Why do you wear a white coat? (if you indeed do)

[RNdynamic]

This thread is designed to explore why nursing professionals and other professionals wear white lab coats to work. As most of us know, medical doctors have had a long history of wearing white lab coats. We also see PAs and APRNs wearing white lab coats, which makes sense to me, given that mid-levels are quasi-colleagues of MDs and prescribers in their own right.

However, I have even seen nurse managers, nurse educators, case managers, and skin team nurses running around hospitals in those long white lab coats. Why? It has even gotten to the point where sometimes I'll walk onto a unit and there are more people wearing white lab coats than there are "normal employees." It's hardly even a status symbol anymore, certainly not when more people are wearing them in a given situation than not.

Some of you may disagree with this, but I think white lab coats are ugly as hell and that wearing one demonstrates an utter lack of style. It's become what people are wear when they can't figure out how to put together an impressive outfit. If I were a mid-level practitioner, I wouldn't EVER wear a white lab coat if I could help it. I'd rather wear well-fitted, professional clothing.

Besides having no style, there are other downsides to wearing those long white lab coats. For one thing, they show everything. I can't even begin to count how many times I've seen people in those coats with black pen marks all over. That's professional looking. Or how about when people drape their lab coats over the backs of swivel chairs? Someone then sits down and starts idly rolling their chair around while the bottom of the person's lab coat drags along a nice gritty, dirty floor. Then they can come back and put on their nice, gritty, dirty lab coat. Ewwwwww.

Alternatively, someone will sit down in a chair with the lab coat still on and it gets all scrunched up under their buttocks. Have you ever noticed how EXTREMELY wrinkled those long white lab coats are in the back? Bingo. That's why. Just look around next time you're at work. The backs of everyone's lab coats are wrinkled and it looks terrible.

So... what is the point of them? If you wear one of these white coats, what is the purpose? Do you like how it looks? Is there some amazing utility to these coats than isn't afforded by normal clothing? Okay -- they have a lot of pockets. I can see the benefit of those pockets if you're working in a lab or are carrying a lot of instruments. However, if you're a paper pusher like a case manager or a unit manager, then what are all the pockets for? What am I missing here?

[ProBeeRN, BSN, RN]

I wear a lab coat as a wound care RN (as per my boss's request) . It helps staff and patients distinguish me from a floor nurse - at my facility we are considered part of the education department.

[veggie530]

I think this topic demonstrates a lot of what's wrong in nursing.

I'll just leave it at that.

[Julius Seizure]

veggie530 said:

I think this topic demonstrates a lot of what's wrong in nursing.

I'll just leave it at that.

I'd be interested in hearing you say more, actually. I'm not really sure what you meant by this?

[TLBNurse]

I am a home hospice nurse, and I work in rural areas east of Reno, NV. When I began this job, I wore simple solid colored scrubs - as per policy. When I realized I had the option of wear professional clothing, I immediately began to do so because I have not had that opportunity since 1998! However, we had a supervisor arrive that insisted we wore embroidered white lab coats. We were allowed to choose our style, and it is embroidered with the company logo. Initially, that was very upsetting to all the nurses because of the following reasons: 1) the number 1 reason is it sets-apart the nurse from the family, and our belief was home hospice nurses really need to be able to relate to the patient in their personal setting, not be set-apart; 2) Seriously? We are not a hospital where hierarchy and position are necessary or warranted; 3) White? Jacket? Dirt, heat, uncomfortable. The first time I wore my coat to a family home, I felt so self-consciousness as I felt as if I were purposely setting myself above my families - counter to my intended goal of being seen as approachable and compassionate. However, I found out a few surprising results, which is why I still wear my coat, especially in certain homes. 1) When I first meet a new family, which has mostly just been in the hospital, it gives me a certain appearance of knowledge - lame, I know, but it initially does set me apart as someone with knowledge, as in the hospital, floor nurses and techs, etc, usually do not wear them (please do not construe this to mean white coat = knowledge and all others are less-than!!) This has given my new families increased confidence that they are in good hands. Understand also, I did not need a coat for confidence and it did not increase my knowledge; 2) It provides a bridge of understanding that I am serious with why I am at the home, and I am professional; 3) And, in difficult cases, it provides an interesting barrier for those patients/families that are difficult with compliance or other issues - an extra appearance of authority. This was immediately obvious in 1 particular home where compliance by the family was tenuous at best.

