Why do I need a dress code?

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A Q&A with Kathleen D. Pagana, Ph.D., RN

Q: Dear Nurse Pagana, My hospital is considering a dress code (as in certain colors and styles of scrubs) for nurses. I’m unhappy with this idea because I like being able to wear whatever scrubs I want. Do red polka dot vs. yellow striped scrubs really have an impact on how I perform as a nurse? —Unhappy Individualist

A: Dear Unhappy Individualist, Yes, you may be just as good at inserting a catheter wearing an evening gown as you are wearing hot pink scrubs, I understand. But how nurses dress has a bigger impact than most nurses realize. The way you dress either adds to or detracts from your professional image. It sends a message about how you see yourself and how you want to be perceived by others. Like most nurses, you probably want to be viewed as professional, intelligent and competent. Does your appearance mirror that image? Here are some ideas to think about:

  • Patients often associate appearance with trustworthiness and ability. If nurses dress too casually, patients may question their professionalism and attention to detail.
  • Does a nurse dressed in cartoon scrubs (outside of the pediatric floor) establish immediate trust, authority and credibility? Probably not!
  • Many patients complain that everyone in a clinical setting looks the same. Patients want their nurses to be clearly identifiable.
  • Family members, physicians and other members of the health care team also have trouble identifying nurses. This impacts communication.
  • Some institutions are adopting a dress code to distinguish personnel. For example, a hospital may dictate that only nurses wear one print and medical technicians wear another print.
  • Many health care systems are aiming for uniformity in dress. Wouldn’t you be surprised if, say, the copilot on your airplane was dressed in a jogging outfit? You would question an airline that permitted pilots to dress as individuals rather than as uniformed professionals.

Proper attire is important for nurses in every kind of setting. This includes hospital, clinics, meetings and conferences. Make sure your uniforms, lab coats, scrubs and shoes are clean, neat and professional.

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Want scrubs like these? Find a retailer near you!

Kathleen D. Pagana

Kathleen D. Pagana, Ph.D., RN, is a keynote speaker and bestselling author. She recently wrote The Nurse’s Etiquette Advantage: How Professional Etiquette Can Advance Your Nursing Career. She is also the coauthor of Mosby’s Diagnostic and Laboratory Reference and Mosby’s Manual of Diagnostic and Laboratory Tests. These books have sold more than one million copies and have five language translations. Please visit Kathleen’s Website at kathleenpagana.com.

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31 Responses to Why do I need a dress code?

  1. sean

    and just maybe your hospital wants to have some order to the look of their staff. they may want certain nurses to wear certain colors to be able to tell them apart for other nurses. if you have ever seen the tv show “ER” you will have notices the different color scrubs to denote what kind of nurse, doctor or whatever they are. blue was surgical.

  2. Bonny

    I was so happy when we nurses graduated from the white, white, white fashion…However, that being said, some of the scrubs out there (as well as the colors) is terrible…Let’s remember we are professionals, and it is my opinion that my dress should distinguish me from the aides, cleaning personell and others. Let’s bring back a balance.

  3. psychrn

    I work on a locked inpatient psych unit. We have a “casual, clean, and comfortable” policy. Street clothes give the patients a sense of normalcy. All the nurses have had the common sense to not push the limits on these guidelines.

    If you are an administrator reading this – I can see why uniformity is nice, but if you are going to implement it, could you PLEASE make the required colors darker? When I was a student, I got tired real quick of having random people I barely knew walk up to me, turn around and ask, “Do you see anything?” or the more direct, “Am I bleeding?”

  4. Pamelia Hendricks

    I graduated in the early 70s and I do so miss the caps. I know, I know…lots of germs, but patients sure liked the nurses in the caps. My school, Galveston College, had the two black stripes like the navy. So impressive. Doctors treated us with more respect, now I look like the NA or janitor. White and caps, wish I could turn back time. :0)

  5. janet

    I work in the Er, most of the patients love our scrubs. And it sometimes helps break the ice if they are alittle nervous

  6. Michelle

    At my hospital, we have a dress code. On the positive side, it is so easy to scope out a nurse, LPN, PCA, transportor, housekeeper and doctor, just by what they are wearig. It is convenient for the employees and for the patients. On the negative side, the nurses wear all black, all white, or black and white. Uniforms are solid, not print of any kind. To me the black is morbid and the white always gets dirty(no matter how careful you are). After a while, it can get depressing wearing the same thing everytime you go to work. Plus, I feel embarrassed with the black when I am not in work.

