Color-coded care?

This isn’t a relatively new topic, but it’s a hot topic still up for debate. What do you think about mandating nurses to wear a specific colored scrub uniform?

I myself have had 2 reactions to this problem. My first reaction was a defensive reflex. “What do you mean requiring me to wear a specific uniform?” Are you paying for it? What the heck? What’s wrong with what I have been wearing for years?

I can’t say I was agreeing or disagreeing with this, I just questioned the notion. Honestly I have always only worn one uniform color of scrubs. I’ve never been one to wear the patterned scrub outfits (I hate to say it – is it because I’m a guy?).

I also starting having this overwhelming nightmarish vision of nurses being in all white again. Whether good or bad, I really can’t say I ever liked the stereotypical all white uniform, or the cap, or the skirt, or polished white shoes. Maybe it’s just me, but when I see an all white uniform I think of the orderlies who work in the psychiatric ward (yes, I fully admit to watching too much television). I guess I just feel that we as a profession have grown and evolved beyond what that uniform represents. We are not hand maidens, nor are we subordinates. We are independent thinkers and patient advocates who demand and require a great deal of critical thinking skills and knowledge. I despise the ‘I’m just the nurse’ attitude and answer.

So, color coded professions ehh? I’ve learned that the movement to go back to all white, or at least one color is motivated by those wonderful people from Press-Ganey. For anyone that has some familiarity with this program, company and service, they provide a measuring tool for how well a certain facility, profession is doing their intended duties. Patient satisfaction is the cornerstone of nursing, and Press Ganey has become the experts on patient satisfaction. (If you’ve ever been a patient, you get a lil’ survey during or after your stay – asking how your stay was)

So, patient satisfaction scores (from surveys) has informed us that most patients have no idea who is going in and out of their hospital room because of all the multiple outfits, uniforms, colors, etc. Are they a doctor? A nurse? A surgeon? A radiology tech? The list goes on.

It was discovered that patient satisfaction increased when the facility made each department and service have an exclusive color/uniform. When a person in a ‘white uniform’ entered their room – even if they weren’t told, they assumed and knew it was a nurse. This is unfortunately due to the stereotype I talked about earlier.

I for one really hate the all white uniform, but I’m all about providing the best care possible for my patients. While I’m joining the ranks of complaining of solid colored nursing uniforms and the all white persona, how can I / we argue with an intervention that increases patient satisfaction?

I’d love to hear you thoughts on this one.

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18 Responses to Color-coded care?

  1. It’s simple: you actually introduce yourself and talk to your patients!

    I do believe however that the proliferation of scrubs into every subset of does make it difficult for our patients to correctly identify who is the nurse, the tech, the housekeeper and on which is why I think it is so very important to introduce oneself when doing anything with our patients.

    The other intervention is to tell Press-Ganey to take a long walk off a short pier…

  2. Sean Dent Scrubs Blogger

    @ Wanderer Great point! I’ve always preached that. And I don’t think there are many ‘fans’ of Press Ganey out there. *wink*.

  3. Elisabeth

    Definitely agree with Wanderer here, ALWAYS introduce yourself to your patients. I’ve noticed most nurses do this, but many doctors and specialists just wander in to the patient’s room and start talking at them without even a hello. By the way, isn’t introducing yourself to patients one of the first things things you learn when you’re a student? I know it was drummed into us when I was studying. In regards to the colour coding thing – I’m in two minds. Most people have to wear some kind of uniform anyway, so does it really make that much difference? On the other hand, I’m not sure it’s really necessary. At the hospital where I work, nurses are ‘suggested’ to wear black pants and a white top (not a specific type, just something in those colours), but many wear whatever colour top they want, and no one seems to be having any trouble figuring out who’s who. I should also mention here that the doctors just wear business clothes (only wear scrubs in theatre and emergency) and physios etc just wear their usual shorts and t-shirt gear. Seems to be working for us.

  4. Nikki

    I personally disagree with color coding… I work in 2 Hospitals. one is a small hospital that has the color coding uniform. and the other is a big hospital with freedom in choosing your colors or patterns as long as you look professional. and believe it or not the patient satisfaction scores in the big hospital are much better than my small hospital. I refuse to believe that the color coding has any direct effect on a patient’s satisfaction. like Elizabeth mentioned the trick is introducing yourself properly. I think perhaps when a hospital has nothing better to offer to increase their scores, they’ll try anything. Happy Nurses & Staff is what will really give them Happy Patients.

