Clinical practice
Developing a new uniform policy for student nurses Julie F o ster/P au l T urner, T he B irm ingham C ollege of N u rse E ducation This article describes the recognition by a group of nurse tutors of the need for a new student uniform in response to research findings that linked back pain with lifting and the wearing of inappropriate attire.
Ms Foster and Mr Turner are Nurse Tutors at The Birmingham College of Nurse Education, East Birmingham Hospital, Bordestey Green East, Birmingham B9 5ST
i n common with the majority of nurse education establishments, The Birmingham College of Nurse Education (BCNE) is now a multisite college, providing educa tion for nurses across three health authorit ies. The College Management Team recog nized the need to homogenize the different uniform policies that existed within these different authorities. A working group was therefore established to decide on a suitable college uniform for students to wear in the clinical areas and to draft a uniform policy. The group consisted of 11 people: two nurse teachers from each site in addition to student nurse representatives. The latter element was thought to be vital to the effec tiveness of the group.
D iscu ssio n The inaugural meeting was held in Septem ber 1991. It was decided that the new uni form should reflect many of the factors that had been identified by research. The first issue for discussion was the way in which traditional uniforms tend to hinder move ment; this can be seen as a contributory factor to back injury (RCN, 1979; Hollinrake, 1978; The Back Pain Associ ation and the RCN, 1981; COHSE, 1992). Many other authors have also contributed to the debate (Sparrow, 1987; Walsh, 1990; Hawkey and Clark, 1990). The second issue concerned the desire for the new uniform to present a corporate identity. It was felt that whatever we chose needed to be of modern design and in line with current thoughts on the therapeutic relationship between patient and nurse, as highlighted by Meade (1980), Rowden (1983), Castledine (1987) and O ’Connor and Wright (1990). A further concern was the laundering and cost of the new outfit, but we realized that this could not be dealt with until a uniform had been selected. Manufacturers’ catalogues were circulated among the group so that members could identify suitable garments.
British Journal of Nursing, 1992,Vol I, No 14
Questionnaire In an attempt to garner a wider opinion, a questionnaire was devised and sent to nurses working in clinical areas, student groups, teaching staff and members of the College Management Team. The results showed that 38% of respon dents wanted female student nurses to wear trousers, 46% preferred a dress and 16% culottes. The group members were pleas antly surprised at these results. We realized that nurses are traditionalists par excellence (Hall et al, 1984). Before the results of the questionnaire were available, members of the working group had favoured female students being given the option of wearing trousers or cu lottes. While the findings of the question naire did not entirely support culottes, it was decided that a student member should wear them for a trial period, during which time all reactions/responses would be monitored. Group members were interest ed to see whether the traditionalist view, as described by McNally (1990), was still held.
Trial period Navy-blue culottes and a pale blue tunic top were obtained and trialled for 4 weeks. Reaction to the new uniform was mixed, but most people were in favour, stating that it gave the nurse a professional appearance and was more attractive than traditional at tire. The student nurse herself found it very comfortable to work in as it did not restrict movement; it also overcame the embarrass ment factor when lifting patients. The district laundry accommodated our request for a test wash. The garments wash ed well and did not shrink or fade. The Col lege Finance Manager costed the uniforms and forwarded these figures to both the working group and the College Manage ment Team. The Principal and Associate Principal saw the proposed outfit and agreed that it
717
© MA Healthcare Ltd. Downloaded from magonlinelibrary.com by 129.127.145.224 on January 1, 2018. Use for licensed purposes only. No other uses without permission. All rights reserved.
D eveloping a new u n ifo rm p o licy fo r student nurses
should be accepted as the new student uni form. They felt that it represented the cor porate identity that the College wished to portray, i.e. it was modern, functional, re search based, dynamic and presented a pro fessional image. The working group’s final task was to produce a college-wide uniform policy. Be fore doing so, it was agreed that female stu dents would be given the choice of wearing a combination of culottes or trousers with the tunic top. A draft policy, taking into account this aspect of individual student choice, has been forwarded to the College Management Team whose ratification is awaited. After the costing exercise it was decided that each student should be given the choice
KEY POINTS • It has been recognized that for many years traditional nurse uniforms are far from ideal. • Inappropriate uniforms can be a contributory causative factor in back injury among nurses. • Many nurses hold firmly to a traditional view of what constitutes a ‘proper’ nurse’s uniform. • Uniforms can act as a barrier and hindrance in the development of the therapeutic relationship between nurse and patient. • Many colleges of nursing face amalgamation. This presents them with an opportunity to re-examine their uniform policies and rationalize the many into the one.