  7. Colleen

    I have a lot of prints and I have found that patients and family enjoy my dog, cat, flower, and ladybug flowers. I have tops for all the major holidays. There is a rumor at work now that we will be going back to standard colors.
    That will bother me. I graduated in 1979 and I HATE white.
    I feel the condition of the uniform is more important. A light starch and press should be what is required. You can still look like a slob and be in compliance with the dress code.

  8. Jess

    I’ve worked in diff facilities and ranks as a nurse (Level 1 trauma ER, rinky-dink small suburb ER, Hospice RN case mgr in private homes and nursing homes, and finally at an outpatient chemo/oncology clinic). I’ve had both of these dress codes. Yes, I LOVE wearing fun and colorful scrubs especially for holidays and scrubs for causes (cancer/disease recognition). Suggest meeting in the middle: solid color coded pants for positions with a fun top. Both families and patients liked as well as staff. In hospice, I frequently had clients in a nursing home and their staff were color coded, made things so much easier and a time saver. If I needed help from their staff (I was not an employee of these places) I wasn’t asking the housekeeper to help me get a client out of bed, or a doctor to help me bathe clients, etc…In a VERY large hospital, when I floated I could easily identify pca’s, cna’s, dietary, MD, housekeeping, maintanance, volunteer, nurse, nursing students, radiology…You get the picture. At the noncoded places pt’s and their families, float staff on numerous occasions, would waste 5 min explaing to a housekeeper when they thought it was a nurse or doctor. 5 min is such a tiny amt of time out of a day, but not when its repeated 10 times per day. All healthcare employees know how precious 5 min can be, could be the difference of life vs.death, overtime or not, happy pt and pt family vs. complaints and subsequent reprimands simply because in their eyes “you didn’t even take 5 min to explain what or why certain things were the way they were. When all said and done at the end of your shift, how many people’s lives did you ease in such a high stress career just as a book title says; “Don’t sweat the small stuff, and its all small stuff.”

  9. Char

    In the facility I work at, housekeeping must wear plain blue scrubs. It wouldn’t be difficult to “colour code” other staff as well. I think we could do away with the insane clown look, but I think we should keep more subdued prints simply because they hide stains. :)

  10. Cindie

    We went colors by disciplines this year. Most of us hated this trend also. However, now when personnel comes into the unit, we know when they are a RN, LVN or CNA or Pharm etc. Our Navy blue uniform do not show dirt or stains (thank GOD). and we get dressed faster as there are no more choices. I am considering a second job so I can wear all my fancy stuff and have given many tops away. PS I hate one color too!, but I hate unemployment more!

  11. Bruce Dawson

    This women is being paid by corporate America and obviously has no sense of reality. I tell people who I am and what I am going to do. Scrubs have nothing to do with how I am perceived. This article is pathetic, cmon who cares what I look like as long as I have a brain. Most hospitals want to do whatever brings in the bucks, its not about patient care its about “image” Obviously this woman is not in touch with reality and honestly takes us back 100 years to Florence nightingale who by the way had a sketchy history….wake up and hold your values, colors and individuality are the only thing we have to keep our sanity in this crazy career.

  12. steph

    I worked at a hospital where we had to dress uniformly. The hospital provided the scrubs. They were awful. I am short and big busted. Nothing fit me right, they were unisex so they did not contour to a female body. Plus I had to take mine home and hem them which meant cutting off about 5 inches at the bottom. I don’t feel it helped me look professional. The hospital wanted to make us wear orange or brown scrubs. Luckily enough of us protested and we settled for a sea green.

