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When OTs Wore White Shoes

OT Practitioners: Are you Thinking about Getting a Tattoo?

Published July 7, 2014 9:02 AM by Debra Karplus
A magazine that I read has a cover story about tattoos in its recent issue.  It gives a statistic from the Pew Research Center stating that four in ten Americans between ages twenty-two and thirty-seven have tattoos. Ironically, I had just sent a proposal to write an article on that exact topic specifically to that particular magazine.  But, it's best that another writer got to it before I did, because frankly, when it comes to tattoos, I have very strong opinions.

Let me start with my own experience.  Being in my sixties, my exposure to tattoos was that only sailors and guys, who had gotten really drunk and didn't know what they were doing at the time, were the only people who had tattoos; usually it was in one color and on an arm, either a picture of a large bird or the name of a girlfriend.  I have no tattoos.  If fact, I don't even pierced ears or anything else pierced, for that matter.  I guess I am comfortable in my own skin, plus I am not a big fan of pain!

When I was riding the city bus the other day, I looked around at the other passengers and it appears that I might have been the only rider without a tattoo.  The majority of these tattoos were very visible, large and colorful.  When did the human body get transformed into some sort of art gallery or three-dimensional murals?

I am a big fan of decorum.  If I went to consult with a new doctor or dentist, I'd be a little freaked out if they sported big and bold colorful tattoos all over their neck or arms.  Frankly, it might be difficult for me to take them seriously and to grant them the same respect as I might if they were not tattooed.

These days, occupational therapists and occupational therapy assistants do not wear uniforms in many of the settings where they work, such as schools.  When I was a new OT, nearly four decades ago, having my patients feel confident in me was very important in gaining confidence as a novice.

So, new OTs and OTAs, listen up!  Many of your patients are likely to be people of my generation, people who are considered to be baby boomers, who share my sentiments about things like tattoos.  Granted, my generation certainly was not perfect; many boomers didn't mess up their bodies with tattoos and piercings, but really did a number on their brains with illegal and frequent drug use.  These folks may become your patients, too, and the subtle mental deficit that you might identify might not be from their recent stroke, but rather from years of habitual marijuana smoking or likely something much stronger and more dangerous.

Healthcare professionals, take Grandma Debbie's advice here, before heading to the tattoo parlor and pulling up your sleeve.  Imagine yourself as a patient or potential employer.  How might the tattoo that you are considering cause people to view you?

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posted by Debra Karplus


I am 46 y/o and didn't even get my first tattoo until I was 34.  I do agree that some people, in my opinion, take it too far but as it was commented on earlier, it is that person's time and money.  My tattoos (I have 4) all have a personal meaning.  They are where they can be covered if need be.  I work in a very laid back and family style facility.  I have had many of my residents ask about them and seem to like them.  

Sherri , ID/DD - COTA/L July 24, 2014 8:57 AM

I don't really have an opinion about tats one way or the other. But it struck me that most of these comments are more judgmental, offensive and disrespectful than the original article that's being complained about. Where's the 'everyone's entitled to an opinion' attitude?

jill sexton, geriatrics - OTR, contractor July 17, 2014 8:12 AM
Ft Worth TX

I understand some folks have difficulty with change, however those times are a changing! This is a time when we are to embrace differences and diversity. I have been working in pediatrics since 2002 and as an OTA since 2009. I have had tattoos throughout my career. Both my clients and coworkers enjoy my tattoos and I get frequent compliments. I do not worry about tattoos affecting my position as I let my work and ethics speak for themselves. I have received many praises and positive comments for the work and rapport I build with my clients and their families.  I would like to think that we are in a generation where we can let the qualifications speak for the individual and not something that is "skin deep." We don't refuse patients for their appearance we certainly shouldn't be shunned for ours. I respect my profession enough that If I had to cover them I would, but I do not as my job accepts me, simply because I am a competent professional who treats people like gold.  Don't judge a book by it's cover.

