When Windber Medical Center in Pennsylvania was building a new breast care facility, Diane Pringle, RN, MSN, wanted a gown that would be as attractive to women as the rest of Joyce Murtha Breast Care Center, which offers aroma therapy, a fireplace and a comfortable sitting area.

Pringle, the center’s executive director, worked with designers to come up with a gown that opens in the front, provides coverage to the knees and has hook-and-loop (Velcro) closures that allow exposure for one breast while covering the rest of a patient’s body.

“They are private, feminine, and pretty,” Pringle says of the gowns. She is working on a more unisex design for male patients who will come to the center for magnetic resonance imaging appointments.

The center sells its patented gowns to other facilities. They are popular with nursing mothers as well as breast health patients, she says. “The gown is definitely one of the best things we’ve done.”

But the front-opening gowns are more expensive than johnny coats, and many physicians want easy access to patients from the back, she says. She does not see them replacing traditional hospital gowns.

“It’s still about functionality and the least amount of money you can put into something that actually works,” she says.

As patients become more assertive and as cultural issues about privacy and modesty emerge, nurses say they expect more health care facilities will look for alternatives to the johnny coat. But for now, in the halls of most hospitals, rear ends will continue to flash.

Though nurses and patients frequently joke about their johnny coat experiences — Ann Landers recently devoted an entire column to funny hospital gown stories — Graves, the Texas oncology nurse, has firsthand experience with the pain they can cause.

When her mother was sick and in the hospital, Graves says, she would not let anyone see her because of her appearance. Her mother isolated herself from her church friends and others. As her illness worsened, her best friends from college — whom she hadnseen in years —flew in to see her.

“She would not let her best friends in to see her unless she was dressed,” Graves says. But the process of getting her ready took hours. “She died in my arms while I was getting her dressed. She never got to see her friends again.”

As a result of their experiences, Graves and her husband, Steve, have started a company called Dignity Duds that designs and sells garments
that look like regular clothes from the front, but are completely open in the back. Caregivers place them over bed-ridden patients and adjust the fit with hook-and-loop fasteners. The clothes aren’t meant to be worn in the halls or outside, Graves says, but patients in bed can receive visitors looking fully clothed, without the fatigue of having to dress.

“Everybody that we’ve spoken to in the medical industry has been very impressed with the idea,” Graves says. “I wish I’d had something like this for my mom.”

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Catherine Domrose is a senior staff writer for Nursing Spectrum.