Clothes do communicate in hospitals
Patients conversing in a hospital room:
“Was that a doctor in the brown scrub suit?”
“I don’t think so. He may have been a transport worker or a nurse.”
“No, I think the nurses wear white pants with a flowered top.”
“But some of them wear jeans. Are they different, like a student nurse or nurses’ aide?”
Maybe that’s not exactly the way it happens in your hospital, but it’s a safe bet that conversations like this happen in every hospital every day—due to confusion over all of the hospital personnel. (The conversation is manufactured, but the outfit descriptions are real—I observed them only recently.)
We know that in the medical field we communicate in a number of ways: verbally, with body language, in how we practice, in how we operate our offices. All modes send messages to patients. Hospitals, too, communicate messages in the same form. And most hospitals send confusing messages as to who is who and what he or she can or can’t do.
When that man appeared with a wheelchair without anyone telling us about it, how do we know his legitimacy? And when a lady appears with some pills, is she a nurse—our nurse—or a student or an aide? And is she supposed to be doing this?
There was a time years ago when hospital personnel could be identified by their uniforms—nurses in starched white, student nurses in colored tops with white apron skirts, interns with clinic jackets or clinic shirts, physicians with long white clinic coats. It was easy to know. Dress was uniform, and jobs were obvious. Everyone, including patients, immediately recognized each health care professional. It is more difficult today, with more and more male nurses and more and more female physicians, the increase of paramedical health care workers, and the widespread trend toward informal attire by all groups.
But the era of informality is with us. Apparently hospital employees wear whatever they wish. In a large hospital that may employ several hundred nurses, even a sharp administrator coming on the floor cannot decipher who is who.
So what communication does this send? To me, it says, “We don’t care whether you know who we are or not, or like it or not, just follow orders. If you are uncomfortable with that, tough. That’s just the way we operate.”
Facetiously—no, semifacetiously—I think the problem could be solved if everyone wore a T-shirt labeled, front and back (like a football or baseball uniform), with “NURSE” or “STUDENT NURSE” or “INTERN” or “RESIDENT” or “TRANSPORT” or whatever. Maybe even include the employee’s name in large letters—no numbers necessary. But, nah, that wouldn’t look professional.
Hospital administrators, who solve so many problems every day, could easily come up with a dress code that would be instantly recognizable. Try this one as a simple (and incomplete) sample: white slacks and flowered tops (which seem to be popular) for female RNs (with a masculine version of the uniform for male nurses), white slacks with solid tops for student nurses, purple scrub suits for aides, and so forth. This could be complemented by an explanation sheet (maybe even illustrated) that would be given to each patient on admission and would simplify recognition and give a brief description of the duties of each uniform wearer.
One other change would help patients recognize the roles of hospital staff: hospital badges. The person’s name and title should be large enough for every patient to read from 10 feet away—the geriatric population, younger patients not wearing their glasses—everyone.
Some attendants introduce themselves on entering a room, but not all do. Such introductions should continue, even when badges are worn and a dress code is in place. Patients, almost all of them, are uncomfortable because of the strange environment, fearful in many cases, and anxious. They wonder who is coming in next and what the attendant is going to do—hurt me, stick me, take me to some unknown area? What will result?
Good identification—no, instant identification—is important in relieving some of these problems and making patients more comfortable in the hospital. In today’s hospital milieu, stays are shorter—too short to develop a full understanding of what is going on.
This new (or return to the old) dress code will communicate a different message: We care for you. We want you to know who’s who and what’s going on and who’s doing what. We want you to have the least possible anxiety. By our letting you know who’s who, you can relax. Welcome to our hospital.
A former president of the American College of Osteopathic Pediatricians and the American Medical Writers Association, Arnold Melnick, DO, is an experienced writer and public speaker, as well as a nationally known leader in pediatrics. Dr. Melnick was the founding dean of what is now the Nova Southeastern University College of Osteopathic Medicine in Fort Lauderdale, Fla.