W, Pediatrics - OTA, various preschools July 16, 2014 12:35 AM
Albany NY

I am a 45 y.o. prior service OT where tattoos were somewhat common. I must admit the tattoos were reserved for only the "tough guys" in the military when I was growing up. My father had them and warned me never to get one because I would regret it someday. I must admit I haven't seen a nice looking tattoo on an 80 year old yet. So remember the skin does sag when we age and this is a lifetime decision. I think gang members today have adopted them as message carrier, do you really want to associate yourself with that?

Blake Weyrich, Outpatient Rehab - Work Strategy and Hand Specialist, NovaCare Rehab July 15, 2014 10:55 PM
Cincinnati OH

This is a very judgmental article indeed.  I teach students in an OTA program and we stress so much about cultural diversity and ridding ourselves of stereotypes with our patients/families, and the author has done just that.  I quote one of her responses: "I frankly have little personal experience with this topic related to the OT workplace."  ???  Then why did you write this piece, and why was it even published?  

Erin July 15, 2014 9:50 PM

I agree that this article was a little less objective and open-minded that I expected.  Let's start with I have no tattoos.  It's a personal preference/choice, not a stance.  We are in the post 911 era.  I simply can't imagine that any logic from a completely different era would have any relevance to a discussion regarding whether or not a novice professional of today would decide whether or not to get a tattoo.  My brother-in-law is a colonel in the US Army, a base commander, aged 49.  He is a physician's assistant, and has a PhD in international education.  He has multiple tattoos, all of which are not visible when he is in his uniform or his clinical attire.  My first assumption is that any professional with an advanced degree and/or in a leadership position would possess the critical reasoning skills to avoid tattoos on the neck, forearm, hand, or otherwise viewable during contact with employees, patients, referral sources, etc.  My second assumption is that open-minded, educated folk of any era would not associate a person's decision to be tattooed or pierced (tastefully) with professional value or judgement.

William Maloney, Home Health - Occupational Therapy Preceptor July 15, 2014 9:23 PM
Dallas TX

I agree that getting a visible piercing or tattoo reduces your chances to be viewed as a professional.  It is a very tough job market and you need every advantage you can get (unless you want to be stuck in a dead end rehab company position).

Elaine , Therapy - Occupational Therapist , School District July 15, 2014 7:55 PM
Oswego NY

I was expecting something completely different when I saw the title of this article. I never would have expected such a close-minded and judgmental piece to be in our professional magazine!  I have always been proud that I belonged to a profession that respected and honored patients' opinions, affiliations, races, genders, orientations, and religions, even when they are different or conflicting with ones own. I am shocked that this same consideration isn't given to ones peers. I am 47 y.o., and I recently had my first tattoo.  It has been a lovely way to relate to people, and the one 80 y.o. patient who is literally the only person not to gush over my tattoo, was much more respectful in voicing his reasons for not liking tattoos than the author of this article was. I work in the schools and at a SNF; in both settings there are several other professionals and para-professionals with tattoos. New OT/COTAs - if you are getting a tat, be smart about it and get it somewhere you can cover it in case it is a requirement for your job - even if it isn't required at your current one.... or move to the Pacific Northwest!  

Mindy, OTR/L July 15, 2014 7:11 PM
Portland OR

I think tattoos can bring some clients / patients closer and alienate others.  Most baby boomers I know were quite the "wild children" of the 60's and 70's and the ones to start the craze with tattoos.  They are also usually very free spirited and don't mind them.  Now yes, the WWII generation would be offended by them as only men got them during the war, as you spoke of.  Or heaven forbid if you have actually heard the horrors of a Jewish person who was "numbered" with a tattoo in a concentration camp it given you seconds thoughts.  However for current generations there is not a negative stigma associated with them.  For many of my patients in acute care it is a jumping point of conversation and a instant way to build a bond with you patient as many of these tattoos hold deep meaning behind them and or the placement.  Patients also worry about the body image, if they have been involved in trauma, with how their ink will look after surgery.  This is an area than OT can help communicate with physicians about patients concerns.  Many of the younger physicians also have tattoos, they just may be placed more discretely.  If you truly get to know your physicians and staff you will bond with them too about this.  Although I respect your opinions, they seem very outdated and isolated to one part of a generation.

