Views vary on national nurse uniform despite current ‘confusion’

In a discussion on the matter at the Royal College of Nursing’s annual congress on Wednesday, union members expressed varying views on the merit of a standardised uniform.

“It’s so confusing for staff, patients must be up the wall”

Carmel O’Boyle

Wales and Scotland introduced national nurse uniforms in 2010, followed by Northern Ireland in 2011.

Presenting the debate, Leonore Newson, from the Plymouth RCN branch, said the variation in uniforms at present in England was confusing for staff, students, patients and families.

For example, she highlighted that her trust had no less than 20 uniforms for its nursing staff.

“Patients, families, staff and our students in England are telling us that they are confused about the number of different uniforms that they see within the healthcare setting and cannot often tell who is a registered nurse and who is a support worker,” Ms Newson told delegates.

The Francis report into the care failings at the former Mid Staffordshire NHS Foundation Trust recommended that patients should be able to clearly identify between a registered nurse and a healthcare assistant, said Ms Newson.

Tracie Culpit, who sits on a nursing support committee at the RCN, said often patients assumed anyone wearing a uniform was a nurse.

“I have often witnessed as a member of staff in a uniform, walking past a patient, you will hear ‘nurse, nurse’,” she said. “It’s essential for us to recognise the importance to patients, visitors, to be able to identify who’s who.”

Ms Culpit also emphasised the importance of staff communicating with patients and introducing their name and role before providing care.

Katie Sutton, a mental health nurse from Manchester Central, told congress that she had traditionally worn her own clothes to work, but her unit was soon to be introducing uniforms for nurses.

While stressing that she would be “proud” to wear a nurse uniform, Ms Sutton said she was concerned about how patients would react.

“There’s an argument to be made that wearing uniforms can help mental health staff to establish boundaries, the flip side of that of course is that a uniform creates a barrier to therapeutic relationships,” she said.

Similarly, John Gillmore, from East Kent, raised concern that standardisation would lead to uniforms being enforced on nurses working in areas where they might not be “practical or suitable”, such as in learning disabilities and mental health.

“I don’t think what I wear is important to my practice”

Matthew Payne

Carmel O’Boyle, a member from Greater Liverpool and Knowsley, highlighted the wide variation in uniforms between different trusts in her area.

She noted that charge nurses and band 6 nurses at her trust wore the same colour as HCAs in another nearby hospital, while phlebotomists at her workplace wore a similar uniform as matrons in another.

“It’s so confusing for staff, patients must be up the wall,” she told delegates. “Please give us a standardised, comfortable uniform that are gender-neutral.”

The conference also heard from Jenna Baker, a learning disability nurse and a social worker from South Yorkshire, who is employed in a prison.

For the first four weeks of working at the prison, Ms Baker said she did not wear a uniform and that to some degree this anonymised her to the prisoners.

However, she said since adopting a uniform she felt like she was a “target”, because she was constantly being approached by prisoners asking for support for all types of health concerns.

“They automatically think that because I’m a nurse I can answer their question, whether it be physical health, mental health or learning disabilities,” Ms Baker said.

“I do find that this makes my day twice as long, so because of my duty of care I have to follow up physical health matters, mental health matters as well my own patients’ matters,” she added.

Matthew Payne, a nurse from South East London, said at his place of work there were distinctive uniforms for nurses and doctors, but patients still mistook him for a doctor.

“I don’t think what I wear is important to my practice, my practice is what is important to my role,” Mr Payne told congress.

“We are not standing out as nurses anymore”

Andy Roy 

“Our colleagues in the community don’t always wear uniforms, and mental health colleagues don’t wear uniforms, other allied health professionals don’t wear uniforms, so why us,” he added.

Andy Roy, from the RCN’s district nursing forum, said district nurses were telling him that they did not want to wear their blue uniform anymore, because it was the same as those used by care agencies.

“We are not standing out as nurses anymore,” Mr Roy said.

“Therefore, I strongly, strongly support some form of new uniform that’s NHS specific that can only be got through the NHS chains, it can’t be bought by care agencies, so we are easily identifiable as the registered healthcare professionals that we are,” he added.

A West Yorkshire RCN branch member, Russel Stringer, used the debate to highlight problems caused by lack of changing facilities for nurses.

He said currently nurses were having to get changed into their uniforms in toilets or wear them to work “which is an infection prevention issue”.

Previously, members of the college have backed the adoption of a national uniform in England, with congress voting in favour of a resolution a decade ago.