How to Dress for Psychiatric Nursing

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 for the psych unit. Specialties Psychiatric Knowledge

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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.

Specializes in Psychiatry, Mental Health.

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.)

Soon-to-be nursing student here. We had our wedding rings tattooed on, thinking we'd have to worry less about it getting lost, or stolen, or caught in moving equipment, or about what kind of gunk and pathogens might be lurking underneath. Did I doom myself to wearing a bandaid to work for the next fifteen or twenty years? Or are permanent rings, like gently stretched earlobes, in the realm of "acceptable" mods?

Specializes in Leadership, Psych, HomeCare, Amb. Care.
Soon-to-be nursing student here. We had our wedding rings tattooed on, thinking we'd have to worry less about it getting lost, or stolen, or caught in moving equipment, or about what kind of gunk and pathogens might be lurking underneath. Did I doom myself to wearing a bandaid to work for the next fifteen or twenty years? Or are permanent rings, like gently stretched earlobes, in the realm of "acceptable" mods?

Might want to post a tattoo thread instead of thread jacking this one. This is about how to dress on a psych unit.

Thought of it because the OP mentioned body mods. Good idea, though.

I worked PRN in a state psych hospital several years ago. Usually I wore plain slacks with a plain top and a short white lab coat with big pockets--I needed the pockets. I felt like the lab coat (along with my name tag) identified me as a nurse. In my area, several religious groups prohibit females wearing slacks, so some nurses may prefer conservative skirts. Although my beliefs do not require it, on several occasions I wore a longish loose skirt and felt quite comfortable in it. The right skirt gives you plenty of coverage and freedom of movement.

I think wearing the appropriate dress code is a way to practice the disciplines in nursing. And I think it would take time.

Specializes in Gerontology, Med surg, Home Health.

Back in the dark ages of nursing school we had a psych rotation in a state mental hospital. We were there in the summer and most of the time it was brutally hot. One day it was chilly so I wore a long sleeve shirt with a pocket in the front. I carried my keys and my cigarettes in the pocket. One of the patients ran in the room and started kissing all the girls. He looked at me with my stuffed pocket and loudly exclaimed "Oh...you're pregnant!!! can't kiss pregnant girls." I wore that silly shirt every day the rest of the rotation.

Specializes in Psych ICU, addictions.
Soon-to-be nursing student here. We had our wedding rings tattooed on, thinking we'd have to worry less about it getting lost, or stolen, or caught in moving equipment, or about what kind of gunk and pathogens might be lurking underneath. Did I doom myself to wearing a bandaid to work for the next fifteen or twenty years? Or are permanent rings, like gently stretched earlobes, in the realm of "acceptable" mods?

IMO it depends on your specific facility. From what I've seen and heard, psych tends to be a little more accepting of tattoos and such. I don't know my facility's specific policy--my ink usually isn't visible when wearing work attire so I never looked it up--but I've seen other floor nurses with visible tattoos on their arms, wrists, hands. But I also noticed that they are all discreet tattoos. I may see the odd visible tattoo here and there, but I don't see anyone with a full sleeve visible, with anything large, obscene or tasteless, or more than 1-2 tattoos max.

Personally, I think a discreet wedding ring tattoo (and I've often thought about doing that myself as I don't wear jewelry) would be OK. Mind you, your facility has the last word on that.

Though when you're a student, keep it bandaged/covered regardless of the clinical site's policy or unit environment.

I've found that clothing with any kind of words/letters on it can be bad news. My work is with mentally disabled folks and not true psych, but I've had more than one consumer who would follow me around reading the words or letters on the garment out loud, at the top of their lungs. Not necessarily harmful in and of itself but when it goes on for a couple hours over and over and over again it can get pretty irritating for you and the other patients, which in the case of the patients sometimes leads to behaviors. It's just as easy to buy and wear plain tops.

Specializes in Psychiatric Nursing.

Safety, practicality, and professional appearance are the most important things to consider when deciding how to dress for work on a psych unit. I remember one incident that occurred several years ago. A 3-11pm female technician came to work immediately following her birthday lunch. She arrived on the unit wearing a sparkly "birthday tiara" and large hoop earrings. Our shift supervisor took one look at her and asked "What are you going to do if a patient grabs that tiara off your head, or yanks out one of your earrings?" The technician proceeded to argue that it was her birthday and her accessories were not "hurting anyone." A short time later, our assistant DON arrived on the unit and ordered the tiara and earrings off immediately. Obviously, not a safe, practical, or professional choice of attire, not to mention the absurdity of arguing with the supervisor!

Great points in your article and I found it helpful. I'm doing some psych teaching work now, and I get to where street clothes. This is after mostly wearing scrubs which are easy and I enjoyed never having to think about my clothes too much (which is kind of a relief). On the other hand, it's nice to wear your own clothes, I just find myself double-checking everything to make sure it's appropriate.

Specializes in Psych ICU, addictions.
Great points in your article and I found it helpful. I'm doing some psych teaching work now, and I get to where street clothes. This is after mostly wearing scrubs which are easy and I enjoyed never having to think about my clothes too much (which is kind of a relief). On the other hand, it's nice to wear your own clothes, I just find myself double-checking everything to make sure it's appropriate.

I've been lucky in that both of my jobs give me the option to wear scrubs because I hate thinking about my clothing as well...plus I can wear sneakers :) One job even allows me to wear jeans, so I'll wear jeans and a scrub top. But a lot of psych jobs in my area have started moving away from the scrubs.