The attire debate - what should nurses wear?

Nurses General Nursing

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there's been a debate on another thread about the way scrubs, particularly patterned scrubs, are perceived by non-nurses. the original poster's position was that they diminish the respect (or potential for respect) other health care professionals have for nursing. many members argued that patients, particularly paediatric and geriatric patients, prefer them.

research indicates that the public find it harder to identify nurses now that the 'traditional' uniform of whites (plus or minus cap) is the exception. skoruspki and rhea (2006) compared perceptions of four kinds of uniforms and ten characteristics, finding that

the white uniform was the most frequently selected for 5 of the 10 characteristics: confident, reliable, competent, professional, and efficient. the print uniform was most frequently associated with the other 5 characteristics: caring, attentive, cooperative, empathetic, and approachable. in contrast, the solid uniform was least of ten selected for 6 of the 10 characteristics with the print uniform being least often selected for the remaining 4 characteristics.

for overall images, the white uniform was paradoxically the uniform most often selected as the nurse that patients would "not like to take care of you" but also most often selected as being "easiest to identify as a nurse." the print uniform was the most often selected as the nurse "you would most like to take care of you." the solid was the least often selected both as being the nurse "you would most like to take care of you" and as the "easiest to identify."

in other words, the white ensemble allows easy role identification and conveys the professional aspects of nursing care, while a patterned uniform makes identification harder but conveys the human aspects of nursing care and is preferred by patients.

as a student i wore a very traditional uniform, complete with voluminous starched white apron and belt, laundered by the hospital. as a newly registered nurse i wore a pale blue dress (known as the blue sack), until a new don noted that the only other staff who wore uniforms were support staff, while the other professionals wore street clothes (scrubs are reserved for or, ed and icu). i wore, and still wear, black laced shoes, navy or black pants, a white polo shirt or t-shirt and a vest (red, navy or black). i introduce myself to my patients and their visitors as "hi, i'm talaxandra and i'm the nurse caring for you today." i've never yet had a patient or family member voice confusion about my role or status.

i think reducing role fragmentation (so patients have interactions with fewer people), uniforms for support staff, and a policy that all staff introduce themselves would improve identification by families and patients without requiring the regressive step of starched white attire. what do you think?

Specializes in Health Information Management.

@bunsterj: Wow! I'm studying to go into the paper side of things, not direct patient care, so please forgive my ignorance. I had no clue that hospitals don't regularly launder employees' scrubs anymore! That's horrifying to me as I consider all the things LPNs, RNs, CNAs, NPs, and physicians are regularly exposed to while working. I understand the pressure to contain costs, but this just seems like a no-brainer to me. Yikes! I wonder how many run-of-the-mill patients realize this?

@bunsterj: Wow! I'm studying to go into the paper side of things, not direct patient care, so please forgive my ignorance. I had no clue that hospitals don't regularly launder employees' scrubs anymore! That's horrifying to me as I consider all the things LPNs, RNs, CNAs, NPs, and physicians are regularly exposed to while working. I understand the pressure to contain costs, but this just seems like a no-brainer to me. Yikes! I wonder how many run-of-the-mill patients realize this?

At one time nearly every hospital had it's own laundry, and many did offer laundry services for nursing and other staff, either free or for a small fee. In the good old days nurse could not only have their uniforms laundered, but those aprons that were a part of most every uniform and caps as well all could be sent. This is where the term "starched whites" comes in, as it was nearly impossible for a home laundry to produce the same results.

Around the 1980's or so when the managed care craze took hold, hospitals looked to streamline operations, and anything that did not bring in revenue, that is was a "cost" either had to go or was reduced. This included in house laundries.

Between changing labour and safety laws, insurance, and other costs associated running a laundry, most hospitals and other clinical sites simply found a medical "linen service" not only a viable alternative, but cheaper as well. Problem is when laundry is sent out the hospital is charged usually by weight, and thus the need to keep laundry costs down, so many stopped offering routine laundry services for all staff, including nurses.

When scrubs were by and large restricted to nursing staff in the OR, L&D or the units, then as now such garments are hospital issued and cleaned by the same. But as modern home appliances such as washing machines and dryers became common, staff/floor nurses were left to fend for themselves, as it was assumed they had such equipment at home, or had other access such as a laundromat.

When uniforms changed from starched whites to "easy care" poly/cotton, pure poly or that god awful poly/nylon blends, again the need for special laundry equipment and service was eliminated so it was felt nurses could take care of things on their own.

Specializes in Urgent Care NP, Emergency Nursing, Camp Nursing.
Where I work, they started with the intention of differentiating staff members... but it has gotten way out of hand. Here are the ones I can remember

RNs- royal blue

LPNs- teal

CNA/HCT- sky blue

RT- black

Pharmacy tech- purple

Housekeeping- brown

Central Supply- gray

I know there are more colors for the EMT techs, the radiology techs, US techs, etc.

What started as a good idea has gotten way out of hand. I agree that if you don't provide direct patient care, then business casual or even a uniform polo should be used. And people still ask the housekeeping staff for pain meds- it is hard to get them to learn the color coding.

