30 August 2007

What is professional?

In our group we are mulling over the thorny question of: what constitutes professional attire in the ED?

Some of our docs, mostly the "old school" really prefer a shirt and tie, some with a white coat.
Some go more for business casual -- khakis and a collared shirt, no tie.
Some are hard-core scrubs guys.

There's no "right" answer. Administrators (who generally wear suits to work) tend to prefer the formal white coat and tie look. They think that patients will be more impressed/satisfied with a formally dressed doc (research suggests otherwise). And ties can be vectors of infection. And a white coat only looks professional when it is clean and pressed -- and I am incapable of wearing a lab coat for more than five minutes before it looks so rumpled you would think I slept in it. I like scrubs -- I joke that I chose this specialty because I would get to wear my jammies to work. Patients seem understanding of the scrubs-in-the-ER thing, too.

I try to look a bit more professional by wearing dress slacks/khakis with a scrub top. Also I like the pockets.

What do you do in your ER? What do you, as patients, prefer?

16 comments:

  1. I don't so much care what everybody's wearing as long as I know who's who and that everyone's going to be professional whatever his or her job. In an ER, scrubs suggest someone who is ready to spring into action and possibly get bloody at any moment, which seems appropriate.

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  2. Our ED has a fairly even mix of dress among the faculty...Not a lot of ties, but a few of the ladies seem to like their dressy clothes. A couple of the male faculty go for the golf shirt. If clothes, then coat. If scrubs, coat optional.
    Of the residents a few sport the BDUs & scrub top look, which is nice for the pockets as well as pants that don't fall off your bum. A couple still wear coats, but most would rather be dead that have to wear real clothes to work. I'm with them.

    Once upon a time the ED was truly color coded...which was nice if you weren't there every day. Hell, it's how I met my husband. Nurses were maroon, respiratory techs were blue, doctors were green, paramedics were white on top/blue on bottom. (My husband was a paramedic then) There was none of this asking 4 different people who the nurse taking care of the patient is before you actually find a nurse who might know.

    That's my rant for the day. Thank you, and have a good night.

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  3. Yes, I too am more concerned about knowing who's who and what role they're filling - so it's more about the ID tag. I want to know if you're an R2 or a fellow or what. And ideally whether you're in, say, internal medicine or just rotating through the department for a few months etc. One doesn't necessarily want to ask because there's a reflexive defensiveness, as though inquiring about someone's status is prelude to a "I only want attendings to touch me" comment. To some extent the dress patterns reflect people's roles, but that's becoming less and less reliable, as noted in this post.

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  4. I'm in favor of large, legible ID badges with MD, RN, PA, NP, etc on them. Aside from that - attitude and knowledge impress me a lot more than clothing.

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  5. I find the khakis + scrub top look highly tacky. Either go full-on with business casual + coat or scrubs.

    I don't mind the scrubs+coat look. The coat with embroidered name looks spiffy and reminds the patients who the doctor is, but can be easily removed for bloody messes.

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  6. When I covered the ER as a surgery resident I occassionally broke out the T-shirt with the "Trust Me I'm A Doctor" slogan.

    I'm not sure if it did anything for patient confidence but I got a kick out of it.

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  7. What isles said.

    Scrubs are fine. If I'm losing pints of blood and bits of me are missing, please do spring into action!

    I think everyone would prefer a climate of getting seen to rapidly and professionally over one of getting seen to eventually but attractively.

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  8. When I come in with a roaring migraine, odds are my eyes are closed until I'm ready to leave, and I'm in too much pain to be able to coherently consider what anyone is wearing. That situation is also the only one where I don't ask to double-check whatever drugs are administered.
    If I'm coming in with an asthma attack, I'm more worried about my next breath, than what you're wearing.
    And, if I'm coming in as the accompanying husband, son, or father, I'm way more concerned about your ability to think, and your knowledge, care, and compassion, to worry about your wardrobe.
    So --- fell free to break out the flannel, if it'll make you happy...

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  9. I'm a member of the "go to work in my jammies" club unless I'm doing EMS ride-alongs (required in my residency) in which case I wear BDUs. I generally wear a lab coat to work (need the pockets) but take it off as soon as I get a chance. You can tell it's been a really busy shift if I'm halfway through and still wearing my lab coat.

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  10. I'm with the "wear what ever you want" crowd.

    You can be buck naked and ride into my room on a circus bike as long as you make me better.

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  11. In our ED, most residents wear cargo type pants with a black scrub top with the hospital's logo on it. The attendings wear business casual and coats, or dress the same as the residents.

    Nurses wear navy blue. Nurse techs wear cranberry.

    I agree that docs should dress professionally, with a coat, and upstairs in the hospital, they do--except on call nights, when they are allowed to change to scrubs and a coat. But in the ER, things can get very messy very quickly, so I agree with scrubs or casual clothes for docs in the ED.

    All of us have to wear our ID tags with our names and titles on it.

    Up on the floors, med-surg RNs wear white. Telemetry and ICU RNs wear ceil blue. L&D and surgery RNs wear green. Easy to tell who's who--except when the radiology techs wear navy, and then we think they're er nurses.

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  12. House Whisperer8/31/2007 3:12 PM

    Me: scrubs, no coat.

    Unless you are over 90. All of my patients over 90 get a white-coated doctor. They are less confused that way, and I figure they earned it.

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  13. speaking as a patient, nurses and doctors who wear scrubs look nicer. friendlier. less frightening.

    business casual attire also gives the patient an idea of who the nurse or doc is, what their style is. that's always nice.

    suits and labcoats look like walking text books, and tend to make me feel tense and ignorant.

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  14. As a patient I kind of prefer scrubs. It's the similarity to pajamas - I find it hard to get stressed when everyone around me is dressed for a slumber party.

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  15. As a patient, I really don't care, but it seems reasonable to me to wear scrubs. Some areas of medicine can be very messy and I personally wouldn't want to wear my good clothes to drain pus or other fluids. I'm pregnant and my OB/GYN wears scrubs and a white coat. Fine with me. That's what I'd wear. What bothers me is wearing scrubs outside the hospital/office. I don't think you'd want to drag what was insided the hospital out (like to the grocery store) and all the germs from the outside in.

    anasmom04

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  16. I forgot to mention...

    When we lived in CA, my daughter's pediatrician wore aloha shirts and khaki shorts. That didn't bother me either. It didn't make me feel he was less of a doctor because he was dressed casually. I felt he was an excellent physician regardless of what he wore.

    anasmom04

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