1. Cohen, Shelley RN, CEN, BS

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Q Recently I've noticed many of my staff coming to work with a professional appearance that's anything but professional. What are acceptable standards for how a professional nurse should appear?


It's your organization that sets the standard of how nurses dress, wear jewelry, tattoos, etc. The challenge with this standard, although often detailed in the employee handbook or in a dress code policy, isn't in the policy. It's the lack of commitment by all nurse leaders to hold all staff accountable to the details. A manager on med-surg may be actively holding staff members accountable to the dress code policy, but if the rest of their peer leaders don't follow suit, the med-surg manager will feel this lack of support. This manager's own peers put them in a position with the staff of "Why do we have to comply if no one else does?"


Historically the nurse has been appearing for duty in some form of a uniform, yet over time the details of this uniform have made a huge transformation. Staff members respond to popular trends without thought to patient/family perceptions or safety concerns. They're inundated with colorful catalogues of clothes, shoes, and clogs that supposedly look trendy and comfortable. At some point, the leader has to take a step back and wonder how the patient/family perceives all of it.


Demonstrate your leadership by meeting with staff members to:


[white diamond suit] listen to their perceptions about their image and appearance


[white diamond suit] educate them on safety issues


[white diamond suit] review the written policy/requirements regarding appearance and clarify any questions


[white diamond suit] gather suggestions/input from them regarding what they'd like to see different in the policy and ask them to validate how this improves their image as a professional


[white diamond suit] remind them what isn't offensive to one person may be to another.



After this process of clarification and reeducation with staff, should an employee continue to not comply with the requirements:


[white diamond suit] meet with him or her to determine if there's another personal issue affecting their appearance


[white diamond suit] verbalize your expectations as to what needs to change and review the repercussions should he or she elect to not comply.



We need our nurse leaders to demonstrate the effects of appearance on confidence, perceptions of professionalism, and respect. Take a good look at your own appearance and how it reflects the profession as well. Support other leaders by demonstrating your commitment to your organizational standards for appearance. Hold yourself as well as staff accountable-your patients and their families deserve a display of visual professionalism.


Q I believe national certification for nurses improves patient care. What are some ways to get this message to staff members, which will hopefully motivate them to want this achievement for themselves?


Some of the very things that motivated you toward certification are the same motivators for your staff. One of your roles as the leader is to coach staff members toward always raising the bar for the care they deliver to patients. Demonstrate this by clearly identifying what specifics led you to certification in the first place. These may include:


[white diamond suit] improving your knowledge base, which in turn reflects the quality of care you deliver


[white diamond suit] ensuring a level of competence to not only the patient but his or her family


[white diamond suit] demonstrating your personal responsibility and accountability to attain a higher level of skill and achievement in your specialty area


[white diamond suit] relaying the pride and self-satisfaction that comes with successful completion of the certification process.



Begin the motivating process for your team by first gathering facts. What do your staff members know and understand about national certifications? How many of them have achieved national certification, and what prompted them to this action? Contact the Web site of your certification agency or group for details you can share regarding benefits, not just to the staff but to the organization and patients too.


The American Board of Nursing Specialties has provided a forum to help increase awareness of how valuable the certification process is. The board's executive summary, which can be found at, reveals survey results from over 94,000 nurses. As leaders, we need to review the results of this survey to better understand the challenges staff members perceive as obstacles to their interest or actions toward certification. We know the value and impact that certification holds for each of us. Our role is to coach staff members through a process where they realize the same.