There is a way to dress properly for home health
Where to draw the hemline
Today it seems that anything goes when it comes to clothing styles, hair color, and jewelry. No longer must hair colors be found in nature, and earrings have ventured into what was once forbidden territory. All these changes can leave a home care agency manager or supervisor at a loss when it comes to setting appropriate limits on what staff wear while also allowing personal freedom and choice.
When it comes to body piercing in places other than earlobes, one Department of Veterans Affairs-based home care agency has a simple policy: "If it’s pierced, keep it covered." Still, there is some dispute over whether a tongue piercing is considered covered; it is covered, until someone opens his or her mouth. The general rule of thumb in these cases is that any piercing shouldn’t be visible to the patient, says Linda Westerman, RN, MN, education director for Home Health Management Inc. in Florence, SC.
Kathy Kieke, RN, MSN, care center director for St. Cloud (MN) Hospital Home Care and Hospice, says her agency sticks to the policy that "a minimal amount of jewelry [no more than two fingers on each hand with rings; two earrings per ear] worn while performing duties is OK. Visible pierced jewelry, except for earrings, aren’t allowed, and excessive tattoos must not be visible while on duty." (For a detailed description of St. Cloud’s policy, see "Dress for home care success," in this issue.)
Don’t take a Band-Aid approach
Kieke notes that some aides have tried covering their eyebrow jewelry with a Band-Aid, "but that is not acceptable, and they must remove the jewelry while working." So far, this hasn’t been too much of a problem, she says, noting that "I did have a discussion with an employee who had four earrings in her ear, so it is helpful to have a hospitalwide policy to fall back on. Now, she removes two of the earrings while she is working."
Jewelry, of course, isn’t the only issue covered by a dress code, and in either case, dress codes must be specific. What about capri pants, clamdiggers, or pedal pushers? In order to be fair to everyone, clearly specified rules must be set out and adhered to. For hospital-based home care agencies, what may be considered acceptable in a home care environment might not be considered appropriate for the hospital floor. This can often prove problematic, as Kieke notes. "I have many staff who wear appropriate sweatshirts in the winter, and I had to work with the hospital to include that as OK," she says. "Originally, they had excluded sweatshirts as appropriate attire."
In summer, especially, when some staff may be tempted to wear as little as possible, dress code problems can pop up. Westerman notes, that in the past, her agency has had trouble with beach attire — short-shorts, midriffs, sandals — being worn by clinicians making home visits. More recently, Westerman says her agency had a complaint from a patient about a physical therapist wearing short-shorts. It begs the question: When it comes to shorts, what is considered too short? Should skorts — half shorts, half skirt — be considered skirts or shorts?
Home Health Management dealt with this issue by setting out the exact length of shorts that are considered acceptable. In her agency’s dress code policy, she notes, "we added that shorts could be worn but no higher than two inches above the knee and, if worn, must be worn with hosiery." The hosiery clause, especially in a place such as South Carolina where spring and fall can be extremely warm and summers unbearable at times, was added as a compromise as a patient had complained about bare, unshaven legs. "The same logic was applied to their regulations banning sleeveless tops," Westerman says.
Sandals, too, have proven to be a touchy subject. St. Cloud forbids home health staff to wear sandals, and originally Home Health Management did as well. Explains Westerman, "Someone thought it was an [Occupational Safety and Health Administration] reg to not wear open-toed shoes, but that’s not so in our line of work, so that will be removed."
Westerman says her agency’s dress code policy was six months in the making and notes, "I can’t begin to tally up how many hours my agency has spent on this dress code thing." She is now pushing for her agency’s dress code to say only "clean and professional attire" will be worn during working hours and while seeing patients. It’s my opinion that if your clothes are clean, in good repair, and fit you and your job function, it should be OK."
It’s bound to happen no matter how stringent your agency’s dress code policy. One day, one patient will complain about [an employee’s] manner of dress. In those cases, what do you do? Tell the caregiver to change his or her style or change the caregiver’s assignment.
Westerman notes that in today’s world the politically correct thing to do is that "if it offends a patient to be cared for by someone with a nose ring, change the caregiver. The same goes if the patient doesn’t like someone with purple hair. "Patient complaints are handled just like any others. If they don’t want a male nurse or a nurse with a nose ring, we change caregivers, but the patients are made aware that the offending’ clinician may need to visit on call or after hours if they require a visit," she says. "And the clinicians are always made aware of the nature of the patients’ concerns. After a while, if you want to work, you may need to remove the ring."
[For more information, contact:
• Kathy Kieke, RN, MSN, Care Center Director, St. Cloud Hospital Home Care and Hospice, 48 29th Ave. N., Suite 15, St. Cloud, MN 56303. Telephone: (320) 240-3265.
• Linda Westerman, RN, MN, Education Director, Home Health Management Inc., 1945 W. Palmetto St., Florence, SC 29502-5599. Telephone: (800) 708-7060, ext. 3050.]
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