  13. Terri

    I teach in a nursing program and uniforms are always an issue we struggle with. Logically we need to have a dress code so both faculty and the staff at our clinical facilities can identify our students. We required quality navy blue scrubs for years and had few complaints (students like them and the staff commented on how nice they looked). HOWEVER, a couple years ago the largest hospital in our area initiated a color-coding program for staff. Once all the departments had made their choices, the only colors left for us were pink, red, black, and brown (we had asked to keep navy but it was chosen by the PT/OT staff). Red is not attractive on heavier-set individuals and, needless to say, our male students were not a fan of pink. Our long-term care faculty were concerned about the image black would give in their facilties so we went with brown. Our students have endured being called the “brown team” (not a favorite nursing phrase) and “what can brown do for you?” The faculty is also unhappy with the lack of professional look — somehow the color hasn’t worn well after multiple washes. We have decided to change to a more traditional nurse look of a dark pant and white top. Will the students like it? Probably not, but I think the patient’s will. And isn’t that who really matters????

  14. I have worked at a hospital where our scrubs were provided for us (3 pairs) and were color-coded, and where we could wear whatever scrubs we wanted. I much prefer the latter, because I’m not into “cutesy” scrubs, as I work with adult patients.

    Our hospital provides hard plastic rectangular badges that attach behind our name tags. The rectangles are red with “RN” in large white letters engraved on them and extend below the name tag, so it can be clearly seen by all. Problem solved.

  15. Karen

    I can’t believe how many dress code changes I have been through in my 37 years :). When I graduated, I bought a beautiful royal blue wool cape (never wore it), my solid gold nursing pin (lost it), two big white hats with a black stripe (had to wash, starch, and iron them), made my own uniforms to save money, bought leather White Swan shoes (the most uncomfortable shoes I ever put on my feet but the only “nursing” shoes out there–how I ever put up with them until they approved tennis shoes I wil never know), and two pairs of white support panty hose!!
    Those were the years of mini-skirts–and the years of MINI nursing uniforms. I can’t tell you how many times my supervisor would YANK my skirt down over my rear end everytime I bent over a bed. I worked in a Catholic hospital and there were absolutely NO Pant suits allowed!!! Short skirts were OK……We had big hair and short skirts and everyone wore white and yes, our patients did exactly what we told them to because we (me and the nurses I knew) were some of the hardes working people I had ever met. We gave out pills in little cups…only had demerol and morphone for pain, cut you wide open for surgery, major or minor–and we helped knit you back together. With our long skirts, mini skirts (when you’re 22), White Swans, support hose, and black stripes on your hat, or royal blue, puppy dogs and Marmaduke….if you DO NOT CARE about your patient and take time to listen, it will not matter what you are wearing. They will SEE right through you. They will now you are NOT really a nurse. You are a pretender.

  16. Kim D.

    You have got to be kidding. I would love to meet all these patients that say they want their nurses to be identifiable. I am a travel nurse and have had to wear all kinds of specific colors even down to all white. Patients do not identify with color. Everyone that walks into their room is a nurse aside from the occasional doctor and I can’t count how many times I’ve been the doctor. We still have to actually write our names and who we are on a board. At the hospital where we wore all white, the patients that did have a clue that white symbolized a nurse complained about something else about what we did or did not wear, i.e., the white caps. Give nurses a break. This country is making it completely impossible to actually take care of patients. If I walk into a patient’s room with cartoons on my scrubs you better believe that my patients are going to know they can trust me. If you walk and talk with confidence, what you are wearing is not an issue!

  17. Sean K. Hess, R.N.

    I am the older nurse and until I was a patient, I too enjoyed the ability to wear prints etc. Then, as a patient, really difficult to pick out the “nurse” from anybody else. Maybe the british blue with the two white stripes is the way to go for R.N.’s, green with one stripe. The students wear there school colors

  18. Renea

    I have more patients tell me that they love the bright cheery colors and the prints that I wear. Our hospital is thinking about going to a dress code and we all hate it! We tell our patients if they like our scrubs then, when they get the survey after their discharge, to please mention that! We are hoping that it helps!

