Health News Digest

July 23, 2012

What To Wear….In The Hospital

Health care workers fashion

By  Michael D. Shaw

Perhaps the biggest change in fashion—in terms of the number of people affected—has been the move to so-called Business Casual. Back in the day, men wore suits and ties, women wore skirts with conservative blouses, and it was considered somewhat daring for men to wear a shirt in a color other than white. While fewer choices made building a workday wardrobe fairly simple, it also made it more expensive to acquire, to say nothing of the dry cleaning costs.

Although casual Fridays started in a very few industries in the late 1950s, it would take 25 more years for the custom to become widespread. Some say that the practice developed from the Aloha Fridays in Hawaii, whereby Hawaiian shirts could be worn on that day, instead of formal business attire. Barriers would gradually fall across nearly all industries, and by the late 1990s, it was not uncommon to see business casual attire every day of the week.

But what about proper apparel in health care? Here, I am referring primarily to the clothing of those individuals who interact directly with patients. The most striking costumes for physicians in the past were likely the long robes outfitted with pointed hoods, complete with leather gloves, boots, and protective masks provided with a beak-like device—worn by plague doctors. As medicine became more organized within the past 200 years, most doctors would don business attire, covered by some sort of lab coat, usually a white lab coat.

For a myriad of physicians, the white coat is still de rigueur, but cracks seem to be appearing in the once universal compliance. Many younger docs prefer scrubs, and this includes a goodly number who are nowhere near an operating room. I’ve heard on several occasions that patients are less intimidated if the doctor consults with them minus the formal, starchy appearance of a white lab coat.

I suppose that one could make an argument in favor of the lab coat as a means of infection control if the dutiful health care professional were to change it often during his shift. However, such a practice is by no means common. Indeed, hospitals have a difficult time convincing their employees of the potential danger involved in wearing scrubs outside the facility, and not changing into a clean pair upon their return.

After all, infection control works both ways. Scrubs (or any clothing for that matter) can become contaminated with pathogens, and if this apparel is worn on public transit on the way home, could infect passengers. Likewise, wearing these scrubs on the subway, as many have observed, can bring all the nasties of the street directly into the inner sanctum of the hospital.

An article published last September in the American Journal of Infection Control entitled “Nursing and physician attire as possible source of nosocomial infections” concluded that “Up to 60% of hospital staff’s uniforms are colonized with potentially pathogenic bacteria, including drug-resistant organisms. It remains to be determined whether these bacteria can be transferred to patients and cause clinically relevant infection.”

As to nursing apparel, organized nursing as we know it today dates back to 1860 and Florence Nightingale. Nursing uniforms came out of her London-based training school, and changed little until the 1940s. Various modifications would then occur, including the disappearance of the once-familiar caps. Virtually all nurses now wear scrubs, with vivid colors available, and allowable in many health care facilities.

Statistics point to as many as 12 million people being involved in health care in the US. Surely, many of them will be wearing uniforms of some sort, but is it possible for them to portray a modicum of fashion at the same time? Keesha Parsons, CEO of My Wardrobe thinks so.

In a recent interview, Keesha took me through her breakthrough website, in which men and women can create their own virtual online closet space, consult fashion advisers, and share fashion ideas and tips—all at no charge. Boutiques are available to members, and yes, Keesha has collaborated with suppliers of health care apparel. There is life beyond standard scrubs.

I wonder what Florence Nightingale would think.