To: Ethics inbox
From: ED nurse manager
Subject: Identification badges
At a recent staff meeting, nurses requested to have only their first names printed on their identification badges (IDs). The nurses were concerned about being stalked or harassed at home if their last names were disclosed. What guidance can you provide?

From: ANA Center for Ethics and Human Rights
These nurses are to be commended for initiating a professional discussion about this ethical question. While the Code of Ethics for Nurses with Interpretive Statements does not specifically address the use of ID badges, the Code does stipulate that “nurses must plan, establish, implement, and evaluate [policies] … to safeguard patients, nurses, colleagues, and the environment,” and “the nurse owes the same duties to self as to others, including the responsibility to promote health and safety.”

Historically, nurses were referred to by their last names, and military nurses continue this tradition. Regardless of setting, nurses should maintain the same standards as other professionals where displaying one’s full name is an expectation. Omitting one’s last name may be perceived as being less professional.

ID badges are used to promote safety by communicating an employee’s name and role to patients, visitors, and other employees. IDs promote confidence that the nurse providing care is qualified. Starr notes that the use of full names is legally required in some states. Omitting last names from an ID appears to be an easy way to promote employee confidentiality and safety, but this may be a temporary measure. For example, a nurse’s full name and address may be accessed through the organization’s or board of nursing’s websites by searching by first name. Also, when patients request their health record, they will see the nurse’s full name.

Nurses can take steps to protect themselves. For example, they should evaluate their social media presence by accessing an internet search engine, such as Google or Firefox, and typing in their name to determine what information is publicly available. They may need to ensure accounts, such as Facebook and lnstagram, are set to private. Additionally, nurses should be cautious about posting personal information. Mcivor and Petch suggest that nurses use work addresses and phone numbers for professional memberships and events.

Healthcare organizations need a comprehensive safety plan. Bailey suggests actions should be implemented to identify everyone on campus by screening individuals entering the building and requiring and enforcing that employees, visitors, vendors, and contractors display identification. Strategies that would de-escalate emotional or threatening situations should be instituted, including surveillance cameras, strategically placed security personnel, secured parking areas, and locked room monitoring. Staff education should address dealing with difficult individuals and how to establish professional boundaries. Finally, policies regarding use of staff names and information on public bulletin boards, websites, or publications are needed. No easy one-size-fits-all answer to your question exists. Maintaining safety requires balancing individual safety against societal safety. Nurses must be vigilant in all aspects of their professional and personal life to protect their information and safety.

– Response by Marcia Sue DeWolf Bosek, DNSc, RN, member of the ANA Ethics and Human Rights Advisory Board, and Sarah Pinard Rogers, MSN, CCRN, an ANA member.

References:

Bailey A. Should last names be on hospital name badges? NameTagWizard.com. 2018. nametagwizard.com/blog/2018/09/24/hospital-name-badges-and-safety/

Starr KT. ID badges: What’s really in a name? Nursing. 2014:44(9):16-17.

Mcivor RJ, Petch E. Stalking of mental health professionals: An underrecognised problem. Br J Psychiatry. 2006;188(5):403-4.