How to Dress for Psychiatric Nursing

Meriwhen, ASN, BSN, MSN, RN

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.