  5. Gina

    I am the psych nurse mentioned and it was actually when still working in a nursing home when they finally said we didn’t have to wear white- then I didn’t wear it until nursing school ( Excelsior College- my clinical). After that, NO MORE WHITE!!! And in psych, they recommend colors or even street clothes as it can be less intimidating to the patient.

  6. Gizzy

    I feel that I should be able to wear whatever scrubs I want to wear. If I feel good about what I am wearing, then I will be happier while doing my job. I always introduce myself to my patients so there is no confusion. I also agree Happy Nurses will help make patients happy.

    Gizzy, LPN

  7. Kevin, APRN

    I have to admit I’m split down the middle on this topic. I see at my hospital, maintenance people medical assistants, cafeteria staff all in scrubs and everyone else not in the white.gray or blue lab coats identified as nurses. Because of this, sometimes, nurses get a bad wrap at my hospital, and like you, I wear solid colors and my patients always know who I am and what my purpose is in coming into their lives. I will not wear the antiquated virgin colors of white that represented us when we were seen as nothing more than the hand-maidens of the physicians, we have evolved as well as the role of women in our society and although our profession is a predominately female profession we are not all females. The only cap that goes on my head is a baseball cap!! For the life of me, I don’t know how the past generations worked in that quasi-nun looking outfit with people losing fluids around them in every way imaginable and still managed to stay clean without changing their clothes every 15 minutes. Why not color-code the IDs, that would make more sense. No butterflies, effemenate colors, teddy bears or flowers just simple solid color coded IDs.

  8. Chanda Kim

    I’m all for uniforms that colour code. I totally understand that feeling of not knowing who the heck you are dealing with because everyone is wearing scrubs. I think the facility should chose the colour nurses wear and not head to white. I think we all know white is incredibly impractical. Many of the hospitals in my area do colour coded uniforms for disciplines and I think it makes everything look very proffesional. I mean I hate being in the hospital ER being looked at by a nurse wearing Winne the Pooh scrubs. Sorry but you come at wearing those and my first reaction is “Whoah dont you belong in the nursery?”: not, “Ok here is a competent nurse” Let’s be honest first impressions matter, and I also think that this is a more relevant matter for hospitals and short stay facilities, I work in a LTC facility where I know every patient by face, name and preference and they know me. I can understand it though when you are in a hospital and the staff is nearly never the same for your stay. I would like to be able to go, “oh that lady is wearing blue therefore she is nurse so I can ask her this…” instead of grabbing the first person in srubs and asking for my pain meds and fnding out she is housekeeping.
    While I totally agree with introducing yourself well I also have noticed while I was a student that patients are less likely to be communicative when they are feeling unsure as to who is who. Because I was a student in a colour coded uniform (green and white!) they able to identify me easily. Lets be honest, there are days when my mind is so on other things I could have a 5 minute conversation with a person and still not remember their name. Lets think about how stressful a stay in a hospital is and what is on our patients mind. Also just because you introduce yourself does not mean you will always be visable to your patient. It’s not like we have mastered the ability to be everywhere at the same time. For some people it is simply comforting to know that every person in blue scrubs are nurses so you know that if you cannot find YOUR nurse you can at least identify and locate A nurse.
    I’m not advocating to go back to white but I am simply sharing a different outlook, many of the comments here are fousing on how WE feel about the issue, lets take a moment to remember our focus is on the patients. Sometimes it’s just about being able to identify everyone around you. Think about it this way too, all the patients in a hospital wear the same gown, do you think they like that much? But in the back of your mind you see that gown and you are like “patient”.
    One last point, make a point of getting involved if your facility is considering going colour coded. Mine is considering and we asked if the different disciplines could submit a few colour suggestions we would like, we were told that was a great idea and were offered a dozen colours to narrow down to 3 for nursing. The whole staff took a vote and we decided on a colour we could all live with (Pewter grey!) and Fridays are our “casual day” where we can wear anything. Honestly a unifrom isnt the end of the world, I think almost all of us have had a job where one was necessary, it’s all in how you approach it. Look at yourself in the mirror and say “I rock this’s me that makes it look good” and you will have a better day guarenteed!

  9. Good post, we BTW use for keeping a tab on patient feedback. Works out well. Makes the staff also think twice about how they treat patients. Plus, all staff wears a name tag just to make sure they know patients can see who the person is.

    Also, this is helping out to let go staff who are not doing a great job. What better way to document something that is provided to you by patients themselves.


