Do you want a national nurses' uniform, or just a clean one?

17 April, 2010 | By Gabriel Fleming

Recent developments in nurse uniforms have provoked a furious debate among readers. Beyond the Bedpan stokes the fire

There’s nothing quite like a uniform to get you lot excited.

As Beyond the Bedpan goes to press, a Welsh scheme to introduce colour-coded uniforms is the most popular story on nursingtimes.net.

In short, nurses at West Wales General Hospital in Carmarthen will now be instantly recognisable by the colour of their uniform, with navy blue for ward sisters, royal blue for clinical specialists, hospital blue for staff nurses, postman blue for midwives, green for support workers and aqua green for nursery nurses.

The scheme was introduced after a report found that patients often struggled to tell the difference between healthcare assistants and registered nurses - or work out who was in charge of the ward.

It has been welcomed, with one sister at the hospital saying it had “enhanced the sense of pride nurses have in their profession”.

This would appear to be backed up by recent research, which found that “uniforms need to balance a professional and modern image while retaining an appreciation for nursing’s heritage. This will project a realistic image to the public and help nurses to form a positive professional identity.”

So far so good. But readers are not so sure. “Who cares?” asks one, “why do people need to know at first glance who we are? If it’s not obvious already then… my god. Aren’t these people the most ignorant of all?”

We couldn’t agree more. Next time a patient on your ward is in desperate need of help and confused about who to speak too, just scoff and ignore them. The ignorant fools deserve no better.

But seriously, readers comments eventually turn back to more worthy matters, like the need to make it crystal clear to vulnerable elderly patients who is who on the wards.

Another reader suggests it would be more helpful for trusts to take the cleaning of uniforms in-house, saving nurses a lot of hassle and vastly reducing the risk of infection in one fell swoop. The prospect of rushing into work, having had no time between shifts to wash your uniform, and then getting changed in a toilet or cupboard is one that nurses, quite reasonably, want addressed.

Are you in favour of standardised national uniforms, or would you prefer laundry and changing facilities, or both? Let us know in the comments section.

Readers' comments (59)

Mark Sheldon | 17-Apr-2010 7:41 am
A clean uniform provided by the employer with a suitable facility to change into it must be the number one requirement surely? However, having a national uniform will at least make it easier for me to recognise the job role of the professional standing in the supermarket queue in front of me. :-)
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Karen Gomersall | 17-Apr-2010 9:17 am
This is nothing new, nurses ans staff always wore different colours for recognition and the hospital arranged for the laundry but cost put a stop to this so we all wore white with a different belt colour and had to launder our own,which is when nurses started going home in uniform
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Anonymous | 17-Apr-2010 9:28 am
ms f nightingale had black and white and how many times did she wash it she gave care first?
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Anonymous | 17-Apr-2010 9:31 am
I have argued for colour coded scrubs for some time, as have many others, so why are we not listened to? I enjoyed your humour Mark and have to admit to being guilty of calling in the shop on the way home from, or the way to, my 12 hour shift but I do make sure I button my coat! Again, insufficient changing facilities. However, I have worked on the community and, as with all people in uniform in the community, I often picked my lunch up from the local shops. Neither did I change out of my uniform inbetween each house call. I currently have a colleague who believes that if she is walking through the hospital door on time then she is not late! Never mind the fact that she spends 10 minutes in the staff room putting her "face" on and then walks on the ward 10-15 minutes late. I dread to think how late she would be if she had to change her clothes as well!
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Anonymous | 17-Apr-2010 9:31 am
green sounds about right it goes well with vomit and poo!
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Anonymous | 17-Apr-2010 10:31 am
National uniform colours would be a plus to help the public identify who hospital staff are at a glance.
Nurses have been highlighting for years, in order to protect the public both in and out of hospital from infection, a hospital laundry service should be available for staff and used. In order for this to work we need enough uniforms and a quick 'turn-around' of uniform cleaning!
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Natalie Jewell | 17-Apr-2010 10:31 am
When I was a student I was told we had to wash our uniforms at 60 degrees. In one of my later jobs I checked the label in my uniform T-shirt and it said it could not be washed above 40 degrees. For infection control reasons I have no idea why any hospital would provide their staff with uniforms which cannot be washed at the highest temperature. Who knows when you start your shift what you will have on your uniform by the end of the day. Patients are at the very epicentre of care but, patients aside, I do not for myself wish to wear a T-shirt that is full of germs.
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helen feest | 17-Apr-2010 11:21 am
Let's all wear scrubs! The trust launders them, reducing the potential spread of infection. Ah! but what about the cost they might say! Issue addressed by removing the tax coding that is given to us ( if we apply for it, from our local tax office ) for doing our own laundry and putting it towards the NHS laundry budget. Problem solved, no think tank required, at a cost of goodness knows how much. Uniforms cost more than scrubs to purchase, it does not take an economist to do the maths, but apparently it is beyond managements short sighted vision.
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Lucy Florence | 17-Apr-2010 12:51 pm
I have to say, as a community staff nurse, when I walk into some of our residential homes and get mistaken for their cleaner or carer, I do feel I should be more recognisable to patients.
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Sandra Joyce Powell | 17-Apr-2010 1:19 pm
The least the NHS can do is provide nurses with recognisable clean uniform to perform their duties on the very vulnerable to infection wards. With all the bugs travelling around our hospitals we need to do our best to fight against them,If a nurse has to wash her own uniform the chances are that they will not be washed at the correct temperature only found in industrial hospital laundry's,i sometime think the cutbacks in the NHS are a little misplaced.

