From Skirts To Scrubs: A History Of Nursing Attire

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During the Crimean War when Florence Nightingale was beginning to revolutionize the way nursing was practiced, she also paid considerable attention to something that would support her ambitious plans for her profession: the way nurses were attired.

Crisp white nurses hat

Nightingale wanted her nurses to look like the trained practitioners they were, and for patients, doctors, and society, in general, to be able to recognize and respect them.

What they needed, she believed, was a uniform.

“The earliest nursing uniforms focused on both functionality and feminine virtue, to better establish the profession as one of the few in which respectable women could pursue economic independence,” notes the article, ”How Do You Look,” on AmericanNurseToday.com.

Today’s nurses can follow in Nightingale’s footsteps – professionally if not sartorially – by pursuing a degree through Duquesne University’s 100 percent online RN-BSN program. The program is designed to offer nursing leadership preparation in a flexible learning environment.

The First Uniforms: Illness Prevention And Morality Protection

Before Nightingale reformed and professionalized nursing, family members and nuns did most of the work of caring for the sick and injured. Basing the first nursing uniform on nuns’ habits wasn’t much of a stretch. For many early nurses, daily attire consisted of simple long-sleeved, full-length dresses in sober colors such as gray, black or brown. Nurses wore an apron over the dress and a head covering much like a nun’s that completely concealed their hair.

Nightingale wanted her nurses in the Crimea to wear “identical outfits that were comprised of a gray tweed dress, gray worsted jacket, plain white cap, and short woolen cloak,” according to “History Of The Nurse Uniform: Florence Nightingale,” on NursePathways.com. “The nurses also wore a sash embroidered with the words, ‘Scutari Hospital’ across their shoulders.”

Besides professionalism, the goal of all that coverage was to protect the nurses from infections, unsanitary conditions, and even fever – though gloves and masks were not yet part of the ensemble.

Nightingale’s nurses thought the outfits were hideous. The Lady with the Lamp didn’t care. She had a second level of protection in mind: to guard her protégés against the improprieties and amorous advances of male patients.

A Vision In White

By the early 20th century, dark colors had mostly given way to white. White was considered clean, sanitary, and scientific. It also called to mind the white coats that doctors wore, which added to the nurses’ sense of status. Skirts and sleeves were still long, however, and aprons, many with crisscross straps, were still worn over the outfit.

Outfits changed in World War I. Field nurses had to be able to move fast, so hems came up (modestly), sleeves could be rolled up and pockets – so important for carrying medical necessities – were added to the dress. As a further identifier, nurses wore armbands with a red cross. Others, including Australian nurses, wore short capes whose colors or detailing identified the hospital or organization with which the nurse was associated.

Variations continued after the war, when no one wanted to go back to bulky attire of the past. Soon, regular nursing outfits consisted of simple ankle-length white dresses, aprons, and smaller caps that kept a nurse’s hair out of her face.

Hemlines gradually began to rise and by World War II, both skirts and sleeves were shorter and more manageable.

By the 1960s, the starched white dress (and white hose and shoes) had become a dignified symbol of the entire profession – and nurses were increasingly in charge of what they wore.

A big factor, as Medscape.com notes in its article, “Nurse Uniforms: Who Cares What Nurses Wear?” was the demise of the proprietary uniform. As a cost-cutting measure, many hospitals quit providing – and laundering – nurses’ outfits. Nurses began buying directly from uniform manufacturers, which gave them greater control over what they wore — and what they wanted was more up-to-date styles and, when they became available, synthetic fabrics that were affordable and easy to keep clean.

To Cap It Off

White dresses may have been the norm, but perhaps nothing symbolized “nursing” quite like the crisp white cap popular throughout much of the 20th century.

More statement piece than hair covering by this time, caps were intended to convey the dignity and pride of the profession. At many nursing schools, capping ceremonies were major events celebrating a student’s induction into the profession.

Iconic or not, caps could be impractical, often falling off at the most inopportune times. By the 1970s, most hospitals no longer required them.

The Debut Of Scrubs

Rules for nursing attire continued to relax, and by the 1980s and ’90s, scrubs had become the “uniform” for nurses and other medical personnel. They offered a number of advantages over the uniforms of the past, according to “Why Do Nurses Wear Scrubs” on NurseTheory.com. Scrubs are easier to work in. They have lots of space for carrying tools and equipment. They can be washed frequently in the harsh cleaners necessary to make them sanitary enough for continuous hospital use. And they’re inexpensive enough that they can be thrown away if blood, bodily waste, or chemicals contaminate them.

Another factor in scrubs’ favor: more men are entering the profession and scrubs are appropriate for either gender. The result is a nursing staff that presents a proud, professional, and unified face to patients and the world – which is what Florence Nightingale intended for nursing uniforms to do from the beginning.

About Duquesne University’s Online RN-BSN Degree Program

Duquesne University’s online RN-BSN program is designed to provide the academic theory and real-world practice today’s nurses need to prepare for nursing leadership.

Duquesne University’s program is 100 percent online, allowing students to pursue their degrees on their own schedule. The university is nationally recognized for excellence in nursing education, with faculty members who work to ensure students are studying the most current practices. U.S. News & World Report ranks Duquesne among the top nursing schools in the nation.