What Nurses Wear

“Nursing is made up of little things; little things they are called, but they culminate in matters of life and death” Florence Nightingale

I have become all too aware of the breadth and complexity of nursing today. With some 57,000 nurses and midwives working in Scotland – in hospitals and within communities, not only practicing care but advocating, researching and teaching, I look for points of connection, those little things that catch my attention and provide a way in to writing and thinking about nursing today. Writing too is made up of little things, an accumulation of words where everything can turn on a small, telling detail.

child's nurse costume

Lately I’ve been thinking about what nurses wear. The design of nurses’ clothing has always been driven by a certain functionality yet when you compare nurse uniforms of 100 years ago to the current uniforms being adopted in Scotland, the changes are radical, boggling even.  It’s not just about the development of easycare materials, but reflects a literal loosening up of the constraints that working women were subject to, and more particularly the roles that nurses occupy.

painting by William Hatherell ©IWM (ART 5234)

Around the time of the first world war, many nurses wore long white veils and floor length gowns and aprons. It’s no accident that they look like nuns, it’s a deliberate reference to the origins of organised nursing within the convent hospitals of Europe. Over the years the veils got shorter, and sat in elaborate shapes on the top of heads. The white aprons remained too, making nurses visual sisters to maidservants and waitresses. 

from the 1970s TV series, Angels

Capes and big belts lasted into the seventies, but in the last couple of decades, we have seen a shift to the simple, androgynous ‘scrubs’ type of clothing influenced by the US. By the end of 2012, all nurses in the NHS in Scotland will be wearing the uniforms modeled below, with different roles and hierarchies denoted only by subtle colour coding. The impetus behind this is to help patients identify who is who, but from the outside perhaps it’s not that obvious. The materials and cut are chosen with regard to washability and hygiene rather than aesthetics. That much is obvious.

new national uniforms © Scottish Government

In my posting about nursing in Malawi, you’ll see that nurses there, as in many developing countries, still wear caps and dress-like uniforms, but in North America and Europe, skirts and hats have disappeared. If you go to buy a nurse outfit for a child, however, it will have a little white hat, as well as a blue dress and apron, and assorted accessories – a stethoscope and upside-down fob watch. If your child is a boy, you won’t find a male nurse costume. Popular imagination is on a time lag as regards what a nurse looks like.

Male nurses never wore little white caps. For a while they looked like dentists. This new simplifying of the uniform is also a way of acknowledging that things have become more egalitarian –nurses may be male or female, surgeons and health care assistants can be dressed similarly, and increasingly care is delivered by teams of differently skilled people working together –ideally with the patient as the focus, not the internal hierarchies.

This is Elsie Stephenson in a photo taken during her nurse training in the 1930s. Elsie went on to be the first head of Nursing Studies here in Edinburgh. Her outfit is so crisp, so constraining at chin and neck and waist it practically makes me itch to look at it. The neatness of a nurse's uniform in that era was an outward manifestation of the discipline and attention to detail that were seen to be central to a nurses’ being. That and an unquestioning obedience. It wasn't so different to being in the army.

Scrubs, on the other hand, are clothes that you can throw on and not think about. But it does make me wonder if anything is lost in this casting off of the traditional idea of what a nurse looks like. And I'm interested to know - does anyone have nostalgic feelings for the nurses’ cap and uniform or is it a case of good riddance and don't look back?