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shirley clements | 17-Apr-2010 1:21 pm
i agree with lucy, working in the community we are unrecognisable as nurses. carers and cleaners wear the same uniforms as us. how many times do you see someone in cropped trousers, flip flops smoking in public wearing a nurse type unifrom. who does joe public think they are? a nurse more than likely. remember we have a code of concuct to adhere to, wouldn't it be nice if we had a national unifrom that we could be proud of that would be easily recognised.
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Sue Bacon | 17-Apr-2010 1:35 pm
I agree with most of the above comments - it is very unprofessional to see nurses in shops with their uniform uncovered.
also thre variety in colour of unifrom around the country is vaste and extremely confusing to both staff and patients.
If there was a national 'scrub' type unifrom then it would be clear to all who was who.
I can understand someone who mentioned 'why does it matter?' as the care that is given is the important thing, but to patients it is important to know who they are talking to , especially if they give important information to the housekeeper about their health (who may not understand the importance) and not pass it on (this happened recently when a patient told someone that she had had DVT during a previous admission but it was not an HCP and thus not documented. - (lets not go down the road of 'should have been picked up before by someone else - that is another story'!) but just to point out the importance of knowing who is who on the ward.
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halfanurse1987 | 17-Apr-2010 1:55 pm
Us Scottish nurses are getting a nationalised uniform too. Its just taking a bit longer than the Welsh one to fully roll out.
The material of the new one is lighter (so no more overheating on the ward), is easier to wash and iron (and so look neat and tidy) and is all round more comfortable.
I just wish that rather a Scottish, Welsh and English uniform we could have a national British one. That way no matter what part of the country you get sick in you know who is treating you.
The next step would be to standardise uniforms in care homes too - I feel so sorry for the elderly patients these days. Hospitals are confusing enough without knowing who you are talking to.
Could I go a step further and ask for names and designation to be embroidered onto the uniform - I have lost track of the number of times I have caught my badge in plastic aprons, patients or staff arms when moving and handling, or sent it pinging across the ward. It is no wonder nurses put them out of site where they cant be seen - they are a bit of a hazard.
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Elizabeth Ferla | 17-Apr-2010 3:09 pm
I began my nursing carreer 1972, and we all wore uniforms that allowed patientts visitors and other staff to identify our role. Nothing new there.
I now work in an operating theatre. Every morning we have hundreds of trouser, but no scrub tops. Spend ages going through all the storage, laundry, bedding stores looking for them. Think this is a ploy to cut costs? Have us all work topless, save 50% on laundry costs!!!! The mind boggles!
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marilyn edwards | 17-Apr-2010 3:15 pm
This takes me back to student days...the same colours....but green for SEN's . We seem to have gone 3/4 of the circle - bring in a laundry servcie and we'll have done the full circle. It IS important that paitients can identify who they are speaking to. As a nurse, gaining the buckle and red belt was the ultimate accolade - senior staff nurse. Those were the days.... no shortage of jeye clothes, soap, nighties, pillows ....
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Anonymous | 17-Apr-2010 4:22 pm
Love your articles, they make me smile every time.
We're in the process of having these new scrubs, and are waiting for measuring and fitting.
But guess what? On the date it happens I (and I'm sure quite a few others) will be on hols. So I will miss out on this. When I enquired, the rather helpful/less manager (delete as appropriate), said I would have to have what's left over: Also, if I didn't turn up, there would be no guarantee that I would even get one.
Seeing as I will actually be abroad at the time, I'm not really sure that BA can lay on a special jet to nip me home halfway through.
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susan mcconnell | 17-Apr-2010 4:50 pm
Hi,
I remember working in a NICU in the UK many years ago. We had to change into their own scrubs before entering the unit as you would if working in the operating theatre. There were often no 'correct' sizes left on the shelf when you arrived in a hurry to get to report on time. I remember trying to squeeze into a tiny top and wearing huge outsize 'clown's' bottoms held up with tape and running down the corridor for report dressed like an idiot!
I hope they get that bit right if they do decide to provide scrubs or uniforms for everyone, never mind the colour!
At least you can wear a plastic apron over your uniform in the UK. Here in the US they don't have that protection and most if not all staff go home in their work scrubs. Lockers are available but there is not enough for everyone and they are very small.
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Anonymous | 17-Apr-2010 5:44 pm
At the moment I work in a path lab, and am going to return to nursing at some point. Our lab coats go to the laundry. They invariably get sent to the wrong destination once done, so I end up taking home my one available lab coat to wash myself or look filthy . My manager has failed to find me size 33" lab coats so for 4 years have been using 2 or 3 which others have left there. Everyone else has half a dozen brand new ones. When the coats finally get back to you (it takes weeks) they don't look any cleaner and you end up saying 'are these the clean or dirty ones?' Uniforms shouldn't go home or to the shops what are we spreading? I put mine in a carrier (yes mine is easier I know) but ideally staff should have loads of them so every day is a clean day, and hospital laundries should do them.
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Anonymous | 17-Apr-2010 6:32 pm
How i have laughed at all the comments made by others. We have had scrubs at our trust for the last 18 months or so, we launder them ourselves. Lovely germs in my machine. we were asked for sizes. i have 3 sets all medium. I have medium that comes to my thighs size top and medium that cuts across my hips size top which rips up the sides when ifill my pockets with nursey things. I have trousers with deep pockets and trousers with pockets that rip to match my top. trained nurses are royal blue, untrained pale blue, and sisters navy blue. Great, easily identifiable you think, no, on a care of the elderly ward those with poor sight think anyone stood at the foot of the bed is a nurse, you could wear jodpurs and a riding hat and you would be called nurse. so a standard uniform doesnt work here. Incidently, when my mother-in-law first saw my lovely blue scrubs she stated oh, is that what you wear when your uniform is in the wash!!!!!
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mike | 17-Apr-2010 11:19 pm
There are quite a number of issues that have been brought up here and are part of the same debate.

