Thursday, July 28, 2016

What do Chaplains wear?

When I first started this chaplain gig four years ago I remember being entirely puzzled by what to wear for my shifts in the hospital.  This is a professional job, but it comes unique challenges when it comes to attire. I will share a few of the things that I have learned in the hopes that it might be helpful for all those CPE students or other chaplains.  I can only speak to women's attire, perhaps my male colleagues have more to offer for men.

First, hospitals will likely have a dress code of some sort.  Chaplains fall into the "professional" category of employees, but do most of their work in clinical areas and have direct patient contact. Other professionals who fall into this category include social workers, registered dietitians, pharmacists and psychotherapists. At the bare minimum, hospital dress codes usually include closed-toe shoes, socks (no flats for women unless wearing tights or socks), and what is termed "professional/business casual attire."  For women this can be button-down shirts, slacks, cardigans, skirts, etc.  Some hospitals have their own specifics.  I've worked at facilities that required me to cover my forearm tattoo (hence why I have a wide variety of cardigans).  My current employer has requested that we dress "for safety", which means no dangling scarves, neckties, earrings, necklaces, etc, that could be become hazardous by being pulled by patient or caught while doing a task.

Next, think about what you need from your clothing to complete your tasks at work.  I carry two pagers simultaneously, which means I need somewhere to clip them.  For this reason, dresses don't work for me and I never wear them to work.  I will wear skirts if they have a tailored waistband that can support the pagers. I also need pockets because I am frequently carrying around pieces of paper, rosaries, and other things.  My work requires standing, but also bending my knees and squatting down next to beds or chairs, and lots of walking around.  I have found that what works best for me to wear are high-end tailored neutral color scrub pants.  My favorite style is the five pocket pant from Grey's Anatomy by Barco. I have them in black, charcoal and khaki.
This is a typical summer work outfit
 They have pockets, look presentable and are comfortable. This may or may not be acceptable depending on your hospital. I am frequently cold at work, as hospitals keep temperatures low to reduce infection risk.  I wear layers (cardigans, fleece vests or sweaters) all year.  Bonus points if your warmup jacket contains pockets. You need to wash your hands a lot, so having sleeves that roll up is important.

This is a typical cooler weather
work outfit for me.

Third, think about your clothing as it relates to infection prevention for yourself and for your patients. Some units (at my hospital the SICU and Burn Unit) require you to remove a sweater, jacket, cardigan or lab coat upon entry. Everything I wear to work is machine washable, because I have no interest in dry cleaning. As evening chaplain, I am on every single unit. I could be in the ER with extremely injured patients, I could be on the burn unit with patients at high risk of infection, I could be on labor and delivery or I could be visiting someone on enteric or contact isolation precautions in the MICU. I do not want my clothing to become an infection vector for myself, my family, or other patients.  So once I wear something to work it goes directly into the hamper at home until it is washed.

Shoes are an important consideration when it comes to comfort, functionality and safety.  I wear a dedicated pair of Danskos to work.  They are the Pro XP model, which has a slip resistant sole and removable insole.  I have custom orthotics which fit into the clogs. I walk about 14-16k steps per day at work, so comfortable shoes are a must. I wear these shoes pretty much only to work and they live just inside my front door because I have no desire to track anything nasty into my home.

With regards to accessories, I wear a watch or fitbit everyday.  I note when I enter and exit a patient's room, because I must enter that into a chart note later. I have a work notebook that is covered with leather and has a pen attached for this purpose. It has taken many iterations to find a system that works for me. Sometimes I use scraps of paper, but I find that the notebook is useful for keeping track of information for more than one shift and sometimes patients or families will request a blank sheet of paper and I can just tear one out of my notebook for them. I usually have one or two pens clipped to my shirt or in my pockets also because pens are a hot commodity in a hospital. Hospitals require you to wear a name badge in a place that is visible above the waist. I wear mine clipped to my collar on the left side. This gives me access to hospital doors, the employee parking garage, and identifies me as someone who belongs at the hospital.

A note on clergy shirts for chaplains:
I would never wear a clergy shirt while visiting patients in my work as chaplain.  For me, a clerical collar belongs in a parish as a work uniform for the pastor or preacher.  Just as I would never wear my employee badge to preach in a congregation, I would never wear my clergy shirt to the hospital while employed as chaplain. I find that the image of a clergy collar can be off-putting to patients who might have had bad experiences with church and who are already in an extremely vulnerable state while being hospitalized. For me, not wearing a clergy shirt is a matter of hospitality.  I also find that outside my specific Lutheran context, a woman in a clergy shirt is confusing and controversial. I find that the shirt is a distraction more than a comfort. People know that I am not a Catholic priest but cannot seem to make the required leap that I am a pastor. Additionally, chaplains are interfaith. I visit patients who are Christian, but also Jewish, Muslim, Buddhist, Hmong, or no particular religious tradition at all. A clergy shirt can create barriers to conversation or create a sense of exclusion.

1 comment:

Marshall Scott said...

We have the same issues regarding dress code in our hospital that you have in yours. There are other applications you didn't mention, but I bet they apply: nails, for instance, must be kept short as a matter of infection control.

We have to review this every year (really, several times a year) as new students come into our CPE program. I'm more traditional myself, and so is our hospital dress code. So, sometimes stating expectations for chaplains runs into cultural issues. Two particularly strike me. One is that congregational clergy these days work more and more in "business casual," rather than - what do we call it now? - "corporate professional." For many of our students, that is the image of professional clergy that is familiar.

The second issue is that most employees in a hospital these days are in scrubs; and many staff who don't have patient contact, while not wearing scrubs, are in "casual" clothes verging on "athletic wear" (I'm trying to use words from ads, as I'm not sure what the etiquette books say any more). That is true, too, of our medical students, still coming daily from a campus environment. Putting a short white lab coat over leggings or jeans just isn't enough difference. So, when for folks who are "professional" the biggest difference between work clothes and play clothes is colors more drab and nicer shoes, setting a more formal standard for new chaplains can be tough.

I do always choose to wear a collar, accepting just the limitations you also recognize (except, and I bow to you on this, issues of being a woman in clericals obviously don't apply in my case). Part of that is being Episcopal and old, and being in an explicitly Episcopal hospital. And, I don't require it of the other chaplains who report to me. Of course, any day now I'm expecting hospitals in the US to follow the leadership of the National Health Service in the UK and ban ties as infection control hazards. For good or ill, a collar isn't going to be affected by that. So, yes, I appreciate well the thought that any chaplain has to go through.