However, now I have learned to how to wear it to the best advantage of the patient. If the family is non-compliant or difficult, I wear it all the time because I find a greater willingness of the family to listen and agree with a plan of action. And, if I am having difficulty with a male patient who wants to be too familiar with hugging or such, it does give me a professional barrier and has changed their behavior in turn. Finally, while I do wear it the first time I meet a family, often I do not wear it again as I am trying to instill a more compassionate and approachable demeanor.

I do hope none of this sounds elitist, as anyone who knows me would not ever conclude that about me, and perhaps it is all anecdotal "evidence," but, with families I know "before the coat," and "after the coat," I do see a difference in their attitudes toward me. Especially, when I need to be firm on an issue and visually remind a family member that I do have the knowledge and experience to educate and support the patient in a professional manner. Either way, the coat has been a useful tool for me in my hospice work.

[elkpark]

veggie530 said:

I think this topic demonstrates a lot of what's wrong in nursing.

I'll just leave it at that.

Really? How so?

[Jensmom7, BSN, RN]

veggie530 said:

I think this topic demonstrates a lot of what's wrong in nursing.

I'll just leave it at that.

You can't do a hit and run post and expect to be taken seriously.

What are your reasons? Have you formulated any personal bias for or against a white coat?

Also, this topic was started by someone who is taken seriously by very few, if any, of the people here. We haven't been responding to him, but rather to each other.

[DT56]

Lab coats are professional and clean. You shouldn't be speaking for others who are professionals...

Drew Totten, MSN, BS, RN, CLNC

[Spidey's mom, ADN, BSN, RN]

elkpark said:

Really? How so?

Maybe the poster just means the OP's question?

It couldn't be what the rest of us are doing, right? Because the rest of us are kinda having fun.

[SpaceCadet77]

Simple answer is "scrubs". The care giving environment has changed...now the unit is inhabited by medical secrataries, EMR technicians, PT/OT, their aides and nurse's aides, housekeeping, and on and on. All of these people wear scrubs. The white coat identifies the nurse as such. It's an old fashioned but known nursing color. People have an idea who to approach in that sea of scrubs when they need care . That's why I wear the white coat.

[ctomrn]

I worked in a teaching hospital, there were literally hundreds of students, residents, docents and staff wearing white coats...as well as, lab staff, pharmacists, nurse managers, etc. Some of it is the culture of the institution, some of it may be their departmental requirements. I don't think I really gave it much thought. You could see them coming a mile away making rounds...a cluster of folks in long and short white lab coats! Funny now that I think about it!

Seriously, to me, I could care less about the white coat...as long as they are giving good quality patient care. The white coat is a "non-issue".

[SWAT_FOOL3]

I think the practice of wearing lab coats comes from a history of nursing and other medical staff wearing white. Nurses used to wear white uniforms, specifically white skirts (remember when sexism was also professionalism?) Also, doctors have always worn white coats, but now with the modernization of traditional hospital values, the white lab coat has been liberated. Now, it's not only for the status bearing doctor, but also available to other medical staff as well. As far as white lab coats being required, maybe it's not that, maybe it's something more practical... like the need to have extra pockets other than the ones on your scrubs. Maybe they're cold. Maybe those white lab coats are less expensive then the cute scrubs jackets or sweater-type pullovers they have on the scrubs sites.

On a different note, my mom has been an RN nurse for over 20+ years, and she's always told me that hospitals are also businesses. If appearance was not important, why would hospitals now be transitioning to nurses wearing one color uniform? For example, UC Davis Health Center in Sacramento, CA. All the nurses wear black. They can be readily identified and I've read in several nursing related articles, that the people in charge of changing and unifying nurse uniform colors state that black is "stylish" and that "everyone looks good in black".

But also yes, competence is first priority, but that doesn't mean there aren't other factors in play when it comes to professionalism, competence, and work priorities. Nursing seems to be a multi-faceted job. But this is just what I gather from my RN Mom. I'm still a Nursing student, so if anyone wants to bite my head off for not officially being a nurse, please do so with a grain of salt.

[PANYNP]

And every time you refer to an advanced practice nurse as a "mid-level provider", dear RN colleague, you are relegating yourself to a classification of "low-level provider".

Stop it, right now! Move away from the label of "mid-level" or "MLP". It is unacceptable, and sells short the education and expertise of advanced practice providers, whether they are NPs or PAs. If your organization persists in using the label "mid-level provider", resist, and explain to them the logic of RNs being ranked at the bottom of the pyramid as "low-level providers".

And I'll let the term "quasi colleagues" go without comment - your using this descriptor tells me more about you than I think you would want me to know.