Karas in healthcare
Issue observed
Generally the issue arising with respect to a Sikh healthcare worker’s Kara relates to the relevant hand and arm hygiene requirements or protocols applicable conflicting with the religious requirement to wear the Kara.
By way of illustration, different hand and arm hygiene requirements or protocols would apply to:
a nurse in a hospital ward
a general practitioner doctor working in a private prasctice
a doctor performing surgery
an aged care worker
a dentist
a physiotherapist in a hospital setting or private practice.
Each state or territory will have their own requirements with respect to the relevant healthcare setting. For example, there are hand hygiene policies for hospital healthcare workers that are different to the hand hygiene policies for dentists in Western Australia. These policies, guidelines and conditions will usually set out the relevant requirement which may or may not come in conflict with the Sikh requirement to wear the Kara.
This state and territory and specific healthcare setting approach means that there is no “standard” issue nationally and accordingly there is no “standard” national solution for Sikh healthcare workers wishing to wear their Kara. We provide below some general observations that are relevant across matters that have been successfully resolved across many states and territories.
Under the relevant state or territory policy, dentists will usually not be allowed to wear anything below the elbow on both arms when practising their profession. This includes not wearing watches, wedding bands, bracelets etc. On the other hand, some hospital health care workers (e.g nurses) may have a hand hygiene requirement that prohibits any items being worn below the elbow. However this policy may provide for an exception for wearing a plain wedding band provided it can be removed when needed to be washed.
For example, the QLD Health’s initiative ‘Bare Below the Elbows’ seeks to elevate hand hygiene. As part of this policy an exception is provided to the general rule of no items to be worn below the elbow.
“A significant ring such as a single flat ring or band, with no stones or ridges may be permitted but should not interfere with effective hand hygiene practice. If working in a high risk setting such as Operating Theatres, wearing of any type of ring is not permitted.
Some examples of the relevant state or territory requirements are contained in the relevant links below.
Potential solutions
Each Sikh has their own individual relationship with Sikhi and the Panj Kakaar (5Ks). This means that depending on the circumstances arising, each Sikh may have their own potential solution that would be appropriate from a hygiene perspective and accomodate their beliefs. This would be something that would need to be determined through discussion between the healthcare provider and the Sikh healthcare worker.
From a non-Sikh’s perspective, the Kara may be considered to just be a bangle, a bracelet, an item of jewellery or fashion accessory. However for a Sikh, the Kara is none of these things and to call it any of these things would be considered offensive for most Sikhs. For practising Sikhs the Kara is a mandatory article of faith. For an Amritdhari Sikh, the keeping of a Kara on the predominant wrist at all times is a must and to part with it is considered a lapse in religious practice.
Where possible the Kara should be allowed to be worn by a Sikh in this manner.
As mentioned above, for some hospital health care workers, hygiene protocols and policies will prescribe for no items to be worn below the elbow except for a wedding band as long as this wedding band can be cleaned along with the hands. Under these protocols it would also make sense for a Kara to be allowed to bre worn as long as it is also washed in the same manner as the wedding band (which can easily be done for Karas).
However where hygiene protocols require no item to be worn under the elbow with no exception, further discussions should take place to determine the appropriate treatment of this deeply religious item with the Sikh to ensure an appropriate outcome is reached. Most Sikhs would prefer to keep their Kara on their predominant wrist and continue their vocation. Solutions that allow for this to occur should be considered first and foremost.
It is important to understand that not all Karas can be easily removed (see heading “How are Karas worn”).
Potential outcomes for Sikhs depending on the relevant facts and circumstances include:
ensure the Kara worn is one that is similar to a plain wedding band (i.e. plain with no grooves)
washing the Kara regularly along with washing hands and keeping it on the predominant wrist
as per 1. and keeping the Kara up high on the arm away from the hand
as per 2. and having a method to keep the Kara high up on the forearm such as a clean wrist band over the Kara and/or taping the Kara in place
there are some practising Sikhs who may be able to and open to taking the Kara off and putting it in their pocket or elsewhere on the body that they deem appropriate while on the job. This is not something that should be considered an appropriate outcome for all Sikhs and circumstances.
Some Sikhs may also be open to having their Kara in the same vicinity or room where they are working (i.e. not on the body). As per above, this is not something that should be considered an appropriate outcome for all Sikhs and circumstances
The above potential solutions do not represent a complete list. They are merely examples of solutions accepted by some Sikhs but does not represent the views of all Sikhs. It is important to discuss the issue in an open and transparent manner and allow the Sikh to make decisions in an informed manner.
To assist in ensuring a mutually agreeable outcome we would suggest an open dialogue occur between employers and employees (or supervisor / academics and students) that commences with some questions rather than closed statements. For example:
“I understand that you are a Sikh and wear a Kara which is an important part of your Sikh faith. Given the requirements for hygiene in your role as a [insert profession], we would like to engage with you to understand your thoughts on how your religious beliefs can be accomdated while you carry out your duties in a safe manner. We have attached the relevant [insert policy documentation name'] for your information. You may have already considered the issue and what may be appropriate for you. If so, could you please let us know your thoughts? Alternatively, if you would like to discuss further please let me know.”
Some conversation pieces that should be avoided especially where mutually agreeable solutions are being contemplated include:
“You can't wear that bangle…”
“You are in breach of a guideline…”
“Your wearing of the kara has been noted and is innapropriate…”
“If you don’t comply with the guideline we will need to discuss this with HR”
Frequently asked questions:
A Sikh in one department is seeking a different treatment with respect to their Kara compared to a Sikh in another department. Is one or both of them incorrect?
It is unlikely this is the case. As mentioned above Sikhs have their own relationship with the 5 Ks including their Kara. While some Sikhs may consider it appropriate to remove their Kara some may not be so inclined. Some Sikhs might be able leave their Kara at home, in their cars, lockers or work desk. Some Sikhs might be comfortable with keeping it in their pocket so it remains on their body while some may not be comfortable with removing it at all or find it impossible to remove the Kara without cutting it. This differing treatment does not diminish the significance of the Kara itself to Sikhs.