Have you ever looked at yourself in the mirror with so much embarrassment you didn’t know whether to laugh or cry? As I stood in the staff bathroom of the medical ICU staring at my tacky, sweat-stained Christmas sweater, I couldn’t decide either. Instead, I did both. The last hour of my life had been one of the most mortifying of my professional career.
It all began earlier that morning. The day was a major one: December 25, Christmas! I had worked Christmas the previous year and had my attire all planned out and ready to spread some cheer. I plucked my bright red holiday sweater and Santa hat from the back of my closet to wear to work. I then packed my mom’s famous pumpkin pie and headed to the hospital. At my job, holiday shifts are always filled with joy and, most importantly, a potluck.
Unfortunately, critical illness doesn’t have the same calendar we do and trouble can still arise at a moment's notice. Shortly after the aforementioned potluck ended, I found myself in the middle of a CODE BLUE performing CPR, with a literal belly full of cranberry jelly. Let’s not forget the expertly chosen red sweater I picked out that day. I can still remember the flashes of light shining in my face from the tinsel gleaming off the fluorescents of the hospital room. To make matters worse, the jingle bells on my sweater didn’t get the memo that it was supposed to be a silent night, or rather a silent shift. The literal loudness of my fashion choice and the looks on the faces of everyone in the room when the code ended, successfully, left me feeling mortified at how ridiculous and unprofessional I appeared.
The experience that day made me realize that there is a fine line in the hospital setting between dressing professionally and being spirited. While my holiday sweater and hat were chosen with good intentions, and I certainly wasn’t the only APP in the hospital wearing such attire, I can only imagine how the above patient’s family perceived my clothing in that pressing moment. They may have had doubts about my ability to care for their loved one because they saw me wearing something playful and “unserious.” Though I dressed that way to bring about holiday cheer to my patients, the message likely got lost in translation in the adult ICU.
Indeed, many public polls and studies have shown that patients trust physicians more when they wear a white coat and trust nurses more when they feel they are dressed professionally in matching scrubs to signify their role, or appear well kept. However, does that mean clinicians should never wear costumes at work? What about relatability, or using humor to put patients at ease? After all, in pediatrics, nurses are encouraged to dress up for the holidays to bring cheer to their young patients. And some patients may feel more relaxed and less apprehensive when clinicians are dressed like regular people, as opposed to in a suit and tie or white coat.
That said, sometimes the risk of unprofessionalism is too high. Imagine if the code blue had not been successful and I had to give the news of the patient’s passing to the family while dressed in an outlandish costume?
The long and short of it is that in the ICU, every decision we make has major implications. I now believe that it is important to dress in a way that honors that. Think about it: Every nurse, APP, doctor, pharmacist, etc. has spent extensive time and resources to obtain the knowledge and skills to care for patients. As a result, we should not put ourselves in a situation where patients doubt our abilities because of unprofessional outfits.
This coming year, I plan on showing my holiday cheer by spending an extra five minutes with my patients and their families, maintaining a positive attitude, and perhaps wearing a Santa hat that can be removed at a moment’s notice if trouble arises and a more serious and professional demeanor becomes necessary. My message to other clinicians is simple: Individuality and creativity should still be encouraged with regard to our appearance, but perhaps think twice before pulling out that tacky Christmas sweater for your holiday shift.
Have you ever had an embarrassing moment in medicine? Share in the comments!
Kymberley Filip is an ICU Nurse Practitioner in Houston, TX at Baylor College of Medicine. She has been taking care of critically ill patients for over seven years. Born and raised in Texas, she attended The University of Texas at Austin and is an avid Longhorn fan. Kymberley is a 2023–2024 Doximity Op-Med Fellow.
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