Professional Respect, Public Professionalism

"Quite frankly, when I was [not] knowing whether I was going to live or die, the last thing I needed to have shoved in my face was a skull. That was offensive."
"If I saw a gang of bikers that had full-on tattoos and were mean-looking and were noisy and had club symbols on their jackets, I'd be afraid of them."
"I don't want that feeling in emergency."
Marie Molloy, Lake Country, British Columbia

Jeff Bassett for National Post   Marie Molloy at her home in Carrs Landing, Lake Country, B.C. on April 4

"The right of patients is to have quality and safe care. A tattoo has no influence on quality and safe care."
"You can dig deep on this one and it gets into very dangerous territory. What about a seven-foot male nurse looking after a newborn? ... Or what if you look 'too young?'"
Linda Silas, president, Canadian Federation of Nurses' Unions

"Currently, you can't look anywhere without seeing a tattoo. You try and encourage students to be as professional as possible, but if society's norms accept tattoos as being normal ... that is not policeable."
Beverley O'Connell, dean, University of Manitoba nursing college

Standards of professionalism may not have eased, but visual representations of professional standards most certainly have. Entering any hospital in Canada now it's difficult to tell from appearances who the nursing and other professionals are. The once-distinguished nurses' and other hospital employees' apparel of neat white garments enabled instant identification. And with it the respect that naturally follows that identification. And with the respect for the profession that cares, came the comfort of trust.

Now, nurses are more likely to be wearing short, colourful, patterned smocks and jeans, or just any casual clothing, not necessarily all that neat and tidy. They are no doubt proficient, know their duties and perform them well, but not accoutered as one might expect them to be. And something is lost in the process. The nurses may redeem themselves by the application of their professional skills, but they no longer have the appearance that gives reassurance of those skills taken on trust.

Vulnerable people dependent on the professionalism and good will of those looking after their medical and health needs at a critical time in their lives are hardly in a position to complain. When complaints are lodged they bear an aura of disgruntlement and unpleasantness and in response to that impression there are natural fears that the individual performing his/her professional expertise will exert somewhat less effort, in response to criticism.

Mrs. Molloy was certainly in a vulnerable position when she was admitted to her local hospital's emergency department and treatment began to keep her alive. She suffers from rheumatoid arthritis positioned in her larynx and coincidentally has an abnormally small airway. Her condition was exacerbated in the aftermath of unrelated surgery and she struggled to breathe, ending up in the emergency department of the Vernon Jubilee Hospital.

The treatment given her remains a blur to the woman. When she awoke after a seven-hour bout of unconsciousness the first thing she saw was an emergency worker beside her, his arm at eye-level, inked with a skull, and it frightened her enormously, seeming to portend a sinister outcome for her to survive the health emergency she was going through. Afterward, after her recovery, she lodged an official complaint but hospital administrators were not impressed.

Some nursing schools in Canada insist that students cover up their tattoos, and although most health facilities in Canada have no official policy restricting body art, studies suggest that patients perceive their display in a negative light. At the Ottawa Hospital, administrators attempted to have staff cover their tattoos. But in 2013 a labour arbitrator ruled that to be an infringement on employees' rights. Toronto's University Health Network representing four of Canada's largest hospitals has no policy on tattoos.

Empirical research on the issue appears to support the reality that the public, exposed to people wearing tattoos in hospitals as health professionals, fail to impress patients with their lack of the appearance of professionalism. It could most certainly be construed as a lack of respect of patients for health professionals to have no proper dress code, let alone restraint in the presentation of tattoos in a situation, and a venue that calls for a professional appearance, if only as a visual assurance.

In 2012, a study in Maryland found that patients exposed to pictures of health workers reacted less than favourably to tattooed and pierced employees. A survey of 765 patients in Italy certainly seemed to suggest that all of those questioned considered it to be inappropriate for doctors to have long hair, visible tattoos or body piercing. It does serve to leave an impression that is not professional, and with that impression comes a diminution of trust in a professional's abilities.

At the University of Manitoba the nursing college established a policy meant to discourage students from giving an appearance of non-professionalism. Students were given instructions that tattoos were to be covered while on clinical rotations at health-care facilities. That rule was initiated by the students' association itself. Perhaps the issue is that people are too casual about the need to themselves observe respect for their profession, and by extension, respect for the perceptions of people requiring professional health services.