Nursing Uniforms Through History

Today’s scrubs are a long way from the starched gowns and white caps of earlier eras

Different polaroid photos sit on top of each other depicting nurses in different uniforms, shows, and caps

Modern scrubs are practical, cheap and easy to care for, but there was something elegant about the nursing uniforms of ages past: long, floor-sweeping skirts; beautifully crisp aprons; neat cuffs; high collars; and of course white nurse’s caps.

Traditional starched white uniforms are rarely seen today except in period dramas, but they’re still an important part of our profession’s history and visual iconography.

Laundry Day

When I was a young girl, my grandmother, a former laundress, would entertain me with stories about the laundry at Bellevue Hospital in New York. She would talk about the endless loads of smocks, aprons and caps that needed to be starched and ironed for the nurses. She and the other laundresses took pride in getting the pleats just right.

During her tenure, the laundries used flat irons that were heated over burning coals. You had to have two going at all times to keep up the pace: one in use and one heating up. The nurses would pick up their packages of clean uniforms and occasionally leave tokens of appreciation, especially during the holidays.

Today, nurses are expected to wash their own work clothes on their own time. Fortunately, that’s far easier than it was in my grandmother’s day: You just toss your scrubs into the washer, tumble dry and wear the next day. Most of us wouldn’t even think of taking the time to iron our scrubs, much less reach for the starch.

From Nun’s Habit to Candy Striper

Many traditional nursing uniforms were modeled on the garments of religious orders, which in turn reflected the clothing styles common at the time that order or congregation was originally founded. (Sisters might go centuries before updating their look!)

Nurses of earlier eras were as much maids as clinicians, and their garb echoed that menial role: large aprons, indoor caps and large pockets. Not until the early 1900s did nursing uniforms begin to adopt elements like distinctive capes, arm bands and pins that indicated the nurse’s professional stature.

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Until recently, uniform colors reflected the nurse’s level of skill and experience. Young volunteers, of course, often wore red-and-white “candy striper” uniforms. A graduate nurse might have a subtle stripe across the cuff or hem or else sport a solid-color rather than striped apron. Darker colors, or black, signified seniority, usually indicating a supervisor.

Wartime Wear

Early nurses’ uniforms demonstrated now-archaic notions of disease control. Florence Nightingale recognized the need for cleanliness, but not for gloves or masks. Nightingale thought that aprons, tight cuffs and high collars would protect against wafting “miasmic emanations,” a popular 19th century concept of infectious disease prior to the acceptance of germ theory and the discovery of viruses.

These fashions also coincided with contemporary ideals of womanly virtue, which kept nurses’ collars closed and their skirts sweeping the floor until the mid-20th century.

The demands of military nursing drove many later changes in nurses’ uniforms. Army and Navy nurses required easily laundered clothing that would allow them to work in conditions far less tidy and organized than the average urban hospital.

A need for greater flexibility combined with wartime material shortages led to shorter, less voluminous uniforms and sometimes even trousers. Nurses aboard a hospital ship or working in a permanent clinic wore traditional white, but in the field, military nurses’ uniforms were often closer to a soldier’s fatigues than a nun’s habit. Big pockets remained, but military nurses’ boots were anything but ladylike!

A Cap for Each College

Although the veil persisted well into the 20th century in some countries, here in America, nurses never depended on veils to protect their hair or keep it out of the patient’s bed. Instead, tight buns and caps corralled locks somewhere out of harm’s way.

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The cap was held in place by white bobby pins — that is, until an IV pole or curtain rod unceremoniously knocked it off.

The various caps told the story of where the nurse had trained. Each school had its own style: a frilly little muffin cup known as the “Bellevue fluff”; the unforgettable winged caps of the Sisters of Charity; or the face-framing bonnets of the Sisters of Bon Secours. Capping ceremonies marked a young nurse’s achievement and entry into the profession.

White Shoes and Stockings

White silk stockings or nylons were also part of the look — and were sure to snag or run within the first few wearings. Until the advent of the running shoe as professional attire, most nurses endured stiff leather footwear with unyielding hard soles. Usually, white Clinic-brand shoes completed the nurse’s ensemble.

Nurses could spend an entire break period in conversations about how to keep those shoes white. Should you use Hollywood Sani-White or snow-white Shu-Milk shoe polish? Chlorine bleach or peroxide for the laces? Today’s colorful clogs and Crocs were far in the future and would have been unacceptable in most hospitals.

Oh So Practical Modern Scrubs

By the 1960s, many things had changed. Uniforms began to follow more closely the trends in popular civilian clothing. Nurses’ uniforms were now cute, figure-flattering and typically of a nurse’s own choosing (so long as they were white).

Hats had disappeared for the most part by the mid-1970s. Around the same time, above-the-knee skirts took hold. Also in the ‘70s, increasing male participation in the profession helped boost a brief vogue for pantsuits.

The now-familiar scrubs began to appear in the ‘80s and gradually became more common throughout the ‘90s. Today, they’re ubiquitous and offer many advantages. Scrubs are gender-neutral, comfortable in every setting, machine-washable and available in a wide array of styles and colors.

One downside: Everyone looks alike, from kitchen worker to doctor, with only color or perhaps lab coats to distinguish departments and levels of hierarchy. Few of us would ever want to go back to the uncomfortable, cumbersome white uniforms of my grandmother’s era, but they did have one thing to recommend them: Back then, you could recognize nurses by something other than their ID badges.

ELIZABETH HANINK, RN, BSN, PHN, is a Working Nurse staff writer with extensive hospital and community-based nursing experience.

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