  10. Sean Dent Scrubs Blogger

    Wow! Thank you everyone for all your wonderful comments and thoughts. I too strongly agree with how you introduce yourself and provide your care will define you as a nurse – not your scrubs color.
    I think we could find a healthy & happy balance to provide the best experience for our patients, without pasting yet another policy or stigma to it. I guess it’s a battle with the already existing stigma of the all-white uniform that causes such a snag in this equation.
    Thank you all once again for your wonderful comments.

  11. Janet

    I am totally oppossed to the one color uniforms. I was around for the all white garbage. To this day I don’t even own white underwear. It is just another way to take away any control over any choice we may have. I will spend less mone as i will only buy 2 and wear them until they fall apart. I introduce my self, wear a name tag that clearly says RN and write my name and CNA name on a board. Belief me the pt that want dilaudid always remember my name both in the hospital and if I see them in the store later. It is total bull.

  12. Sean Dent Scrubs Blogger

    @ Janet I don’t think a lot of nurses would argue with that thought.

  13. Gail

    We are now looking at this color coded scrub issueat work, with much controversy. How does it improve patient satisfaction? Working in the ER, I will guarantee you that the person who is in.. 1.)C.A. and we save, or the person who is in resp. failure, or any other magnitude of EMERGENCY situations do not give a damn about what we are wearing, just the results. 2.) The children and mentally challenged LOVE our kid friendly scrubs. 3.) How well does charcoal work out on whites or light scrubs? 4.) When you have a complaint or compliment it is MUCH easier to figure out whom we are talking about.
    Yes , if we are in a business setting we would have to buy our own suits… BUT we buy what we want to wear. If the hospital wants to go 1 color then buy that color for us. I will not put a dime into it. When it gets stained for whatever reason, yep I will wear that too. Janet, I 100% agree with you!
    I can bet that if you TALK to your pt and keep them INFORMED the PRESS-GANEY will improve. We ranked 99% without the scrubs. Now, it has dropped significantly since the proposed implementation of taking away our AUTONOMY.

  14. Sean Dent Scrubs Blogger

    @ Gail All very valid points, and a lot of nurses would agree with your thoughts. I guess it really depends on the facility, but it seems that the majority rules no matter where we work.
    One’s interpretation is one’s reality.

  15. Sherri

    I’m an ultrasound tech in a large hospital that was once all color-coded, then changed to allowing us to wear what we chose and now has all nurses in ceil blue, clerks in red and black, housekeeping in navy, etc. and is now choosing a color for the radiology department. The fact of the matter is if you are a woman walking into a patient’s room and you are in scrubs, you are a nurse. If you are a man, you are a doctor. Not one of our patients has ever been able to figure out which color belongs to what group. It’s as someone else mentioned, do your job and that’s all people really want.

  16. Sean Dent Scrubs Blogger

    @ Sherri I agree that we all should be aware and perform our given responsibilities, but unfortunately I can’t agree with your statement about the gender. Thanks for sharing your thoughts.

  17. LoveANurse

    No matter what colour health care workers wear, people are STILL going to ask/think we’re all nurses. So why bother colour code? Plus, we have NAME TAGS with our titles for a reason. We are in 2012 now. Let us have a choice! As long as you’re neat and professional looking, who cares what colour we wear. I just got my BSN (I’m 24 years old, and my closet is FILLED with new scrubs in: purples, greens, pinks, yellows, prints, ect…. and I’m stuck wearing dull blue day in-day out ’cause of annoying family members who can’t read name tags or ask. On top of that, my boss calls me other co-workers names often because we ALL LOOK THE SAME!

    Let’s not resort back to the olden days, people. White scrubs? Please. Heck, why not bring the nursing caps back too. *Rolls eyes

    We ALL have to wear white shoes/socks, nude underwear and undershirts. PLEASE do not take our choice of scrubs away. It took years to get prints and colours in.

    Stand up to choice! :)

  18. Night.Owl

    I absolutely hate the idea of being mandated to purchase a specific color/brand of uniform outside of nursing school. The uniform I put on each day reflects how I feel that day. It may sound odd to some, but: I never wear black (my staple pants color) on the day I woke up on the wrong side of the bed, instead I wear what I call my easter egg scrubs; on my fat/ugly days I wear my black bottoms with my black/zebra print top or my black, baggy hospital tee. Also I enjoy that I can be an individual at work as a part of our team.