of being provided with 5 tunic tops and 3 pairs of culottes/trousers, or a combination of these, e.g. 2 pairs of trousers and 1 pair of culottes. The desirable aspect of unisex uniforms did not extend to allowing male students the choice of either trousers or cu lottes; trousers would be compulsory. The working group felt that they had an opportunity to change dramatically the stu dent uniform policy. Our solutions are not as radical as some nursing units which have proposed no-uniform policies. However, we must wait to see how our choice is ac cepted once it is in wider use. ]iflfcf
Back Pain Association and the RCN (1981) The Han dling o f Patients — A Guide for Nurse Managers. JB Shears and Sons Ltd, Hampshire Castledine G (1987) The uniform farce. Geriatr Nurs and Home Care 7(5): 10 COHSE (1992) Lifting and Back Pain in Healthcare Work. Guidance for Health Care Workers. COHSE, London Hall F, Martin H, Nolan M, Taylor V (1984) A ques tion of uniform. Nurs Times 80(24): 53-6 Hawkey B, Clark M (1990) Dress sense or nonsense? Nurs Times 86(3): 28-31 Hollinrake EM (1978) Too tij;ht for comfort. Nurs Mirror 146: 12 Meade H (1980) O r no uniform at all? Nurs Times 76(4): 147-8 McNally M (1990) Uniform distress. Nurs Standard 4(20): 51-2 O ’Connor S, Wright M (1990) Removing barriers to communication. Nurs Standard 5(12): 26-7 RCN (1979) Avoiding Low Back Injury Among Nurses (Report). RCN, London Rowden R (1983) Uniforms for psychiatric nurses. Nurs Times 79(47): 24-5 Sparrow S (1987) The uniform question — the case against. Nurs Times 83(15): 41 Sparrow S (1991) An exploration of the role of the nurses’ uniform through a period of non-uniform wear on an acute medical ward. J Adv Nurs 16: 116-22 Walsh A (1990) Dress sense. Nurs Standard 4(20): 54
BJN CLASSIFIED SECTION Just the job for BJN readers! Are you looking for a job? Or are you interested in going on a course? Turn to our new classified section starting on page 741 718
British Journal of Nursing, 1992, Voi l,N o 14 © MA Healthcare Ltd. Downloaded from magonlinelibrary.com by 129.127.145.224 on January 1, 2018. Use for licensed purposes only. No other uses without permission. All rights reserved.
Developing a new uniform policy for student nurses Julie F o ster/P au l T urner, T he B irm ingham C ollege of N u rse E ducation This article describes the recognition by a group of nurse tutors of the need for a new student uniform in response to research findings that linked back pain with lifting and the wearing of inappropriate attire.
Ms Foster and Mr Turner are Nurse Tutors at The Birmingham College of Nurse Education, East Birmingham Hospital, Bordestey Green East, Birmingham B9 5ST
i n common with the majority of nurse education establishments, The Birmingham College of Nurse Education (BCNE) is now a multisite college, providing educa tion for nurses across three health authorit ies. The College Management Team recog nized the need to homogenize the different uniform policies that existed within these different authorities. A working group was therefore established to decide on a suitable college uniform for students to wear in the clinical areas and to draft a uniform policy. The group consisted of 11 people: two nurse teachers from each site in addition to student nurse representatives. The latter element was thought to be vital to the effec tiveness of the group.
D iscu ssio n The inaugural meeting was held in Septem ber 1991. It was decided that the new uni form should reflect many of the factors that had been identified by research. The first issue for discussion was the way in which traditional uniforms tend to hinder move ment; this can be seen as a contributory factor to back injury (RCN, 1979; Hollinrake, 1978; The Back Pain Associ ation and the RCN, 1981; COHSE, 1992). Many other authors have also contributed to the debate (Sparrow, 1987; Walsh, 1990; Hawkey and Clark, 1990). The second issue concerned the desire for the new uniform to present a corporate identity. It was felt that whatever we chose needed to be of modern design and in line with current thoughts on the therapeutic relationship between patient and nurse, as highlighted by Meade (1980), Rowden (1983), Castledine (1987) and O ’Connor and Wright (1990). A further concern was the laundering and cost of the new outfit, but we realized that this could not be dealt with until a uniform had been selected. Manufacturers’ catalogues were circulated among the group so that members could identify suitable garments.
British Journal of Nursing, 1992,Vol I, No 14
Questionnaire In an attempt to garner a wider opinion, a questionnaire was devised and sent to nurses working in clinical areas, student groups, teaching staff and members of the College Management Team. The results showed that 38% of respon dents wanted female student nurses to wear trousers, 46% preferred a dress and 16% culottes. The group members were pleas antly surprised at these results. We realized that nurses are traditionalists par excellence (Hall et al, 1984). Before the results of the questionnaire were available, members of the working group had favoured female students being given the option of wearing trousers or cu lottes. While the findings of the question naire did not entirely support culottes, it was decided that a student member should wear them for a trial period, during which time all reactions/responses would be monitored. Group members were interest ed to see whether the traditionalist view, as described by McNally (1990), was still held.