First is the issue of a national uniform. A uniform is vital in creating a cohesive professional identity (which nursing lacks), creating pride in ones profession (which nursing sorely needs) and for ease of identification for the general public. The uniform for professions such as ours becomes so much more than simply a piece of clothing, it becomes a symbol. All relevant public service professions, the Police, Military, Paramedics, Fire Service, etc ALL have an instantly recogniseable uniform, and this not only creates a sense of professional pride and 'belonging', but allows the public to identify them instantly. This is not a trivial point. We should have a uniform that easily identifies us as qualified, highly educated and skilled Staff Nurses. It is very easy to have a rank system incorporated into that (just look at the military or police). This uniform should be protected legally, and should not be allowed to be imitated by cleaners, hairdressers or anyone else trying to bask in our professional light.

The uniform itself, scrubs/vs tunic is a different matter. Pesronally I think that it should be more along the lines of the traditional tunic and trousers, but the tunic should be made of a much lighter, thinner and more comfortable material so we are not sweating five minutes into a busy shift, resuscitating someone or or whatever. Colour wise, Nurses have traditionally worn blue, so blue should be for qualified Staff Nurses with Navy blue/blue variations to denote rank.

Now the whole infection control/wearing uniform outside of work debate. As I have said previously current evidence shows that it just doesn't matter, infection control IS NOT compromised by wearing of uniforms outside of work.

Therefore I think if we are to be forced to NOT wear our uniforms outside of work, then we should be allowed to force all Doctors/specialist Nurses/speech therapists/nutritionists etc who all come into work in their OWN clothes to wear a hospital uniform, and ban all patient visitors who after all come in their own clothes then quite happily get on public transport/go shopping etc afterwards (and a lot of visitors I have seen have way more questionable hygiene standards than the staff!) or why stop there? Why not stop patients themselves from having their own clothes brought in? Wards are NOT sterile quarantine areas, so why should Nurses be held up to a different standard as long as we follow hygiene/infection control practices at work?

Finally the trusts themselves are supposed to provide us with proper changing rooms for each ward, they never do. I refuse on point of principle to get changed in a cupboard or a toilet, and after a long and tiring shift, often after being forced to stay longer as it is due to some patient emergency or the workload or whatever, I am not taking even more time out of my precious free time to get changed, unless I start getting paid for that time, or time is given specifically for me to do so during my shift.
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