  19. Jean Malizia

    Identify yourself as you meet people and whatever scrubs you choose will not be a problem – our facility has no restrictions on colors and prints and quite a few nice conversations have ensued about mine. Even though my Mets top gets a lot of razzing from the Bronxite Security guards. :)

  20. Tina

    First off, I love my print and even cartoon character scrub uniforms and have gotten a number of compliments from my patients on my uniform and personality. I worked in a hospital setting that had color coding for the pants you wore only. Nurse (RN and LPN wore navy etc.) the patients had no idea about this dress code. Myself I prefer autonomy with discretion for my clothing preferences and feel that a large NURSE badge is sufficient for identification purposes for the patient.
    My biggest compliant when it comes to scrubs is that I worked hard for the right to wear my scrubs and hate that many places (as mentioned in the article) have non-professional staff wearing scrubs. From dietary to receptionist. Why is this? I feel that this takes away from my professionalism and confuses the patient more then the color of my scrub and I should not be forced to wear a white or any other color scrub so I will not be mistaken for housekeeping. Doctors no longer wear scrubs outside of the surgical area either. They are in professional attire with white lab coats.

  21. Sean Hess

    Aw come on, Ladies and Gentleman. Looking professional should be a no brainer. Our medical colleagues , physicians, have no problem with a
    an understood code of dress. Nursing cannot continue to battle of ” how I dress is my perrogative” argument. Dress professionally appropriate and there is not any concern . Look like you slept in your uniform and that compromises your professional credibility. Hence, ” Dress for success.”
    Clean shoes, pressed uniform, appropriate manicure, and combed hair. Huh, it might catch on……..

  22. Jody Nerhood Edwards

    I too have had the blue RN that Stephanie D described and the LPNs also had one that went behind their nametags as well. Does anyone know where you can purchase them. I recently went to work for a very small home health agency and we would like to go in that direction.

    As far as what should be on the name tag RN, etc. I worked very hard to achieve my other degrees but I don’t put them on every name tag. When I worked in Advanced nursing roles I would use the RN, PhD, Clinical Nurse Specialist or FNP designation and it was useful as an educational opportunity as patients and their families would ask me about them and I could teach them about the varying nursing roles. Now, in home health I just wear Jody RN

  23. Granny RN

    Reply to Sean Hess:
    You are SO right on brother! Nurses remain a DIVIDED group of easy to intimidate workers because of the way that we just keep on squabbling among ourselves over everything from what kind of uniform to wear to ‘entry into practice’ education standards.
    DOCTORS and even PAs on the other hand DO NOT have these silly issues! The biggest ‘wardrobe issue’ for doctors in the course of my 35 year career has been a recommendation that the wearing of neckties be abandoned because they carry GERMS (like my beloved white cap which no longer exists) and tend to ‘fall’ over onto the patient.
    What we NEED to be doing is sticking together and pushing for things like a National Nursing License instead of 50 different ones, kicking the ‘bullies’ the hell OUT of our profession and acting like BIG boys and girls!
    I hope to see this come to pass before I die…

  24. Doug RN

    It should be noted that not all brands have adequete sized scrubs for taller men. Dickies, for example, makes an excellent and well fitting tall pant but their matching tunics do not come in a tall. The point is, matching colors between manufacturers isn’t possible and some nurses select their uniform based on function (read: number of pockets), comfort, and quality rather than just appearance alone, further diminishing selection. When confined to a particular color, one chooses between not matching and fitting properly;neither are appealing options.

  25. debrella RN

    My first RN position the staff wore whatever scrubs we felt like. I did not care for that system because the patients and doctors seldom mistook the nurses as aids. Where I work now nurses may wear purple, black and/or white; however, we must either wear a purple top or bottom I love this code because there is no confusion. For examble: If I need a nurse to sign off on a med with me and there happens to be a face I do not recognize (ie: float or a traveling nurse), I know they are clinically qualified to help simply by our dress code. Our techs, aids, etc also have a color code. Believe it or not, the color code makes life a lot easier for all involved, patients and doctors appreciate the dress code as well. I must mention, I feel the level of respect is higher with a dress code and I enjoy that very much because I worked hard to get to where I am today and I am proud of my RN degree.

