I've come full circle regarding professional attire. I've returned to wearing white uniforms.
At my first job after nursing school, in 1979, I wore white uniforms. It was common practice then; crisp white dresses and pantsuits abounded in uniform specialty stores in almost every city. I even owned a pair of those sensible white oxfords.
A year later, the dress code at the hospital relaxed, and we were allowed to wear colored tops. So I donned colored turtlenecks with white skirts and a lab coat; I looked neat and professional and could still be identified as a nurse. Soon after, I started working in a critical care unit at a large urban teaching hospital, where the critical care nurses were given hospital blue scrubs. We saw these as a status symbol-they set us apart from other nurses and made us look like the interns we practiced beside. Unfortunately, some of us looked more like interns who had just rolled out of bed after a long night on call. The scrubs were often wrinkled, torn, or poorly fitted. Only my name tag identified my profession, and although I wore it every shift, I wonder how many confused or visually impaired patients knew I was a nurse.
When I moved into yet another job-this time as a clinical instructor-I chose to wear uniforms instead of street clothes. They were easier to take care of and allowed me to make fewer decisions at 5 AM. But uniforms had fallen out of favor with my colleagues, and the specialty stores I used to frequent were out of business. A mail-order catalog found its way across my desk, with brightly colored and patterned scrubs on every page. In it, I found what I was looking for: a neat and professional-looking uniform that still allowed me to express myself. These were scrubs, but of much better quality than hospital blues.
But when I appeared in my rose-colored scrub pants and top during a clinical rotation at a long-term care facility, I was mistaken for the ward secretary, who was required to wear pink scrubs. All the nurses were in white. This didn't bother me as much as did the patients' reaction. On one occasion, a 98-year-old man refused medication from one of my students (who was also wearing colored clothing) and then from me. When a staff nurse intervened, he swallowed the pills promptly, telling her we "didn't look like nurses." When I arrived home that day, I dug out the mail-order catalog and ordered the one white scrub dress on the back page.
I wore it the day after it arrived. As soon as I put it on, I was transformed, feeling confident, proud, and energetic. But on entering the unit, I felt a little conspicuous. What would my students think? How many times had they expressed jealousy of my informal attire, eager to be rid of the green striped shirts that marked them as students?
As I walked down the hall with a bounce that I hadn't felt at 6:30 AM for a long time, I thought of my former nursing supervisor, whom we called "the white tornado." She'd materialize before you could finish paging her, solve the problem at hand, then disappear, leaving utter stillness in her wake. Dumping alcohol over her feet to revitalize them, she'd speak of the good old days when she worked double shifts.
Now, when patients refused medications from my students during med rounds, they willingly accepted their medication when I arrived. And a man with dementia and anxiety, who had refused help from students, only stopped yelling "Help me!" when I appeared. Although I was a stranger to theses patients, they were elders and accustomed to nurses wearing white. In my white uniform, I didn't have to explain myself.
The "nurse in white" emerged in the early 1900s when nurses were trying to dissociate themselves from the profession's previous drunken, unkempt image. Until then, they had worn the dark colors characteristic of nursing's military and religious roots. The white uniform-representing purity and virginity-offered the image they sought. But in the last few decades, nurses of both sexes have rejected the hand-maiden image. And the assignation of white as a symbol of good can be distasteful to people of color. Still, as I've become more independent and confident professionally, I've embraced the white uniform for several reasons.
First, I want to set standards for my students, whom I hope will think twice about going to work looking like they're in their pajamas. Also, I want my professional life to remain separate from my personal life, and attire makes that distinction. Mostly, I want patients to recognize my role without explanation; so much else needs to be taught.
People often complain about not being able to identify caregivers in modern hospitals. A nurse's very presence assures patients that a competent professional is caring for them. As long as a white uniform helps establish this, I'll wear one. Just stop me before I resurrect my cap!