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Healthcare uniforms are a relatively modern concept, only coming into effect during the Crimean War in the 1850s with the famous nurse Florence Nightingale. Before then, the role of nurse was awarded to a female member of the family, and in the absence of that, a nun from the nearest monastery. This is why we use the term “sister” for both nuns and senior nurses, and why the very first nurses uniforms worn by those nurses in the 1850s resembled those of nuns’ habits. They wore ankle-length, long-sleeved dresses with aprons and veil-like caps. As there was little understanding of infections and cross-contamination, the aprons were meant to protect the nurses themselves from illnesses, specifically fever, and the caps were merely designed to cover the nurses hair in the same fashion as those worn by nuns. Both evolved slightly over the decades, with dresses shortening, wide belts being introduced for aesthetic purposes as well as to hold tools, and veils becoming caps which held no more purpose than just acting as a statement of role and rank.
Headpieces fell out of favor altogether in the 1970s as they were largely impractical, and in many cases, especially in a surgical setting, nurses' uniforms changed from long dresses to scrubs due to the move away from feminine clothing and the arrival of more male nurses. During the 1918 flu pandemic, doctors just wore masks and aprons to protect themselves and their own clothing from stains and marks, although they also began to wear scrubs in the 1940s when the outbreak of World War II brought about an awareness of wound infection. This saw the need for medical scrubs and a sanitary operating area. Medical scrubs were gowns that covered the surgeon and medical staff; now, scrubs are usually v-neck, short-sleeved shirts and drawstring pants, with additional jackets and gowns where necessary.
Where nurses were previously identifiable in the military setting by the red cross emblazoned on their uniforms, now logos tend to be for the specific brand being represented, and the iconic nurses tunic, tunic dress or surgical scrubs make healthcare professionals stand out.
But why is standing out so important? And what other benefits are there of healthcare uniforms? We’re about to delve into the details.
Healthcare uniforms cover a number of different roles in the healthcare industry, from surgeons and nurses, to physiotherapists and healthcare assistants. But they’re not just limited to clinical roles. There are plenty of non-clinical staff in healthcare facilities who also require uniforms, such as housekeepers, receptionists and administration assistants.
Clinical staff tend to wear scrubs or tunics, depending on the nature of the work they carry out as well as the independent choice of the facility, while those in operating theaters must wear scrubs to abide by hygiene laws. Administration assistants and receptionists usually wear blouses or shirts and suits as they are in more formal roles which require smarter clothing and makes them easily distinct from clinical staff.
Housekeepers’ uniforms are slightly different to that of other non-clinical staff as they do work in a clinical setting. This means that they require a nurse-like uniform when moving between patient rooms, as the material and style mean they are more easily cleaned and don’t stain so easily. They also require medical scrubs when cleaning hospital theaters as this is a highly hygienic area of a healthcare facility that requires the utmost cleanliness. Rubber shoes must also be worn in these areas as they are wipe-clean, so that bacteria and dirt are not brought through from other areas of the hospital into the operating theaters.
Below is a list of clothing items necessary for healthcare uniforms:
While these items are all necessary and must be made of a kind of fabric that is easily cleanable, durable and flexible, there are also disposable items that are necessary in clinical roles including, plastic aprons, gloves, hair nets, face masks, visors and glasses. These must all be worn over other items of healthcare uniforms to protect them from stains and splashes and disposed of between patients to ensure that no bacteria is brought from one patient to another. Cross-contamination can be incredibly dangerous in healthcare settings.
Footwear is not necessarily part of the uniform in all areas of healthcare; non-clinical staff are recommended to wear comfortable shoes, usually in black, or that fit with the color scheme of the brand. However for clinical roles and housekeeping, rubber shoes or comfortable, wipe clean shoes should be provided for staff. This is because cleanliness is of the utmost importance in a healthcare setting and any spillages or stains should be easily cleaned, especially on footwear.
Each uniform in the healthcare sector is designed for a specific purpose and they are all important for a number of reasons. Firstly, cleanliness is the priority of all aspects of the healthcare environment. Healthcare uniforms are designed so that the material and the style are easily cleaned, meaning wipe clean and durable to withstand high temperature washing to remove all bacteria.
Having a uniform creates the idea of a team among staff and visitors. If everyone is dressed in the same clothing then those using the service have the notion that all staff members work together smoothly and coherently, which gives them a certain sense of trust in the facility. This is especially important in a healthcare environment as patients and visitors want their minds to be put at ease over their upcoming care.
Having a uniform in any setting saves staff time and money. No longer do they have to choose what to wear in the mornings or buy their own clothes to suit certain requirements set out by a dress code, but instead a uniform is provided for them and cleaned by the housekeeping department. Again, this is particularly important as healthcare staff work long shifts and saving them time in their day is crucial to allowing them to perform their role adequately. It would also not be possible to allow clinical staff to wear their own clothes anymore due to the extreme risk of infections and contamination!
A uniform will also allow full function of the role and create a desired aesthetic for staff and visitors. We will go into each of the factors now.
The most important aspect of healthcare uniforms is for staff to be able to perform their duties as comfortably and easily as possible, given the highly important nature of their work.
This means that healthcare uniforms, from scrubs, to tunics to blouses and suits should all be made of soft, comfortable materials so that they can be worn for long shifts without irritating their skin, and be flexible enough that employees can move freely without any restrictions. Whether they’re moving patients, helping them with the exercises, or simply sitting at a desk, staff uniforms have to be flexible and comfortable. Elastane, also known as lycra or spandex, can be very beneficial for flexibility as it is a very stretchy fabric and returns to its original shape quickly and easily so it does not require much maintenance. In high quantities, however, it can be too figure-hugging making it look quite unprofessional in a healthcare setting, so it is usually used in blends; less than 10% elastane is most common.
