Children's Responses to Multicolor and Themed Uniforms

The effects of hospital atmosphere and nursing attire have been shown to have significant effect on children's emotional responses. Several studies have indicated that multicolored uniforms created a distracter from painful procedures, fear and an overall positive response without detracting from the professional atmosphere of the hospital. This article reviews studies that signify responses from children and their families towards multicolored uniforms. Specialties Pediatric Article

Children's Responses to Multicolor and Themed Uniforms

Going to a hospital and having a procedure done could be a very stressful experience for children. Some children in addition to anxiety of anticipating dealing with strangers, changing into a hospital gown, experiencing pain, internalizing anxiety of their parents, and not knowing the outcome of their condition become very anxious, frustrated and scared. Their reaction can range from being very quiet and subdued, internalizing all the tension to being enraged and losing control. Some of them cry, scream or cling to their parents. The ambiance can be contagious making other children feel the same or worse.

Our job as nurses is not only to provide the best nursing care physically, but also emotionally and psychologically. We know from many studies in psychology and nursing that having a better response and rapport helps all medical procedures to be smoother and more comfortable for a patient and parents. The environment plays a major role in how children respond emotionally. Positive environment makes them feel happier and more comfortable.

There are several components in creating a positive environment. First, the physical surrounding and the atmosphere, such as color of walls, furniture, pictures, etc. Second, and one that is often overlooked, is the uniforms nurses wear. Where the surroundings make the overall environment feel comfortable, the uniform creates an added friendlier approach. Having different uniform themes not only brightens up atmosphere, it frequently serves as a distracter where children focus on characters and not on the procedure that is being done. Children identify with some of the more popular characters such as Disney and other well-liked cartoons. Prints of flowers, different types of vehicles, or designs helps children to relax even more.

Several studies have reported significantly positive results when nurses wore multicolored or themed uniforms. Meyer (1992) conducted a study with 100 children ages 3-5. She reports that not only children preferred colorful and patterned smog uniforms, 41% found traditional white to be frightening (p=.001). Weissman (2009), describes the same results in her blog. She also adds that animals on badges, cartoon characters or even festive patterns may help children feel relieved or even help ease communication and relationship between a nurse and apprehensive child.

Festini, at. al. (2008), conducted a study with 112 hospitalized children. She found that by using multi-colored and themed attire, children's perception of nurses to ease the discomfort experience due to hospitalization improved 96.2% (p=.01). Not only parents perception improved, but they also found nurses more reliable (p=.0003).

According to Campbell, at. al. (2000), although there is a complex relationship that exists between the perception of the authority figure, providing security for families and suggesting an approachable figure, multicolored and themed uniform allows for more effective communication between staff and families.

Not only in research, but also in our experience children who come to our unit for procedures respond positively to the multicolored and themed uniforms. They spontaneously verbalize their satisfaction and amusement. Parents who accompany children have reported many times that they prefer our uniforms and that they don't see the degration of professionalism.

Based on nationally recognized studies and our experience in the Joe DiMaggio Hospital, hospital units should consider the multicolored and themed uniforms as a way to improve children's moral and ease the pain of their condition.

Refrences

Campbell, S., O’Malley, C., Watson, D., Charlwood, J. and Lowson, S. M. (2000),
The image of the children’s nurse: a study of the qualities required by families of children’s nurses’ uniform. Journal of Clinical Nursing, 9: 71–82. doi: 10.1046/j.1365-2702.2000.00347.x

Festini, F., Occhipinti, V., Cocco, M., Biermann, K., Neri, S., Giannini, C., Galici,
V., De Martino, M. and Caprilli, S. (2009), Use of non-conventional nurses’ attire in a pediatric hospital: a quasi-experimental study. Journal of Clinical Nursing, 18: 1018–1026. doi: 10.1111/j.1365-2702.2008.02430.x

Meyer, D. (1992), Children’s Responses to Nursing Attire. Pediatric Nursing, 18
(2), 157-60.

