Not so long ago, Cindy Ham's fingernails were proudly fake and painted a scarlet color called "I'm Not Really a Waitress."
But Ham is an epidemiology clinician at Tampa General Hospital, so her job is to keep patients from getting infections.
Because of that, her shimmery nails are now gone.
Last week, Tampa General joined hospitals across the country in putting more restrictions on employees' fingernails.
Fake nails may be a fashion frivolity, but studies show they have a serious downside: They can harbor bacteria and spread it from patient to patient.
Infection is a major concern for hospitals. About 2-million patients get infections during U.S. hospital stays each year, estimates the Centers for Disease Control and Prevention.
Last fall, federal officials recommended that caregivers for high-risk patients, such as those in intensive care or in transplant units, should ditch fake nails and cut their natural nails to a quarter of an inch or less.
Tampa General has gone a step further, banning fancy fingers for all caregivers.
The fake nails "made me feel good about myself," Ham said. "Now my self-identity is in my toes."
Those still shine scarlet.
Tampa General is far from alone. On June 1, All Children's Hospital in St. Petersburg banned such nails for caregivers and employees who handle sterile equipment. Last fall, Morton Plant, Mease Dunedin and Mease Countryside banned fake nails in neonatal units, labor and delivery, and surgery. St. Anthony's Hospital bans nail jewelry.
Peggy Thompson, Tampa General's director of epidemiology, used to wear fake nails, painted in a pink and white French manicure. But no more.
"I'm a hand-talker, too," Thompson said, waving her hands for extra emphasis.
Deadly infections have been linked to nails. In an outbreak in Oklahoma City in the late 1990s, the bacteria under nurses' nails were linked to about half of the 16 babies who died in a hospital's neonatal unit, according to newspaper reports.
Thompson said she became more concerned after reviewing studies showing that hand washing didn't remove bacteria under fake nails.
Artificial nails separate a little from the real ones, forming a tiny, moist pocket that is a perfect home for bacteria with names such as pseudomonas aeruginosa.
The bacteria probably won't harm a healthy person wearing the nails, Thompson said. But they can travel from nails to wounds or IV lines, or contribute to lung infections in those who are already ill.
At first, some caregivers didn't want to get rid of their nails.
"I have a lot of single young girls who are attractive and in that dating thing," said Pam Sanders, nurse manager in the hospital's neonatal unit. "The nails do look really pretty."
But once employees learned of the risk to patients, they changed their minds. Many workers shed their nails before the June 30 deadline, Sanders and Thompson said.
In the neonatal unit, Sanders handed out bottles of nail strengthener to those with newly nude nails. Clinician Mary Plumb snapped photos of staffers showing off their shortened fingernails.
Plumb even wrote a poem in honor of Rose Kutniewski, one of the first nurses to remove her nails. One verse: "Artificial nails can carry a nasty bonus,/Cooties, germs, staph and pseudomonas."
In the end, Sanders said taking them off wasn't really so hard.
"You can't do anything that would be harmful to your patients," she said.
Ham agrees. Her nails now are clear, and will stay short and fake-nail free. They have to grow out a bit more, she said. Then "I'm Not Really a Waitress" will reappear.
_ Times researcher Kitty Bennett contributed to this report.