Melissa Leffler, Acute Care - Senior OT July 15, 2014 5:58 PM

I have been an Occupational Therapist for 23 years in almost every setting possible.  I recently have gotten 2 tattoos which are visible (ankle and wrist).  Even though I do not live in an area with huge diversity, I must say the reception to them has been positive.  I have had many patients admire them, even ask me to e-mail pictures of my "next one".  These patients have been in the 70+ age range.  I say "don't judge a book..."!  My dental hygienist has had one for years, the nurse in my MD's office has a whole sleeve.... Does she do her job professionally?....YES!  Does it change my beliefs and morals because I choose to put meaningful things permanently on my skin?  No!  Why did I chose the parts of the body that I did?....because I wanted to be able to see them.  Do they mean something to me and my family (and my patients, students and co- workers) that have seen them?....yes!  If I've had someone that opposed tattoos... They didn't make themselves known to me.  I don't particularly like or understand gauged ears... Would I shun my MD or other healthcare worker if they chose to have them? I would not... To each his own!

Ann, Public School System - OT July 15, 2014 2:35 PM
Rochester NH

we have several sites who require that tatoos be covered , several who state no facial/nose piercings and no more than three earrings per ear. Students with tattoos have never complained about having to cover them, students with nose rings or several earrings have never complained about having to remove them......Personally, find the nose ring/facial piercings somewhat distracting, but really, these body ornamentations are so common now that I doubt many clients worry about clinicians with them

Michael , OT - Director, OTA Program, community college of RI July 15, 2014 1:32 PM
Newport RI

I agree that large visible tattoos are not conducive to being perceived as professional.  I have two that I got after becoming an OT but are covered by typical clothing. I think if they are small and unobrusive they aren't a problem (IE inside of wrist).  

thomas, OT - Director, RRMC July 15, 2014 12:15 PM
Rutland VT

I agree with the general sense I am getting from the other, close minded, judgmental and definitely offensive. I have been in this field now for 13 years and have worked in many settings with many different kinds of patients as well s different types of professionals. I am wondering where you live and work and if this is due to the fact that you do not have much exposure to cultural and ethnic diversity? I have worked with awesome therapists with varying physical disabilities or even skin problems that make them look very different. Will they not be an adequate therapist because of how they appear? Will different types of outfits worn due to religious observances mean one is not professional looking? Piercings, is all a part of our culture now...does a visible arm tattoo mean that someone gets drunk and is not able to be a professional? Times change, they always have, cultures change, people change. Judging a therapists level of professionalism or skill based on what they wear or how they look is just, well, simple minded in my opinion.

Kiera Anderson, COTA/L July 15, 2014 11:41 AM
Longwood FL

SHe says she doesn't have pierced ears because she is comfortable in her own skin?  What a crock.

A very judgmental article with pedantic and outdated thinking.

Marc Landry, PEDS - OT, private practice July 15, 2014 11:26 AM
Vancouver, BC CT

I am a 50 year old OT, and I have a tattoo.  Despite that fact, I agree with your blog.   You are entitled to your opinion, and I respect it.

I intentially created a tattoo that could be shared with others when I want, but covered when it is necessary to do so.  

It is reality that we are judged by our interviews, when we walk into a patients room, when we are meeting with physicians/families.  Right or wrong, we are held accountable to the decisions we make as professionals.    

Kari Lukken July 15, 2014 11:25 AM
Coon Rapids MN

Debbie - I am also a baby boomer and was in complete agreement about no tattoos; until my son passed away.  I now have a tattoo, although placed where it is not displayed publicly under normal circumstances.  This experience has taught me not to judge others when it comes to reactions to life events.  The next generation does mark events by tattoos - and I now understand that.  We used to demand that our parents' generation adapt to us; maybe it is time for us to adapt to the next generation.  

Cindy, AT - President July 15, 2014 11:15 AM
Grafton WI

I guess there are more reasons in life to think off and be happy :)

Rohin July 12, 2014 11:21 AM

I probably shouldn't have implied that tattoos are inherently bad, Tim.  My concern is more about how they are displayed, and most important, how they are perceived by our patients.  

