How to Dress for Psychiatric Nursing

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    Many psychiatric facilities and settings allow nurses and support staff to wear street clothing instead of scrubs. Those new to psych nursing are often not sure what is the best thing to wear. This article provides some guidance in how to dress (and how not to dress) for the psych unit.

    How to Dress for Psychiatric Nursing

    Many psychiatric facilities and settings allow or require that nurses and support staff wear street clothing instead of scrubs. Those entering into psychiatric nursing often ask, "If I can't wear scrubs, then how should I dress?" Likewise, a common question asked by nursing students and their instructors is, "What should I (or my students) wear for psych clinicals?"

    I would like to offer some guidelines regarding how to dress for working or attending clinicals on a psychiatric unit. I've been a psych nurse for a few years; when it comes to nurses and students dressing for the job, I've pretty much seen it all. So here's some tips to get you started; as you feel out the atmosphere on the unit, your attire will probably evolve to match it.

    Please keep in mind that your school or facility's dress code policy trumps whatever guidance I give here. If anything I say conflicts with how your facility/school wants you to dress, go with their guidelines.

    1. Don't Dress to Attract.

    Some people, especially students, often see "street clothes" as an excuse for them to cut loose. The psych unit is not the time or place for self-expression, showing off your body, or trying to attract the romantic attentions of a classmate. And trust me, you DO NOT want to attract the attentions of my psych patients!

    2. Do Dress to Impress.

    A good guideline is to dress like you're going to church or court: the more conservative, the better. A nice pair of slacks/pants paired with a blouse, dress shirt or polo shirt is usually a safe bet. Whatever you wear should be clean, neat and well fitting (neither too tight nor too baggy). Learn to iron, or at least do what I do: throw your clothing in the dryer for 15 minutes to take the wrinkles out.

    3. Don't Wear Anything That You Don't Want to Risk Having Stained or Ruined.

    Even though this isn't med/surg, there's a real chance that you will come into contact with vomit, dirt, water, urine, blood, and other gross products.

    4. Big NOs:
    • No rips, wrinkled, ratty or stained apparel
    • No cutout, see-through or sheer items
    • No garish colors or prints
    • No jeans, shorts or skirts
    • No hats
    • Sneakers: No if you are student. Otherwise, the plainer the better
    • No visible undergarments (bra straps, "whale tail", red underwear under white pants, etc.)
    • Nothing sleeveless or strapless. Long sleeves or 3/4 sleeves are preferred
    • Nothing with strings, trim, or decorations that can be pulled out and used as weapons. Shoelaces and belts are OK
    • No logos or sayings on your clothing other than designer trademarks. The Izod crocodile on your polo shirt is acceptable; a "Budweiser: King of Beers" patch is not
    • Sports logos: No if you're a student. Otherwise, get a feel for the environment first. Depending on the level of sports spirit the facility has, it may not go over well if you're not a fan of the local team

    5. Wear Larger Size Shirt / Pants

    Whether you are sitting, standing, reaching, bending over, whatever position you get into, all of the "Bs"--boobs, belly and butt -- should remain covered at all times. If one/all of your "Bs" are ample in size, wear a larger size of shirt and/or pants so you don't look like you're about to burst at the seams.

    6. No High Heels, Open-Toes, Sandals or Anything Strappy.

    Shoes should have a gentle heel (1 inch or less) or no heel, be closed-toe, and have non-skid soles. They should be shoes that you can move fast in without difficulty.

    7. Keep the Bling to a Minimum

    In my opinion, a watch should be all the jewelry that is worn. But if you insist on the bling, keep it to a minimum. No rings with large stones or multiple rings per hand. No hoop or dangle earrings. If you have gauges, use a solid plug in them. If you insist on wearing a necklace, keep it under your shirt so it can't be grabbed. No unusual piercings (eyebrow, lip, nose, etc.).

    8. Miscellany

    Go easy on the hair products, as the scents can trigger reactions in some patients. No false nails. Tattoos should be covered. If you wear your ID on a lanyard, it should be a breakaway lanyard. And no no NO perfume!

    9. Wearing Cultural or Religious Items

    Some students and nurses wear apparel and items for religious or cultural reasons. While I support the right for everyone to practice his or her beliefs, the safety of the milieu is of the utmost importance. A head wrap may be snatched from your head and used as a weapon; the act of it being snatched may even cause you injury. Paranoid patients or those suffering from PTSD may not react well to a caregiver whose face is partially or fully covered. Shawls, stoles, rosaries, and anything worn around the neck can be used to choke someone, possibly you.

    If this applies to you, I strongly suggest that you talk to your facility's HR department or your clinical instructor for guidance and for making any necessary accommodations. If necessary, you may wish to consult your religious advisor to discuss whether any modifications to your apparel, or even a dispensation to forego wearing the items while at work/clinical, would be possible. In many (but not all) instances, the nurse/student will be able to wear the items with little to no modification necessary.
    Last edit by Joe V on Dec 18, '14
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  2. Visit Meriwhen profile page

    About Meriwhen, ASN, BSN, RN Senior Moderator

    Meriwhen has worked for more than four years in psychiatric/mental health nursing. She prefers wearing scrubs over street clothing only so she can wear sneakers.

