In the April 2016 issue of Home Healthcare Now, I invited readers to share responses to the questions related to professional names and titles on their employer-issued identification badge. I received 10 responses and share a summary here. I replaced actual names with "first" or "last" name rather than identifying respondents.

1. How many years have you been a registered nurse?

The years ranged from 8 to 52 years

2. What is your practice setting?

Respondents are home care nurses, case manager, educators, and consultants from Massachusetts, Pennsylvania, Tennessee, Florida, Michigan, and California.

3. Do you remember your name on your student nurse pin or badge?

Miss or first name initial and last name, RN, Student

First and last name, student nurse, SN or BSN, Student

First name only

4. Do you remember your name and title on your first employer-issued identification badge?

First and last name, RN, Clinical Nurse 1

Ms. first initial and last name, RN

First name, RN

First and last name, RN, neither photo nor BSN

Full name, BSN, RN

5. How is your name and professional title listed on your employer-issued badge in 2016?

First name only

First name, Registered Nurse or RN

First name, RN, BSN

Full name, RN/title/credentials, that is, Director of Quality and Performance Improvement, Education and Informatics Specialist, Consultant, PhD

First and last name, RN. "I do not use all my initials when visiting home care patients. It's too confusing to them."

6. If there is a difference in your name and title on you current badge, when did the change occur, and why?

Two nurses indicated there was no change.

"I requested BSN be added when I obtained my BSN and this was granted. I requested my last name be added, this was not. Felt it was a safety issue, even though home care staff all requested last names be added."

"There is no specific change with my current company. For 12 years I worked as the National Director of Education for a large company whose policy it was only to put the RN's first name and last initial on their badges."

"Changes resulted from more education and certifications."

"Name changed as a result being single, married, divorced, and remarried."

"The organization's name, photo, expiration date, and full title designation is required (among other items)."

7. Were you invited to participate in the decision to change?

"All staff was asked how they wanted names and credentials to be done, but last names were not added due to safety concerns."

"Yes, I was invited to participate in this naming decision. It was changed after we had a few incidents with patients calling the RNs at home."

"For all healthcare facilities/agencies in Pennsylvania, format is mostly mandated."

"I requested the change, but the request to change all the nurses' badges to include credentials didn't go anywhere. Cost was the stated objection."

8. What are your positive or negative comments related to your name and title on your employer-issued name badge today?

"I don't think it matters really. 31 years ago I introduced myself by my first name. Never as Ms. and last name. I've always felt that the use of Miss/Mrs./Ms. is an affectation. While it is a sign of respect, it is not real respect. I don't feel someone who calls me Ms. and last name respected me because I have done nothing to earn it. Respect is earned (I actually remember having this argument in nursing school). My daughter is a DVM and worked for a conservative clinic fresh out of school, she had a very hard time being addressed as Dr. and last name, years later, she got used to it, but doesn't prefer it."

"I understand both positive and negative comments about putting both names on the name badge. Due to the widespread use of the internet to look up any person's personal information, I can see why employers would want to 'protect' their staff from handling unwanted patient calls during their non-work time. I do agree with you that the last name on the badge does add credence to their expertise and knowledge."

"I think credentials are earned and deserved to be recognized. It would also raise the profile of the educational efforts of the profession. However, I appreciate the first name basis which sets the standards between patients and nurses."

"No comments except from those who know me ask me if I like quality."

"I love to wear my name tag."

"Some facilities/agencies only put your name title, RN or LPN but our agency will put whatever you would like on yours. I think it is a positive to have your educational title as well, if for no other reason in that it is an honor/acknowledgment by the employer. Others have stated to me that an RN is an RN regardless of whether they have a BSN or Master's degree or an associate degree and putting education on the name tag is demeaning to those without a BSN or MSN."

9. Does your current name and title have an impact on your interactions with your patients and families?

"Nope"

"No real impact noted, as my full title is not used when I'm doing patient care, but is used during my other businesses."

"I feel that first name basis is best in home care. I feel like it makes it more personal for the patient."

