Perceptions of nurses' uniforms

A scoping review exploring people's perceptions of healthcare uniforms

BACKGROUND

Healthcare staff uniforms are a subject of debate in the UK, and this is particularly true in the case of less understood roles such as advanced nurse practitioners. Aim: This review explores what is known about people's perceptions of health professionals' uniforms.

METHOD

A mixed methods scoping review following the Joanna Briggs Institute (JBI) methodology. Five databases (CINAHL, ASSIA, PsycINFO, and EMBASE) and several search engines were searched. Eligible reports were peer-reviewed English-language studies using any methodology to explore people's perceptions of different uniforms for health professionals.

FINDINGS

Forty-six studies (mainly from North America) were included, presenting a variety of perspectives on the uniforms worn by doctors, nurses and other health professionals.

CONCLUSION

Culture and context likely influence how uniforms are understood. Practitioners should consider how this may affect communication with both patients and colleagues. What health professionals wear matters, particularly in relation to less well understood roles.

Nurse uniform wearing practices and associated factors among nurses working in Northwest Ethiopia: a cross-sectional institution based study

Background

Wearing uniforms help in the formation of professional identity in healthcare. It fosters a strong self image and professional identity which can lead to good confidence and better performance in nursing practice. However, most nurses in Ethiopia are not wearing nursing uniforms and the reasons remain unclear. Therefore, the aim of this research is to assess nurse uniform wearing practices among nurses and factors associated with such practice in hospitals in Northwest Ethiopia.

Methods

A hospital based cross-sectional study was conducted from March to April, 2014 in five hospitals located in Northwest Ethiopia. A total 459 nurses participated in the study. Data was collected using a pre-tested self-administered questionnaire. Descriptive statistics were analyzed in order to characterize the study population. Bivariate and multiple logistic regression models were fitted. Odds ratios with 95 % confidence intervals were computed to identify factors associated with nursing uniform practice.

Results

Nurse uniform wearing practice was found to be 49.2 % of the total sample size. Around 35 % of the respondents that did not implement nurse uniform wearing practices stated that there was no specific uniform for nurses recommended by hospital management. In addition to this, nurse uniform wearing practices were positively associated with being female [AOR = 1.58, 95 % CI (1.02, 2.44)], studying nursing by choice [AOR =3.16, 95 % CI (2.03, 4.92)], and the appeal of nursing uniforms to nurses [AOR = 3.43 95 % CI (1.96, 5.98)].

Conclusion

Nurse uniform wearing practices were not exceptionally prevalent in Northwest Ethiopian hospitals. However, encouraging students to pursue interest-based careers and implementing a nurse uniform wearing policy may have the potential to improve such practices.

Electronic supplementary material

The online version of this article (doi:10.1186/s12912-015-0117-3) contains supplementary material, which is available to authorized users.

Patient perception of contemporary nurse attire: a pilot study

Patients have expressed difficulty accurately distinguishing registered nurses (RNs) from other hospital personnel because standardized uniforms are no longer worn by RNs. According to American studies, such complaints are widespread; moreover, patients' perceptions of nurse caring and competence and of other traits associated with nurses' professional image have been negatively affected by casual, non-conventional attire. As there are no published Canadian studies, we conducted a pilot study to examine patient perception of the nurse uniform. Adult patients viewed photographs of the same RN dressed in eight different uniforms and rated each uniform according to 10 traits associated with nurses' professional image. The white pantsuit scored higher for professionalism than uniforms with small print, bold print, or solid colour, and most patients preferred that the RN dress in white. Our preliminary findings suggest that RN attire warrants further investigation, and we are planning a large-scale, fully powered study to inform patient-driven change to existing uniform policies.

The professional appearance of registered nurses: an integrative review of peer-refereed studies

BACKGROUND

There is a paucity of research examining the impact of standardized uniform style and color for registered nurses (RNs).

OBJECTIVE

The aim of this study was to appraise published peer-refereed studies on the effect of a standardized uniform style and color for RNs.

METHODS

Seven peer-refereed studies exploring standardized uniforms for RNs were identified. Using the Oxford Centre for Evidence-Based Medicine evidence hierarchy, each study was assigned a level of evidence and overall rating.

RESULTS

Data suggest that patients felt that RNs appeared professional and were easily identified by a standardized uniform style and color. No strong evidence supports a patient's preference for a specific style and color of uniform.

CONCLUSIONS

Findings are inconsistent but demonstrate that a standardized uniform style and color increased the perception of professionalism and recognition of RNs among patients.

Patients' perceptions of today's nursing attire: exploring dual images

OBJECTIVE

To determine what image is conveyed to patients by 3 different nurse uniforms.

BACKGROUND

With the shift from the historical "single note" white nursing uniform to the current cacophony of uniforms, it is difficult to recognize the registered nurses. Uniforms are nonverbal messages sent to patients, making it critical to know what images patients associate with different uniforms.

METHODS

One hundred eighty patients (convenience sample) in a Pacific Northwest hospital completed a 13-item survey asking for perceptions of 3 nursing uniforms. Participants selected 1 of 3 nurse uniform photos that best reflected each of 10 characteristics and 3 overall images.

RESULTS

Using descriptive statistics and multivariate analyses, 2 themes for images emerged; the first is described professional and the second, approachable. When demographic variables were included, 4 generational-age strata yielded these same themes. However, different uniforms were selected for the various characteristics by age. Patients in the Seniors category consistently chose the white uniform for both themes, whereas Generations X, Y, and Baby-Boomers chose a uniform with a print as being approachable.

CONCLUSION

The dual images of nursing present a challenge for nursing leaders deciding whether uniforms should be standardized for nursing staff. Complicating this issue are differences in perceptions among the 4 generational ages.

The symbolism and myth surrounding nurses' uniform

This article addresses nurses' uniform from the perspective of the symbolic, myth, legend and competing discourse. The analysis touches upon why nurses working with people who have learning disabilities discarded the nurses' uniform and why other nurses may consider doing so, particularly if suitable alternatives exist. The analysis draws from various areas of nursing practice, including the nursing of disabled people, elderly people and people with learning disabilities. Nurses' uniform is revealed as a totem of considerable potency such that to wear a uniform in just any setting or context has to be cautioned. The practicalities of protective clothing are addressed. A differentiation is drawn between uniform and protective clothing such that much of the undesirable symbolism associated with uniform may be discarded with a consequent enhancement of the image of the nurse.

Bringing support home for families of children with cancer

The Macmillan paediatric service at Southampton has grown in the context of an established service and in response to the perceived needs of families. In the environment of an internal market, care provided must be more explicit to inform decision making regarding its continuation.

Nursing uniform preferences of parents and children in a paediatric setting

There is a growing movement towards more casual uniforms within paediatric nursing. However, children's and parents' preferences should be considered before deciding what type nurses should be wearing.