As someone who is currently semi-retired, and not tattooed, I frankly have little personal experience with this topic related to the OT workplace.  The opinions from you and the many others who have commented both on this blog and on Facebook, has truly opened my eyes, and also has opened my mind!

So, thanks for reading and commenting.

Debbie K, author

Debra Karplus July 10, 2014 11:08 AM

Debra- I have to agree with most others here. Tattoos are not a bad thing if done tastefully. I do think that large piercings and tattoos on the neck/face are not appropriate for a medical professional though. Just a few years ago at the college where I taught they did not allow students to have visible tattoos or piercings, cover it or drop out was the unwritten rule. (harsh) Yea, some people go too far and get covered, but that's their body (and money). I do have one myself, and I'm your age!

Tim Banish, COTA, Retired July 10, 2014 10:22 AM
Cincinnati OH

Thanks for reading & responding, Lauren.  I didn't expect that my opinion would be so unpopular.  It could be that my age is showing a little too much, but I am open to the possibility that I may need a bit of an attitude makeover regarding tattoos.

Thanks for sharing. I hope others will jump in and say what's on their mind about tattoos as well as other topics that I write about each week.

Debbie K, author

Debra Karplus July 9, 2014 5:54 PM

This is one of the most close minded, antiquated things I have ever read, and from an OT to boot! To define tattoos and piercings as "ruining your body" but then ask sympathy for generational/long term drug use- bizarre. This article is in poor taste. Decorum and an unmarked body do not go hand in hand- nor does being an older therapist and learning to be more accepting.

Lauren Condron, OT July 9, 2014 4:42 PM
Stamford CT

Thanks for your input, Kim.  Indeed, embracing diversity is an important component to the professional training of occupational therapy practitioners.

Debbie K, author

Debra Karplus July 9, 2014 2:32 PM
Champaign IL

As an OT educator, I am expected to teach my students about cultural competence, which includes being open-minded and non-judgmental about superficial characteristics like tattoos. I hope to give the same respect to colleagues. People decorate their bodies (tattoos, piercings, fingernail art, hair color, etc) for a variety of reasons, and it's not my place to link their choices about their bodies to their competence as professionals. I wouldn't judge my patient for having a tattoo, so why should I judge my fellow OT?

Kim July 9, 2014 12:37 PM

I appreciate the comments from both of you, Lauren and Tina,  on my recent blog.  I know that some of my opinions might be somewhat generational, and some, just my own individual opinion.

That each of us is different is part of what makes our work so interesting and fulfilling, and what makes life on this planet so very exciting.

I truly value your input.

Debbie K, author

Debra Karplus July 8, 2014 5:28 PM

Are you kidding me?? I'm a 42 year old COTA and more then a little offended. I have 11 tattoos and no, I'm not finished yet with the artwork on my body and am already planning my next two tattoos.  For you to 'freak out' about the beauty that comes from pretty colors and beautiful self expression that I alone have chosen for MTSELF is ridiculous. I work in the geriatric community, in an orthopedic shirt term/ long term nursing home facility and my patients mostly are curious about why I have them and what they mean to me and have started many meaningful and heart warming conversations.  So the next time you need surgery, or have an emergency, I'd like you to ask the surgeon... Nurse... Or emergency room doctor  if they have a tattoo instead if their accolades, or experience in handling a case like yours.... And see what happens. The skin they are in has nothing to so what's in their HEART  or their BRAIN . Give me a break

Tina , COTA July 8, 2014 5:02 PM

I am 29, without a tattoo but with pierced ears (2 holes/ear) and no other piercings.

While an earlier generation might view tattoos as a negative thing or something that would make the client wary of the practitioner, my generation definitely does not and it may even give the client and practitioner something to talk about and break the ice.

A body full of tattoos and/or piercings might make someone wary, generally people do not have that many. I don't think that a few tattoos or piercings are something to necessarily avoid.

Lauren S July 8, 2014 3:10 PM

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