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“Specific service lines wore colors, but it was all over the map,” said Laura Fortin, RN, BSN, CHE, chief operating officer and chief nursing officer. “Our dress code just got really sloppy. I was concerned about whether we looked professional.”

Patients responded in a survey that it didn’t matter what color nurses wore as long as it was obvious who they were. So, Fortin formed a committee of all hospital departments, which asked a uniform company to present all styles and colors available. Then representatives went back to their departments to negotiate who would wear what.

The result was specific guidelines for uniform styles, with two or three different tops and pants to accommodate tastes and body types. The hospital gave staff 90 days to change over.

Now, all nurses wear royal blue uniforms, and Fortin said response has been positive. “It looks really good. You know who everybody is. We list the colors every department wears in information books in all the patient rooms. For some patients, everybody who walks into the room is a nurse. But now, if a patient says something about what someone did, we just ask what color they were wearing.”

The uniforms are available through a select company at a discount, and typical cost is between $30 and $40, but can be as low as $20, depending on style and size. Nurses who want to get their uniforms elsewhere or have them made can get fabric swatches from the hospital. Color match must be exact, though, Fortin said.

Up to code

“I think attitudes are more professional, and we get a lot fewer patient complaints,” she said. “We’ve seen our patient satisfaction go up a bit, and I can’t say it is all related to the uniforms, but you can kind of correlate it. Managers and staff tell me it has made a significant difference.” Fortin said one key to the program’s success was staff involvement. “You can’t have management get together and make the decision. You need staff to buy in. And once the staff sees, they do buy in.”

Recently, nurses visited from another hospital, all wearing scrubs. “Everyone here said how sloppy they looked,” Fortin said.

Nurses at Marina Care Center in the Los Angeles area wear traditional white uniforms and caps every day, said Matilda Rogers, RN, director of nurses, who advocates a widespread return to the whites. “We need to be professional and look like nurses. Here, patients love it, families love it. Doctors like it. Every place you go, you can identify the nurses.”

Nurses buy the $12 to $14 whites and are given caps.

But that approach won’t work everywhere. “I don’t think scrubs look that professional,” Stovall said, “but this is the real world, and I don’t think you could find uniforms [at Jasper Memorial].”

Waxman recognizes that white uniforms may be a stretch, but thinks scrubs should stay in the OR, and revealing attire has no place in a hospital. She said she has worked in places where nurses didn’t wear uniforms or scrubs, but low-cut tops and low-rise pants.

“I’ve had to send nurses home because a thong showed,” she said. “No one cares what your title is if they are busy looking at that, and we aren’t going far in the nurse-physician relationship if doctors are looking at you just to look at you. You need to be professional.”

“I think it is up to the manager to enforce the dress code policy,” she said, even at the risk of having a nurse transfer or quit. “We need to be consistent about enforcing, even with the nursing shortage. I honestly think it is about accountability and professionalism.”

“If you go to school and get educated, why would you let your dress stand in your way?” Zoller said. “There are so many other issues. Why let someone disregard who I am just based on my dress, before I even open my mouth?”

“We worked hard for our degrees and even harder for our experience as nurses,” said Judy Davidson, RN, MS, clinical specialist at Pomerado Hospital in Poway, Calif., where nurses wear uniforms. “We deserve to be seen as professional, and while actions and words are important, a dress code can put us over the top toward gaining respect and recognition.”