"Rarely patients or families will ask me what all those letters mean. More often other employees will ask. It is also a little humorous that patients/families feel like all those letters indicate power or authority (which in my case does NOT)."

"Yes- as the Director of Quality I handle patient complaints. They see my position as one of authority and they assume that if they tell me I will facilitate meeting their needs."

"Patients seem to like it that I am an RN. And I print my first name large enough for them to read it."

"Yes, when I make home visits many patients and family members comment on my nursing credentials - of course, I always introduce myself as a registered nurse when walking into a home and introducing myself."

"When I graduated in 1973 and for a few years after, we were known as 'Miss...' or 'Mrs...' and our name tag reflected that. I think nurses were held in higher esteem when we were known more formally and I wonder if more informal first names encourage patients to try to breach boundaries. I always ask my students if they would consider going to a physician whose name tag said 'Chuck MD.' Of course they say 'no.'"

10. How do you identify yourself if in independent practice?

"A nurse and a geek, I get to play with toys all day."

"I identify myself by first and last name when I'm doing consulting work for home health care agencies. I hand them my business card with the logo and information below. When I'm teaching, it is the same. When I'm doing patient care, I just introduce myself with both my names and just RN."

I always introduce myself as "Nurse first name."

"To help promote the brand of the WOCN society/WOCNCB certified nurses and our certification, I am trying to identify myself as a WOC nurse instead of the common wound care nurse. But when I call patients to set up visits I usually try to identify myself based on the reason for my visit - this is the ostomy nurse or this is the wound care nurse to avoid any confusion."

"Wearing my consultant hat I self-identify as a nurse specializing in home health care with a focus on the use of technology to promote improved patient care. My tag line is 21st Century Home Health Care."

"I use my full credentials in all written identification."

"Note: Many agencies now will email a photo of ID badge of the nurse, therapist, or aide to the patient/family for security reasons."

Additional comments

"A personal anecdote on names and titles: working home care some years ago I had an MD who always called me 'Nurse and last name.' I so loved that."

"I was so happy to see your commentary on professional names. I have long thought that the way we present ourselves as nurses is the way others perceive us."

"What a great topic. I have often contemplated the name issue. About 10 years ago, a male colleague, both of us were front line nurse managers, decided that the title issue was bothersome to both of us for different but parallel reasons. The two of us decided to address each other by 'Nurse full last name' and 'Nurse full first name' instead of the traditional first name only convention. It raised eyebrows, but never caught on."

"I feel that there is a definite generational divide. I saw it myself as a child 50 years ago, in how my parents and their friends addressed each other. I see it now in the Gen X'ers and beyond. I remember working with a former military nurse who used her last name when answering the phone, but I've always answered mine with 'this is first name' because that is who I am. How I see myself. The other titles just make me feel old. Because that is what I saw growing up, old people were called Mr. and Mrs., not your peers. While I am careful when addressing patients, to find out what they want, it would be interesting to see how your survey stacks up on age (which you didn't ask. I know a lot of folk who became nurses in the 40s and 50s) and place in the world you reside."

Summary

The Pennsylvania's Department of Health Act 2010-110 Photo Identification Badges (45 Pa.B.24271, Saturday, May 15, 2015) lists the items that must be included on a badge:

A recent photograph of the employee; the employee's name; the employee's title; the name of the employee's healthcare facility or employment agency. The document notes that "an employee is not required to wear an identification badge while delivering direct care to a consumer if it is not clinically feasible" and "The last name of the employee may be omitted or concealed when delivering direct care to a consumer who exhibits symptoms of irrationality or violence."

At least 10 states have regulations regarding healthcare provider identification (Dube, 2010). Readers should refer to their state's requirements as well as the requirements of the organizations that license or accredit home care agencies. A nurse's full name and credentials are not on the current ID badges of many of the respondents (not only those who are working with individuals who exhibit irrationality or violence). Readers need to form their own conclusions as to the positive or negative impact of current practice as it relates to professional titles and credentials that are shared with patients.

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