You say that as if it's a bad thing. It's like working on an Aircraft carrier - you can take one look at a person and know exactly what they do. While a patient/family member may not pick up the whole system, they'll learn the colors for the professionals they interact with quickly.

Also, as a current nursing student, I definitely prefer being on floors where there is a color-coding scheme, especially if there are a lot of allied health professionals around - that way, if I need to find a nurse to ask a question, I can do it quickly without having to go peering at the small lettering on everyone's flipped-over nametags.

I wear a white shirt, my personal preference, at all times but never a white pair of pants. We need not go back to prehistoric times and though I am aware that the female nurses, forgive my machismo, look beautiful in whatever they wear I, nonetheless, support them wearing printed scrubs if they wish so to do. Different colored scrubs for different levels is a whole lot of bull because it serves no purpose to the patients or visitors. My opinion is that it is repressive and oppressive. Hey, no hate mail.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.

also, as a current nursing student, i definitely prefer being on floors where there is a color-coding scheme, especially if there are a lot of allied health professionals around - that way, if i need to find a nurse to ask a question, i can do it quickly without having to go peering at the small lettering on everyone's flipped-over nametags.

you won't always be a nursing student, and it's not too much to expect you to know the health professionals you work with on a regular basis. if you're saying you favor color coding for you, why should we professionals submit to a color code for the benefit of students who are just temporary visitors to our unit. and if you're saying you favor color coding for the benefit of the patients, understand that it doesn't work. even if you provide the patients with a code to the colors, some of them can't read, can't read english, lack reading comprehension skills, have poor short term memory, are demented or are just too sick to care.

nurses are professionals; attempts to force us into certain colors is nothing more than an attempt to make us subservient to the management gods. and i'm against that.

I agree, HUC and Monitor tech often get confused as the nurse and it confuses visitors/patients. Even our housekeeper...once a patient kept saying "nurse please give me my meds" the housekeeper pulled the trash, looked at the pt and walked away. Never even offered an explanation that she isnt the nurse. I think the pt thought it was rude that the nurse ignored him but she wasnt the nurse. She had scrubs on...

Specializes in Rehab/LTC.

I work in a rehab facility, so most of our residents are over age 65 and on Medicare. They LOVE it when I wear my white dress, white pantyhose, white shoes (NOT sneakers and not CROCS) and white nurses cap. They rave about how I "look like a nurse should" and how "professional" I look. Yeah, it is a bit more work starching and ironing, and some days I hate the thought of putting on pantyhose. And, has anyone tried to find a nurses cap lately? They are not in the scrubs catalogs. I had to sort through Mediao outfits on Ebay to find a true nurses cap.

I work in a VA center, and we are absolutly forbidden to wear, all black (depressive color) any red due to it reminds pt of the war (blood i assume??), and no camo no matter what color there again reference to war.

Specializes in Nurse Educator; Family Nursing.

That's interesting! I was an Air Force Reservist and was activated for Desert Storm to back-fill (replace state-side folks who were immediately activited to go to the "front"). We were ordered to wear camoflage to show solidarity with those of our brothers and sisters who were serving. Is this becoming something PC? This was on all units. . .even OB and Public Health Services.

When I worked as a HUC, we had a confused patient leave the hospital, so we had to call the police to go look for her. I actually almost lost my job because of a major role-confusion mix-up by the police officer. Our dress code is that the HUCs wear scrubs--no particular color, same as the nurses and CNAs.

He took down my name from my name tag, but assumed I was the patient's nurse because I was sitting at the front desk. I even reminded him verbally that I was not the nurse, but he didn't seem to "get it." Then he got more and more frustrated that I couldn't give him exact details about what the patient was wearing, how she looked, what meds she was on, etc. He reported me to our DON, saying I was rude to him. (I did nothing rude, and was actually extremely nice and respectful--witnesses backed me up on that.) If it weren't for a few corroborating witnesses, the DON would have had to assume I was smarting off to a police officer while attempting to pass myself off as a nurse.

In the hospital where I did my LPN clinical--every specialty wears a specific color so the patients (and staff) know who is who.

All nurses (RNs and LPNs) wear white tops and blue pants. techs wear dark blue, physical therapy wears light green, and respiratory therapy wears crimson and so on. T

why differentiate between LPNs and RNs. They are both nurses. Sure the LPN has some limitations, fewer in Oklahoma where I live but they are still a nurse. LPN or RN on someone's badge or uniform should do.

LPN's aren't considered (real) nurses in my neck of the woods and in fact they mainly work in LTC facilities. Hospitals have pretty much stopped hiring them unless they are in the RN program.....and a lot of facilities are offering tuition for their LPN's to get their RN degree because in the not too distant future they won't be hiring them either. And I'm gonna be honest with you...if me or my family member is critically ill, I'd like a RN rather than a LPN please. LPN's are very helpful but 1 year of schooling is no comparison to the 2-4 years of schooling for a RN. This is a no brainer. And before you take offense I like LPN's & hope there is always a place for them.

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