluent clientele (read "Old School"), and I have had only one single complaint regarding my tattoos, and it was barely a complaint. We ended up having an intelligent discussion about culture and counterculture, the history and significance of tattooing, and the evolution of social norms. Other than the usual questions from the curious, I've heard nothing. I may be judged by my appearance at first glance, but it doesn't matter, as my actions and words say more about me than my body art does. I'd pick tattooed competence over a clean-cut doofus anytime, and apparently so do my patients.

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Specializes in CCU, SICU, CVSICU, Precepting & Teaching.

Professionalism does indeed encompass how we look. I've seen some mighty fine clinicians who did not inspire confidence in their patients due to their appearance. One nephrologist I worked with was very astute, but her habit of wearing nightclub chic to work was off putting to her elderly patients and to many of the nurses she encountered. We judged her by her appearance as being unprofessional and possibly not up to date or interested in her work. My very first encounter with a certain endocrinologist was when he was creeping around our unit in very, very, (indecently) short shorts that exposed more of his anatomy than I needed to see and a tank top. As he was creeping from room to room, peering through doors at patients, I confronted him telling him that he peeking into patient rooms is not allowed. "Oh," he said. "I'm looking for a patient." It wasn't until I was preparing to call security to remove him that he introduced himself. I didn't believe him -- I had our medical director verify his identity. We don't expect to encounter scantily dressed physicians of either gender in the workplace.

Tattoos and piercings can be discreet or they can be blatant, they can be tasteful or they can be tasteless. The male nurse whose shaved head revealed a tattoo of a Nazi symbol on his scalp was being offensive, but perhaps the full sleeve of flowers and birds is not. Personally, I find gum chewing in the workplace to be unprofessional. There is an NP with whom I used to work who had a habit of blowing bubbles and popping them during rounds. Twice, she got her gum in a colleague's hair. Now that is unprofessional.

Courteousness is professional; rudeness is not. The coworker who answers the unit phone with "Yo. What'd ya want?" Is not being professional, nor is the one who answers merely "Hello." "It's not my job" and "He's not my patient" aren't very professional responses to any question. Surely "I'll find housekeeping to wipe up that spill for you," or "Suzy is your husband's nurse. She's with her other patient right now, but I'll be sure she knows you're looking for her. Is there anything I can help you with in the mean time?"

Clinical competence is indeed professional, but even the most clinically competent nurse will not be regarded as professional if they fail to dress, groom and conduct themselves as professionals.

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Specializes in M/S, Pulmonary, Travel, Homecare, Psych..

Hmph, this is a peeve of mine. I don't talk about it much because my thoughts on it are never popular lol

I agree, there is a dress code and it needs to be adhered to. That should go without saying. I'll even "one up" that and say, there are both written and unwritten rules of attire and they all need to be respected. Dress code policies can't cover every variable, and they shouldn't have to. You're smart enough to pass boards, you're bright enough to know what attire will upset the curve.

But I don't think this has much to do with "professionalism". It's a question of maturity when we talk about this sort of thing. I guess you could say a professional has to be mature but that's splitting hairs.

Why do I feel this way? Simple: Too many get so caught up in the ascetic version of professionalism and never get onto the clinical/performance side of being a professional.

Everyone has seen them, they're young, older, male, female................

Those people who have perfect hair, crisp new shoes at all times, uniform ironed well enough to pass a military inspection and they use all the right etiquette in conversation. But that's where they think being a professional nurse ends. In their minds, their job is done, no room for growth (unless a new haircut is needed, or a prettier stethoscope is available for purchase).

They can't function at all clinically though. Meds never done properly and they're always behind, patients call bells going off on their assignment all the time and everyone else has to cover for them, orders not taken off the chart or followed through with...............

You'd call them a professional nurse? Not me.

I don't consider our appearance to be a big part of us being a professional. THAT SHOULD BE A GIVEN! You have not "arrived" just because you wear the scrubs.

I call it politeness, or maybe just maturity.

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