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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 an integrated health services organization widely recognized for its innovative use of the electronic health record and the development of innovative care delivery models such as ProvenHealth Navigator® and ProvenCare®. As one of the nation’s largest health service organizations, Geisinger serves more than 3 million residents throughout 45 counties in central, south-central and northeast Pennsylvania, and also in southern New Jersey with the addition of AtlantiCare, a National Malcolm Baldrige Award recipient. The physician-led system is comprised of approximately 30,000 employees, including nearly 1,600 employed physicians, 12 hospital campuses, two research centers and a 510,000-member health plan, all of which leverage an estimated $8.9 billion positive impact on the Pennsylvania economy. Geisinger has repeatedly garnered national accolades for integration, quality and service. In addition to fulfilling its patient care mission, Geisinger has a long-standing commitment to medical education, research and community service. For more information, visit or follow the latest Geisinger news and more on Twitter and Facebook.


CONTACT: Richard Fogaley, 570-214-4887,