Trial period Navy-blue culottes and a pale blue tunic top were obtained and trialled for 4 weeks. Reaction to the new uniform was mixed, but most people were in favour, stating that it gave the nurse a professional appearance and was more attractive than traditional at tire. The student nurse herself found it very comfortable to work in as it did not restrict movement; it also overcame the embarrass ment factor when lifting patients. The district laundry accommodated our request for a test wash. The garments wash ed well and did not shrink or fade. The Col lege Finance Manager costed the uniforms and forwarded these figures to both the working group and the College Manage ment Team. The Principal and Associate Principal saw the proposed outfit and agreed that it
717
© MA Healthcare Ltd. Downloaded from magonlinelibrary.com by 129.127.145.224 on January 1, 2018. Use for licensed purposes only. No other uses without permission. All rights reserved.
D eveloping a new u n ifo rm p o licy fo r student nurses
should be accepted as the new student uni form. They felt that it represented the cor porate identity that the College wished to portray, i.e. it was modern, functional, re search based, dynamic and presented a pro fessional image. The working group’s final task was to produce a college-wide uniform policy. Be fore doing so, it was agreed that female stu dents would be given the choice of wearing a combination of culottes or trousers with the tunic top. A draft policy, taking into account this aspect of individual student choice, has been forwarded to the College Management Team whose ratification is awaited. After the costing exercise it was decided that each student should be given the choice
KEY POINTS • It has been recognized that for many years traditional nurse uniforms are far from ideal. • Inappropriate uniforms can be a contributory causative factor in back injury among nurses. • Many nurses hold firmly to a traditional view of what constitutes a ‘proper’ nurse’s uniform. • Uniforms can act as a barrier and hindrance in the development of the therapeutic relationship between nurse and patient. • Many colleges of nursing face amalgamation. This presents them with an opportunity to re-examine their uniform policies and rationalize the many into the one.
of being provided with 5 tunic tops and 3 pairs of culottes/trousers, or a combination of these, e.g. 2 pairs of trousers and 1 pair of culottes. The desirable aspect of unisex uniforms did not extend to allowing male students the choice of either trousers or cu lottes; trousers would be compulsory. The working group felt that they had an opportunity to change dramatically the stu dent uniform policy. Our solutions are not as radical as some nursing units which have proposed no-uniform policies. However, we must wait to see how our choice is ac cepted once it is in wider use. ]iflfcf
Back Pain Association and the RCN (1981) The Han dling o f Patients — A Guide for Nurse Managers. JB Shears and Sons Ltd, Hampshire Castledine G (1987) The uniform farce. Geriatr Nurs and Home Care 7(5): 10 COHSE (1992) Lifting and Back Pain in Healthcare Work. Guidance for Health Care Workers. COHSE, London Hall F, Martin H, Nolan M, Taylor V (1984) A ques tion of uniform. Nurs Times 80(24): 53-6 Hawkey B, Clark M (1990) Dress sense or nonsense? Nurs Times 86(3): 28-31 Hollinrake EM (1978) Too tij;ht for comfort. Nurs Mirror 146: 12 Meade H (1980) O r no uniform at all? Nurs Times 76(4): 147-8 McNally M (1990) Uniform distress. Nurs Standard 4(20): 51-2 O ’Connor S, Wright M (1990) Removing barriers to communication. Nurs Standard 5(12): 26-7 RCN (1979) Avoiding Low Back Injury Among Nurses (Report). RCN, London Rowden R (1983) Uniforms for psychiatric nurses. Nurs Times 79(47): 24-5 Sparrow S (1987) The uniform question — the case against. Nurs Times 83(15): 41 Sparrow S (1991) An exploration of the role of the nurses’ uniform through a period of non-uniform wear on an acute medical ward. J Adv Nurs 16: 116-22 Walsh A (1990) Dress sense. Nurs Standard 4(20): 54
BJN CLASSIFIED SECTION Just the job for BJN readers! Are you looking for a job? Or are you interested in going on a course? Turn to our new classified section starting on page 741 718
British Journal of Nursing, 1992, Voi l,N o 14 © MA Healthcare Ltd. Downloaded from magonlinelibrary.com by 129.127.145.224 on January 1, 2018. Use for licensed purposes only. No other uses without permission. All rights reserved.
