Respect Patients’ Religious Hair Wraps or Coverings When Taking Accurate Height and Weight Measurements
Patients who follow various religious practices may wear head coverings that can affect their height or weight measurements. Accurate height and weight measurements are essential for weight-based medication dosing to prevent inadvertent over- or underdosing.
Almost all religions have associated head coverings. Some are worn only during religious ceremonies or by certain individuals, such as a nun or priest. However, Islamic, Sikh, Jewish, or Amish practitioners may wear head coverings more routinely. Although meanings may differ across religions, the most universal representation is of modesty (https://www.headcovers.com/resources/hats-scarves/religious-head-coverings). See the sidebar for examples of head coverings you might encounter during patient care.
How to Approach Your Patients
When preparing to measure height or weight in a patient wearing a head covering, first understand the meaning and whether it will affect an accurate measurement. For example, if the patient is wearing a scarf or thin head covering such as a kippah, nurses can obtain an accurate height and weight without asking them to remove it. However, if the head covering is large or heavy, follow these recommendations, always making every effort to minimize the amount of time the patient is uncovered:
- After verbally addressing the head covering using respectful language (https://doi.org/10.1111/bjd.20665) such as the formal name (e.g., hijab, burka, turban) or by referring to it as a headscarf or veil, explain the rationale for removal while emphasizing its importance (https://doi.org/10.1111/bjd.20665) as a religious symbol.
- When asking a woman to remove their religious head covering, offer them a private space (https://www.ncbi.nlm.nih.gov/books/NBK499933/) and inquire whether they prefer that a female clinician does the measuring. In some religions, a male cannot see a woman with their head uncovered (https://www.ncbi.nlm.nih.gov/books/NBK499933/).
- When asking a patient to remove a turban, allow them to keep their head covered with an alternative covering (https://www.sikhchaplaincy.org.uk/images/publications/booklet-caring_for_a_sikh_patient.pdf), such as a scarf. When removing the turban, carefully give it to a family member (https://www.sikhchaplaincy.org.uk/images/publications/booklet-caring_for_a_sikh_patient.pdf) if one is present. Never place it with shoes or on the floor (https://www.sikhchaplaincy.org.uk/images/publications/booklet-caring_for_a_sikh_patient.pdf).
Acknowledgement: We thank Reverend Paul Yoon and Chaplain Mira Abou Elezz from Memorial Sloan Kettering Cancer Center in New York, NY, for contributing to the development of this article.