Dress codes are standard practice in many professions. In nursing, however, how nurses dress can influence patient care and satisfaction. Since insurance reimbursements now rely heavily on quality-of-care metrics, dress codes matter more than ever. Nursing administrators are often responsible for determining appropriate dress codes for their staff, so students completing a Master of Science in Nursing Administration (MSN) program can expect to examine this topic.
History of The Dress Code
One of the most important reasons for a dress code is to establish professionalism. Nurses must represent their employers in a positive light — their appearance is an important part of this responsibility. In the past, dress codes for nurses were strict and often included a uniform skirt, nursing cap, hose and plain shoes — typically white.
Uniformity gave way to individuality over the years as scrubs, in a variety of patterns and colors, replaced traditional attire. Colorful sneakers and clogs replaced white nursing shoes and hose, and nurses could finally express themselves a bit more.
In 2014, Geisinger Medical Center in Pennsylvania surveyed patients about nursing attire. Fifty-seven percent of patients felt it was challenging to distinguish licensed nurses from licensed practical nurses or nursing assistants. Seventy-four percent of respondents believed that nurses wearing identical uniforms communicated more professionalism. Fifty-nine percent of patients preferred solid-color scrubs — 95 percent ranked navy as the most professional.
Other studies support these results. When asked to rate the professionalism of a nurse based solely on a series of pictures, respondents preferred a standard uniform style and color. Further research indicates that patients view nurses wearing solid-colored scrubs as more skilled than those wearing patterns.
Nursing dress codes go beyond scrubs and shoes. Piercings, tattoos and jewelry can be distracting for patients. Even personal preferences like hair, makeup and perfume can affect how patients regard nurses and the quality of care they receive. For example, when shown images of a nurse with visible tattoos or piercings, patients rated the nurse on the lowest end of the scale in terms of knowledge, aptitude and compassion — regardless of the nurse’s gender. Patient perceptions like these can make it difficult for nurses to establish trust with their patients.
In response, many employers have revised their dress codes to include additional guidelines regarding body art and uniforms. Some have designated specific scrubs for licensed nurses, based on the nurses’ specialties. Geisinger Medical Center now requires licensed nurses to wear gray and white scrubs bearing the facility’s logo and “registered nurse.”
Dress Codes Matter
While something as simple as a dress code may seem trivial, it can have a significant effect on how patients perceive the quality of care. Misperceptions can even hinder nurses’ ability to establish trust with their patients. A standardized nursing dress code can improve nurse-patient interactions and increase patient satisfaction.
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Petrilli, C. M., Mack, M., Petrilli, J. J., Hickner, A., Saint, S., & Chopra, V. (2015, January 19). Understanding the role of physician attire on patient perceptions: A systematic review of the literature–targeting attire to improve likelihood of rapport (TAILOR) investigators. http://bmjopen.bmj.com/content/5/1/e006578.full
West, M. M., Wantz, D., Campbell, P., Rosler, G., Troutman, D., & Muthler, C. (2016). Applying Evidence Based Practice to Support Changes in Nursing Dress Code Policies. http://www.medscape.com/viewarticle/865170
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