The uniform.....

I'm glad you all enjoyed the old photos of the nursing uniforms and the transition of the nursing uniform.

As I mentioned in my post yesterday, I used some of those photos in a power point presentation I had done for a course along with a paper and lesson plan I written, I titled it

"Nursing - Do the clothes really matter? The Nursing Uniform and its effect on Caring in our profession".

In doing my research for the assignment I found many articles about the uniform, why it came to be,why it changed, and people's perception of the nursing uniform. What I found most interesting was the impact the changing uniform had on patients. One of the articles I referenced was from The American Journal of Sociology...the author of the article had this to say about the uniform....

"The uniform is viewed as a device to resolve certain dilemmas of complex organizations-namely, to define their boundaries, to assure that members will conform to their goals, and to eliminate conflicts in the status sets of their members. The uniform serves several functions: it acts as a totem, reveals and conceals statuses, certifies legitimacy, and suppresses individuality. The interaction of these components and the acceptance or rejection of the uniform and its associated status by the wearer are described."

Another article I referenced in my paper,was one that was a result of research done by a, Professor of Psychiatry in Lancashire England. It appeared that in over a 3 year period there had been numerous requests for the staff to go back to wearing uniforms. These requests came mainly from relatives, service users and in-patient staff. The reasons given for the request were in relation to clearer identification of staff, ,better boundaries with patients and more professional rapport, which would lead to a better established alliance. It was determined that this would apply to all the in-patient psychiatric wards, including the psychiatric intensive care unit, and rehabilitation wards. What I found most interesting about this article was that it was the patients requesting the change for the nurses to change back to the uniform as the patients felt it helped them set boundaries.

You use to be able to identify where the nurse had trained based on the uniform. There was much pride that came along with that. Up until the 1970s, when hospital rules about wearing uniforms became less strict, nurses wore the uniform and cap from the nursing school where they completed their nursing training. Each school had their own uniform and cap design as well as methods for indicating the level of training the student had received. When the student first began their training they would wear the school's uniform and once they had successfully completed their probationary period they would be presented with the school's cap. After the 1940s the presentation of the school's cap took place at a "capping ceremony", which signified that the student had completed the first major step to becoming a professional nurse and that they were now officially accepted into the nursing school.

Times have changed. With our male counterparts entering into nursing the uniforms needed to be inclusive.

Victoria General Hospital Nova Scotia Canada 1892

As evident by this picture the male nurse uniform was very different from the female nurses and hence were often mistaken for the doctors and were given more privileges than their female counterparts.

Victoria General Hospital Nova Scotia Canada 1925-1928

You certainly could tell who was your nurse in those days. Here are some photos of uniforms we wear today....

Now I don't know about you, but I for one don't wear anything as bold as this, well maybe the lavender one in the middle. When I started nursing I wore the white dress the heavy duty stockings and white shoes, when I went into critical care that is when hospital funded uniforms for ICU staff, so we would change into the hospital uniform when we arrived. This I think brings to mind the infection control aspect of the uniform. Leaving your dirty uniform at work for them to sterilize to me is way better than bringing those germs home to my family. So when it comes to patients not being able to distinguish the nurse from other health practitioner's, I think the bottom line is, as professionals it is our responsibility to identify ourselves to our patients, wear our ID badges, and when another health care professional other than a nurse enters the room it is their responsibility to identify who they are and what department they represent.

So do the clothes matter? I am of the opinion that nursing practice should be based on a personal commitment to caring from a health promotion perspective. If in the case of the mental health patients they find our attire having a negative effect on them, then we as nurses should consider wearing something else and if that means going back to an identifiable uniform then so be it.