  26. Belasko RN

    So much to say on this loaded topic! The hospital I work in went to standardized dress uniforms about a year ago. The official line on it was that in “multiple studies” it improved satisfaction scores and that pt’s prefered being able to identify what department staff belonged to (medical imaging, nursing, therapies, etc.). I asked to see some of the “studies” and have yet to hear back on that. As for people not being able to wear individual yet professional uniforms, I never once saw an issue with that (w/ the exception of one that bought cheap white scrub pants so you could see the pattern of their underwear). Either way, after a year in the new uniforms I have had multiple pt’s still call me doctor, or ask me to get a nurse for them despite me wearing navy which clearly indicates I am a nurse if they had just bothered to read the small cards that were handed out a year ago explaining the color coding ;-). More importantly, why don’t they read (this applies even more so to staff. Floats, temps or otherwise) the name badge we are required to have at all times where it says in bold large print RN! I have not heard from anyone that they feel people take better care of them and I have not noted an increase or decrease in peoples concerns or comfort since the change. I have noted many staff gripe about a decision that was made by higher ups when the affects do not apply to them. In the end I think the decision to enforce a standard uniform is resisted because it is dictated to us. Americans have never taken it well when someone over them tells them they have to do something. I think that is majority of it. After all, once the change was done for a few months no one says a thing about it any more.

    For nursing students, a uniform of some sort is a good thing. It clearly tells staff that they are learning and allows for instructors to more quickly identify their students when they walk on the floor. My nursing school required navy pants and a white polo shirt. The next year they went to a standardized scrub color. Another nursing school near us has a navy and white combo top/bottoms. The key for all of them though is their logo or patch is on the front where it’s easily spotted.

    As for physicians always being professional appearing, I’m waiting for them to stop making Saturday rounds in their bike shorts.

  27. NurseRosie

    At the hospital where I work we added the larger card with our title behind our name badges a few years ago, in order to make the nursing staff more easily identified. The hospital has since adopted a dress code requiring color coding for employees, x-ray wears one color, respiratory another color, etc. so that we are all easily identifiable. I my experience this only works for the staff as the patients and families are too stressed to really remember who wears what color. All RNs and LPNs must wear white or navy solid color scrubs, or a combination there of, which is OK: except for the fact that we all must have the scrubs embroidered with the hospital name and logo on the front chest and our title (RN, LPN, CNA, LAB, RRT, etc) on the sleeve, hence making the scrub tops/jackets unwearable at any other place of employment. And we are still required to wear the card with our ID badge! Feels like triple charting to me.

  28. Nurse Rene RN

    To: Unhappy Individualist

    Unfortunately dress codes exist because too many people do not seem to know or care how to dress professionally for work or otherwise. I have seen nurses with red panties under white pants with all of the docs gawking as she bent over, some with mini-dresses so short that the unmatched panties could not be missed, people who walk around with their thong line OVER the top of their trousers, no bra, no shoes, pants hanging Below the Buttocks… All in the hospital. Some visitors, some not.
    All it takes is a few bad apples to screw up a ‘free dress’ environment. And since management cannot ‘discriminate’ by singling out the offenders, EVERYONE else must pay the price and adhere to a dress code.

  29. OBRN

    And I bet you don’t have to wear scrubs do you? Why can we not be individuals? It makes me so mad to hear of going to a one or two color dress code when all the administrators, nursing educators sure can wear what they want. It’s just another way to keep us under your thumb. MY patients happen to like the cheerful looking scrubs. Right now we have a dress code of certain colors, all blues, purples, greens, tans, burgandy and are allowed to wear reasonable prints. No flourescents, no cartoon characters (execept in peds), no slogans. I think that is very reasonable and the vast majority of staff abide by it and look very professional. I do have a problem with the ones who abuse it by wearing t-shirts instead of scrubs, some of them very form fitting and low cut. I don’t like the flourescents, . I had never thought about it until my son was a patient and a nurse consistently wore them, they were very hard on the eyes, very distracting and she looked like a traffic cone.
    But patients should be identifying us by our badges, our identification of ourselves etc, not by some randomly picked, depressing color because someone wants to yet again assert their power and control over the staff.

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