It’s also important for staff uniforms in healthcare facilities to be breathable while they are conducting their tasks. For this reason, most uniforms are made up of cotton, as it is lightweight and breathable as well as being soft and durable. However it can be shrunk at high temperatures and colors can fade easily after many washes, making it less than ideal for medical scrubs. For this reason, cotton blends are most common for clinical uniforms.
All uniforms need to be clean and presentable, but none more so than healthcare uniforms. This is not just to present a hygienic appearance to patients, but to ensure the wellbeing and safety of patients, visitors and staff. In order to keep uniforms clean, they need to be washed at a high temperature, with scrubs needing to be washed at at least 60ºC. For many fabrics this temperature would make them threadbare and worn very quickly, so the fabric chosen for scrubs is highly important. Blends such as cotton/ polyester/ elastane hold some of the qualities of each fabric, so they are durable as well as breathable, flexible and moisture-resistant. This allows staff to move comfortably as well as prevent stains and allow for washing at a high temperature to kill all bacteria that might be on the clothing.
Hygiene is of course of vital importance in healthcare and can be dealt with in a number of ways. One way is by using antimicrobial fabrics. This is a technical process of embedding certain alloys or emulsions into the fabrics that actively destroy or prevent the replication of bacteria. Silver alloy can be used and prevents bacterial cell division, while organosilane-based quaternary ammonium and hydrophobic fluoroacrylate copolymer emulsion cause cells to burst or prevent cell replication.
While it must be noted that this only prevents the spread of bacteria, not viruses, it can be very effective when woven into scrub materials and combined with standard hand washing and other hygienic practices. It doesn’t change the way scrubs are washed and cared for either. It also has other benefits, since prevention of bacteria growth means less smell from sweat, some fluid resistance and fewer stains.
While style largely determines the aesthetics of a uniform, there are some practical prerequisites to boot. All healthcare uniforms benefit from pockets. Whether you are in the operating theater, cleaning patient rooms or tending to patients in some capacity, large pockets on the front of tunics or scrub tops or scrub pants allow for the carrying of essential equipment, in the same way nurses belts did in the early twentieth century. You don’t want such huge baggy pockets that they snag on anything around, but large pockets for a work phone, notepad and pen or emergency medical supplies can really make a difference to how staff are able to do their jobs.
Similarly, clothing should be made with options to fit all shapes and sizes. A uniform that is too tight will prevent the flexibility needed by employees to do their jobs properly, while a uniform that is too baggy will impede in other ways: dragging on the ground, catching on instruments and objects, and causing a trip hazard, to name a few. It will also remove the employees pride in their appearance if their uniform is poorly fitted and does not suit their figures.
The aesthetics of healthcare uniforms are very important as well. This is because the appearance of staff can make a big impact on the way they are received by patients. A sleek, clean and professional appearance will assure patients and their family members that the care they are about to receive is of a high standard, as a staff who takes care of their appearance will surely take care of their patients. This is also why stain-free clothing is essential to present an image of cleanliness to patients to assure them of the high standards in the healthcare facility.
Color is a large part of aesthetics and can represent many different things in a healthcare setting. In an operating theater, staff will have face masks, hair nets, gloves, boots and aprons as well as their surgical scrubs, meaning most staff are largely unidentifiable. So, it’s important to have different staff in different color scrubs to show who is who. Normally, the surgeon is in a turquoise scrub set, while theater nurses are in the classic navy blue scrub so that the surgeon stands out. Anyone more junior tends to wear a different color scrub, sometimes a raspberry pink. In such a scenario, other staff who are required to wear scrubs, such as housekeepers, should have a different color scrub set altogether so it can be made obvious who should and shouldn’t be in the theater at a certain time.
In other healthcare facilities, color is less important, however it can be used to match the logo and color scheme of the company as well as denote rank between employees - physiotherapists may choose one color, while healthcare assistants wear another. This differentiation helps patients as well as staff identify staff members from each other and understand who can help them with their enquiry.
Whichever color preferred, darker colors are ideal to hide stains, while brighter colors can be more joyful, and pastel colors more calming for patients. White or pastel colors can be impractical, however if pristine and stain-free, the clean appearance can imbue trust in the patients that the entire facility holds itself to high hygiene standards.
Non-clinical staff generally require uniforms that abide by the color scheme of the brand rather than denoting rank, however there should be a differentiation in style between management and receptionists and administration assistants in order to make it clearer to staff and patients, who is able to deal with what kind of query. This differentiation is often made by allowing a smart dress code for management while other administration staff adhere to uniform regulations, however experienced uniform suppliers are able to design blouses, shirts and suits to be appropriate for each role.
Regardless of the style chosen, an important aspect of uniforms for non-clinical and clinical staff is to have pride in their appearance. Scrubs have a certain aura, as they allow a prestige among wearers to feel they are an important part of the medical community, however they can always be designed to be more stylish and have a more attractive fit to allow staff to feel even more comfortable in their appearance. For non-clinical staff, uniforms should be smart and professional, with stylish designs, as when staff have pride in their appearance, it leads to high employee satisfaction which translates to excellent customer service.
While aesthetics are not the priority for surgical staff, after all, most patients are unconscious and the important thing is to be able to get the job done, it can be important for other clinicians to have a fitted scrub set for their work. Physios, dental nurses and other healthcare workers in direct contact with patients, especially in private clinics, perhaps take more pride in their appearance and the image they present to patients.
