The increasingly-tabloid Freethinker is running an indignant story about how – apparently – rules about bare arms have allegedly been relaxed for Muslim staff within the NHS (scroll down a bit – they’re indignant about quite a lot).
Female staff who follow the Islamic faith will be allowed to cover their arms to preserve their modesty despite earlier guidance that all staff should be “bare below the elbow”.
The Department of Health has also relaxed rules prohibiting jewellery so that Sikh members of staff can wear bangles linked with their faith, providing they are pushed up the arm while the medic treats a patient.
It goes without saying that anyone who thinks that exposing their forearms is being immodest is silly, and that anyone who thinks that this “immodesty” is so grave that the hygiene implications of wearing sleeves are minor in comparison is just about certifiable. So, if the story is true, it’s worrying.
If the story is true.
It doesn’t sound as though it’s true, though, does it? I mean: it somehow lacks a sense of plausibility. So where did The Freethinker find it? Well, their story offers a link to the Telegraph; and the Telegraph offers a link to… er, actually, it offers no links. But it does tell us that
The Mail on Sunday reported the change had been made after female Muslims obje…
Ah. Let me stop you there. Any citation the either the Daily Fail or the Wail on Sunday ought always to carry some sort of warning (“DANGER: BOLLOCKS AHEAD”); but I held my nose and followed the lead. Sure enough…
Muslim doctors and nurses are to be allowed to wear long sleeves for religious reasons – despite the risk of spreading deadly superbugs.
The Department of Health will allow female Muslim staff to opt out of a strict NHS dress code to cover their arms and protect their modesty.
It’ll come as a surprise to noone that the story also has no link – just a quotation from an unnamed Department of Health spokesperson.
So went to the DoH website and had a look around for the guidance. It’s hard to find: there’s a search box, and I tried terms like “muslim”, “sleeve”, “MRSA”, “political correctness gone mad”, but none of them gave me the story in question. Obviously, the next step was to ring the press office at the DoH. I explained who I was, and asked about the story, and how I suspected that it was nonsense: was there a link the press officer could send me? I could almost hear the sound of eyes rolling at the other end of the line; but a link was provided to the latest guidance on dress codes.
And, indeed, the guidance does talk (in Appendix B) about accommodating the bizarre wishes of those who think it immodest to show their forearms in public. I’ll come to that in a moment.
The body of the guidance on dress-codes is clear, though. (The bold emphasis is all mine.)
Where, for religious reasons, members of staff wish to cover their forearms or wear a bracelet when not engaged in patient care, ensure that sleeves or bracelets can be pushed up the arm and secured in place for hand washing and direct patient care activity.*
Hand hygiene is paramount, and accidental contact of clothes or bracelets with patients is to be avoided.
*In a few instances, staff have expressed a preference for disposable over-sleeves – elasticated at the wrist and elbow – to cover forearms during patient care activity. Disposable over-sleeves can be worn where gloves are used, but strict adherence to washing hands and wrists must be observed before and after use. Over-sleeves must be discarded in exactly the same way as disposable gloves.
So the policy amounts to this: if you’re not treating patients, there’s a bit more leeway in respect of dresscodes; but the primacy of patients’ welfare is unaffected anyway. If you are treating patients, and if you do have weird beliefs about the propriety of having your forearm on show, you can use disposable sleeves if and only if gloves are used in similar circumstances. In other words, it looks like the sleeves are treated in the same way as gloves – which is reasonable – and if gloves would be inappropriate, then so would be sleeves. This, actually, looks pretty unobjectionable.
On to the appendix. This seems fairly accommodationist (and, for the sake of greasing the wheels, there’s nothing obviously problematic about that), but the accommodations offered are fairly small all the same. The first thing to note is that we’re talking about recommendations here, not policy. The second is that it’s explicit that
[i]ncorporating any of these recommendations into trust policy will have to be agreed in conjunction with clinical managers and the local infection prevention and control team.
That is: if you want to change the standard arrangements, you have to get the approval of the infection bods. In other words, they have a veto on changes. This seems like the right approach.
More importantly, though, the recommendations are simply that
Uniforms may include provision for sleeves that can be full length when staff are not engaged in direct patient care activity.
Uniforms can have three-quarter length sleeves.
Any full or three-quarter length sleeves must not be loose or dangling. They must be able to be rolled or pulled back and kept securely in place during hand-washing and direct patient care activity.
Disposable over-sleeves, elasticated at the elbow and wrist, may be used but must be put on and discarded in exactly the same way as disposable gloves. Strict procedures for washing hands and wrists must still be observed.
In essence, this just iterates the main body of the policy; but, once again, as soon as patients are involved, all bets are off.
So, in other words, this “relaxation” of the policy on bare arms actually boils down to this: impose on yourself whatever crazy restrictions you like, unless patients are involved, and providing that you adhere to a couple of other supplementary rules for the sake of patient safety.
But that doesn’t generate quite the same headline, does it?