    Joined: Mar '07; Posts: 10,347; Likes: 12,528

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  3. by   beckyboo1
    As a student we are expected to wear our polo with school name, nice slacks and reasonable shoes. A watch and wedding set is ok. Everything else is discouraged except for break away lanyard. It's all about safety. Thanks for your tips!
  4. by   fawnmarie
    Very good article! When I first started working in my facility 10 years ago, "comfortable street clothes" were the designated dress code. The rationale behind this was (and still is, many places) that psych patients will feel more comfortable and less intimidated by unit staff. Unfortunately, we had many, many employees abuse the dress code, and in 2011 our CEO decided to require direct care staff to wear scrubs. Too many female nurses and technicians came to work in tank tops with bra straps peeking out, or wearing flip-flops and sandals in the summer. I especially remember one male technician who was sent home to change clothes when he showed up in a T-shirt that said "I'm not schizophrenic, that's just what the voices say." I do miss being able to come to work in comfy jeans and a sweatshirt, but I think that scrubs appear much more professional.
  5. by   ShelbyaStar
    As someone that works in a group home for some psych patients, I'll add that hoodies aren't a great idea either. Way too easy for someone to pull partially over your head and try to choke you with all while you can't really do anything about it. They are banned at my work.
  6. by   WillyNilly
    And to the neck ties. This should be a no brainier but you would be amazed....
  7. by   Meriwhen
    Quote from WillyNilly
    And to the neck ties. This should be a no brainier but you would be amazed....
    You'd be surprised how clueless people can be when it comes to safety. I see so many necklaces on people that it boggles my mind.

    Or how many people when seeing "street clothing" think it's license to dress like they're going clubbing.

    Sad part is, I've seen most of the "NOs" listed in my article in the flesh. Most are committed by students but I do see the occasional nurse/staff member wearing inappropriate attire. I remember listening to one student argue with her instructor about how the pants she (student) had on were on the only pair she had to wear. The pants looked as though they were painted on.
  8. by   Hygiene Queen
    Scrubs really are the best way to go on a geri unit.
    They usually cost less than street clothes and they can usually take a good wash in hot water better than street clothes.
    The elderly women, especially, love the bright and pretty designs that are available.

    I would also recommend good shoes that are non-slip and can be wiped down with Sani-wipes.
    You will deal with bodily fluids on a geri unit.
    I have had my shoes piddled on more than I care to think.

    It seems like you can't go wrong with nice clean, ironed and well-fitting scrubs.

    I know that scarves are really popular right now, and I do love them, but leave that fashion statement at home.
    I see this waaaaaay too much and it's foolish to supply a weapon to an angry pt!

    Skirts... never.
    Our bodies are in some pretty awkward positions when we are in codes, fighting w/ a combative pt.
    Some of the male pts also seriously lack boundaries and social skills, so if you don't want some "creepy" man commenting on your gams, then you'd be wise to stick to pants.

    Just use your brain:
    Is there anything I'm wearing that can be used as a weapon against me?
    Is what I'm wearing going to keep me from "getting away" from someone in a hurry?
    Is what I'm wearing practical?
    Do I look professional?
  9. by   Whispera
    I can't control myself: kneehighs and flipflops!!!
  10. by   jellytarzan
    My first day on the job at the State Mental Health Institute, I thought they were letting one of the disheveled patients administer medications...then I learned he was just one of the "seasoned" nurses. Oye.
  11. by   MrChicagoRN
    Quote from jellytarzan
    My first day on the job at the State Mental Health Institute, I thought they were letting one of the disheveled patients administer medications...then I learned he was just one of the "seasoned" nurses. Oye.
    One Monday, I observed a this guy on the unit, in the hall, talking to staff once in awhile. Big oversized t-shirt and what looked like what could be hospital pajama pants. He became insulted when I told him he couldn't enter the nurses station and to ask staff for what he needed.
    Turns out he was a clinician delivering a treatment to a pt.

    No ID, not in the scrubs required by his company. Completely out of uniform, nothing to identify him as a caregiver. Staff reports they heard him say he'd never come back on our unit again. That's fine with me.
  12. by   PsychPAC
    I would agree that conservative dress is best. Watch how the practitioners dress, if there are female ones.
  13. by   shamrokks
    We wore our lab scrubs and sneakers to the psych hospital which were a light blue. They did not want us wearing whites. The staff all wear one color of scrubs depending on your job title. The RNs wear black, LPNs wear green, CNAs wear wine/burgundy and housekeeping wear navy.
  14. by   Retired APRN
    A word about religious head coverings. Here in Jerusalem, there are many Jewish and Muslim nurses who are religiously observant and cover their heads. There are head coverings that meet religious requirements, will not harm anyone if they are pulled off (cannot be used as ligatures and slip off easily if pulled by a patient), and can be easily laundered. Here is a link to a picture of one kind, but they come in all different colors and styles.

    Orthodox Jewish men who wear kipot/yarmulkes with a hairpin or grip to hold it on need to remember to keep track of the metal pin and not to lose it. Yes, it's small and very weak metal, but I've had some very ingenious patients when it comes to self-harm or aggression. (I even had one patient who managed to hurt herself with cotton swabs she got out of the trash.)