Weissman, A. (2009), Scrubs and Uniforms to Wear When Working With Children. MyNursingUniforms.com / Young Lion Incorporated

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sashamedvinsky

About sashamedvinsky, BSN, RN

My name is Sasha Medvinsky. I am an RN, BSN. I work at the Joe DiMaggio Children's Hospital. My specialties are pediatric nursing, pediatric dialysis, pediatric moderate sedation.

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Specializes in Hospital Education Coordinator.

I do not understand how a child who has never seen someone in a white uniform would be conditioned to associate white with pain. I think the colored uniforms are fine for pedi, but I do not buy in to the "White-Coat syndrome" for people who have never experienced healthcare providers wearing white.

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Well when I work in peds I can tell you the kids LOVE the different fun scrubs I have. It gives them something to focus on when I do a painful procedure or when they are scared. It also is a way to break the ice. Many adults also have the same fears as my peds patiets, they are less likely to voice it. When I wear something fun it gives us a conversation start.

To be honest I don't really care what I wear, but I see the positive effect it has on my patients so I try to keep it colorful and fun. Even if it is a solid set I try to wear bright colors.

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I refuse to wear cartoon characters, period. But I work in an adult population, so of course it's not expected, either.

Now, I do wear colorful tops most of the time; I wear seasonal tops that are tasteful and bright colors because I like them. My patients often comment on the "cheeriness" of my scrubs.

So I wonder what the same study would show if it used adults as the test and control groups? Would my patients still be as happy to see me if I wore whites all the time instead of my purple or blue or yellow prints? I'd be betting they wouldn't care either way, but I'm curious.

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My child went through some medical issues as a baby/toddler that involved frequent visits to the specialist, a couple of hospital stays, and outpatient tests. By the time she was 8 months old she had developed a fear of people wearing badges and uniform-looking clothing. Sometimes at the grocery store the clerk or a stranger wearing a badge would come up and say hi and she would cry, but if they did not look so official she would smile or at least not cry and cling to me. At around 10 months old we started PT at an outpatient clinic. The therapist spread a white clean sheet on top of the floor mat and my child started to cry and cling to me and was very stiff and scared. The therapist was perceptive and took up the white sheet and brought out a colored blanket, and my child then started to relax and do the play based therapy without any problems! It's amazing how fast these little ones make those connections. Now I'm a ped nurse and I get good reactions from the kids when I wear my Elmo top and flowers. I'm not a huge cartoon fan and going to work with Dora scrubs does not seem professional, but it's all about the patients, right?

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Specializes in PP, Pediatrics, Home Health.

I know when my daughter has been sick the print scrubs cheer her up.She definitely responds better to pictures and lots of colors.From my past experience working in peds I find that a lot of patients felt calmer when they had something bright and colorful to look at,especially if they had to endure an uncomfortable procedure.I prefer wearing my prints.

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I refuse to wear cartoon characters, period. But I work in an adult population, so of course it's not expected, either.

I always hated cartoon and cutesy scrubs. But then I got a job in peds, and noticed that the kids do in fact seem to prefer the fun, colorful prints. My Tinkerbell scrubs were always a hit with the preschool set.

But then we went to a dress code color, and there's been so much back and forth abut what types of prints and print colors are acceptable that I just stick with the solid color. Maybe I look more professional, but to little kids that's a scary look.

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Specializes in Peds/outpatient FP,derm,allergy/private duty.

I'm kind of surprised that there would be any dissent when it comes to children and bright colors. When I graduated I went immediately to work in a pediatric hospital. Not long after the traditional whites, cap, etc started to fall out of favor so I never had a chance to wear whites..

You will occasionally encounter a child who is afraid of a particular cartoon character or afraid of clowns, but it's easy enough to make the child feel more safe and secure without affecting the rest of the little patients. :)

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