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The nursing uniform has evolved into a traditional image of nurses and serves as a way for patients and other health care professionals to identify a nurse in the hospital setting. The public's perception of nurses influences nursing image in the community and affects patient decisions when seeking care. The culture of an organization is affected by factors such as safety and appearance that can directly be linked to the nursing uniform and patients' perceptions of professionalism (Spragley & Francis, 2006). Nursing administration is faced with the difficult task of constructing policies and procedures that dictate uniform standards and acceptable behaviors that promote a positive image for the profession. Clear descriptions of professional expectations would provide clinical educators with objective guidelines to promote a professional work environment and improved professional image for the discipline.
The first nursing uniforms were documented in the 1860s during the time of Florence Nightingale and the Crimean War. Nightingale was a nursing pioneer whose tireless efforts during the war to improve sanitation and hygiene practices drastically reduced death rates of soldiers. Nightingale and the first nursing apprentices trained and practiced in the St. Thomas Hospital in London wearing floor length dresses with long sleeves, an apron, and bonnet. These traditional uniforms were adorned with colored embroidery that differentiated rank between nurse and servant. These uniforms were worn until the first and second World Wars, when the role of nurses was intensified to assist in the treatment of the growing number of wounded soldiers. The long dresses were shortened due to impracticality and hindrance of safe practice in the work environment (McDonald, 2014).
Cantanzaro (2013) stated that the origination of the National Health Service in the United Kingdom in 1948 created stricter sanitation standards and regulations on laundering of hospital linens. These changes created financial challenges for hospitals, causing shortening of the uniform skirt and removal of shoulder and neck ties. Between 1950 and 1970, nurses added colored belts on their uniforms to signify rank and facilitate identification of the nurse in the clinical arena. Cotton aprons and hats were transitioned in the 1980s to disposable variations as awareness of infection control heightened. Even stricter uniform regulations were implemented in the 1990s that eliminated belts to reduce risk of patient injury....