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DANVILLE, PA -- Decision-making in large institutions often starts at the highest levels and is then passed down through the levels to employees. Geisinger’s recent implementation of a dress code for nurses and other front-line employees was initiated from another source -- patients.

In an article published this year in The Online Journal of Issues in Nursing, Geisinger nurses and nursing leaders show how patients were surveyed on perceptions of professionalism based on clothing, jewelry, tattoos and piercing. The authors used evidence-based practice -- the use of evidence, clinical nursing knowledge and patient values -- to assess how patients perceive the quality of care and professionalism of the nursing staff.

“Our goal was to increase our understanding of patient perceptions regarding the professional image of nurses at Geisinger Medical Center,” said one of the authors, Crystal Muthler, RN, chief nursing officer and vice president of nursing at Geisinger Medical Center. “We continuously strive to improve the patient and family experience. When the patients and families responded, we listened.”

About 400 patients participated by filling out surveys and reviewing photos of nurses in various types of clothing to identify the look they preferred. While they generally rated nurses highly, the patients sometimes had problems identifying the registered nurse, licensed practical nurse and the nursing assistant.

The respondents said they wanted all nurses to dress the same, but were divided as to whether solid colors or patterns were best. T-shirts with pictures or sayings were not liked at all.

While it may be OK for a waitress to call someone “honey” or “sweetheart,” patients said they want to be called Mr. or Mrs. when first introduced, and then by their first name afterward.

In January, registered nurses began wearing pewter gray and white scrub uniforms embroidered with the Geisinger logo and “Registered Nurse.”

As the study was being implemented, the study team found that Geisinger Medical Center had about 70 different dress codes. Those policies have been consolidated into a single document. “Today not only nursing has made changes in dress code, but many other departments are pursuing the same,” Muthler said.

About Geisinger
Geisinger is committed to making better health easier for the more than 1 million people it serves. Founded more than 100 years ago by Abigail Geisinger, the system now includes 10 hospital campuses, a health plan with more than half a million members, a research institute and the Geisinger College of Health Sciences, which includes schools of medicine, nursing and graduate education. With more than 25,000 employees and 1,700+ employed physicians, Geisinger boosts its hometown economies in Pennsylvania by billions of dollars annually. Learn more at or connect with us on Facebook, Instagram, LinkedIn and Twitter.

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