Should Clinicians Strip Down or Suit Up?

Nurse's Cap

Don’t worry. We’re not turning this into a fashion blog. But the topic of what health care professionals should and should not wear is a hot topic lately, and I’m finding it fascinating.

On June 25th my fellow blogger Susan Shaw explored the issue and provided some thought provoking ideas in her post “What (NOT) to Wear”. A few days later, Globe and Mail columnist Andre Picard was asking “Why do physicians wear white lab coats?”.

Clearly, hospital fashion is all the rage this summer. And I for one am glad it’s up for discussion.

One of my biggest pet peeves as a patient/family member continues to be not knowing who my care provider is. When I go into a hospital and need assistance, am I asking for help from a care aide, an RN, a doctor, a student, a lab tech, or a nurse practitioner? I am always relieved when I see someone wearing a hair cap because then I know they are from dietary services. Or, wait… maybe they’re the scrub nurse from the operating room?!?

I agree with Susan that the white lab coat phenomenon does create a power hierarchy that can affect the relationship between the doctor and patients, as well as between the doctor and other care providers. But what’s nice about the white lab coat is that I can tell, almost immediately, that the person coming into my room is likely a doctor. And, I have to admit, I kind of like that.

In Lean they often talk about the “5 second rule.” Anyone should be able to walk into any area and find what that they need within 5 seconds. Can we say that about our health care providers? Can I readily assess who I’m talking to in a clinical environment within 5 seconds? If not, is that introducing waste by creating more opportunity for interruptions, or worse yet, safety issues?

Don’t get me wrong. I’m not saying we should go back to the days of hats, skirts, and white pantyhose. But there is something intriguing about visual identification of health care providers not only for patients but for other care providers too. Let’s face it, in a busy environment or emergency situation we forget to introduce ourselves. And who can read those tiny little nametags?  When I worked as an RN in a busy Calgary Emergency Deparment we did have some color coding.  Hospital issued scrubs that were navy blue for RNs, pink for porters, green for docs (with a lab coat), and light blue for care aides.  As a new employee I really appreciated being able to ask my colleagues for things in a rush understanding their role based on the color of their uniform before I knew them by name.

Nova Scotia tackled the issue head on last fall by introducing standard uniforms for RNs in the province: white top and black pant scrubs. The change has been welcomed by some and resisted by others.

So what do you think? Would patients and families appreciate being able to distinguish their care providers out by standardized uniforms? Does the “5 second rule” even apply in this case? What are the opportunities and risks of stripping down or suiting up in an effort to design better care and better teams?

Maybe there are bigger fish to fry in our system right now. But sometimes the things that seem small ultimately have the biggest impact on our patients.

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