LEWISTON — In 1988, there was a local revolution in nursing attire: The starched caps came off and white uniforms gave way to colorful fashions of the day.
In fact, colored scrub tops were encouraged to boost patient cheer, and nurses continued to wear white bottoms and shoes. Years later, the requirement to wear white disappeared altogether, and nurses could wear scrubs of any color or design.
Now the uniformity of uniforms is back. At least it is at Central Maine Medical Center, where this week the hospital is finishing a three-month pilot program testing patients’ ability to better recognize nurses and certified nursing assistants when each are dressed in uniformly colored scrubs.
No decision has been made on whether to make uniformity permanent, but patient and staff reaction has been good, according to Sharron Seilman, vice president of nursing at the hospital.
The test of same-colored uniforms has been conducted among 250 employees on three floors of the hospital: medical oncology, the adult and pediatric unit, and the cardiopulmonary unit.
In those units, registered nurses have been wearing navy blue scrubs and CNAs have been wearing gray, purposely gender-neutral colors to accommodate everyone.
Seilman said that after the pilot program got under way, people thought the gray scrubs were a little gloomy, so if the hospital moves to require uniform scrubs across all floors, CNAs will move to light blue scrubs.
The decision to make the change permanent won’t be made until administrators have a chance to review patient surveys, Seilmansaid. But Seilman also said the program has been so popular that staff working on other floors of the hospital have asked to participate, including respiratory therapists. And, so far, patients have responded well to the easily identifiable colors.
“The standardization is so professional,” Seilman said. “It’s such a delight to see them” working with patients, and seeing patients and families being better able to identify members of the nursing staff.
Some patients have mentioned that they miss the brightly colored scrubs, but these same patients also appreciate knowing who is a nurse as soon as a person walks into the room, Seilman said.
The change was prompted when hospital officials reviewed patient satisfaction surveys and saw that patients wanted to spend more time with their nurses, but since not all patients always know who the nurses are, administrators wondered whether patients may have spent more time with their nurses than they realized.
With uniformly colored scrubs, patients do seem to be more satisfied with the amount of nurse contact, Seilman said.
“Before,” she said, “we had a regular professional dress code. And while colors are pretty, it’s not conducive to letting people know who they are speaking to.”
During the pilot, Seilman said articles in professional journals about the move toward uniformly colored scrubs were shared among the staff. “We don’t want to make this a dress-code issue. We want to make this about patients,” and there are a number of studies that have concluded patients like the uniform approach.
"What we’re interested in is patient perceptions of nurse attire,” Seilman said, and “just getting people to think about their level of professionalism and their perception to the patients.”
At the Cleveland Clinic in Ohio, Nancy M. Albert, a registered nurse and director of nursing research and innovation, led a study of how patients and visitors viewed nurses, with some nurses wearing white scrubs and others wearing patterned or solid-colored scrubs. Among adults, nurses wearing uniform white were perceived as more professional than those wearing patterns or colors, but children didn’t indicate any preference for either set.
The results of that study were published in Applied Nursing Research in 2008, concluding that, with aging, “adults create perceptions of nurse professionalism based on uniform color and style,” and many hospitals around the country have begun adopting uniform dress codes, not just for nurses, but for other hospital employees so patients can more easily differentiate among workers.
In fact, according to Krista Meinersmann, professor of nursing and director of the School of Nursing at the University of Southern Maine, uniformly colored scrubs have become a national trend, something the teaching staff started discussing last year. But Meinersmann wasn’t aware of any hospital in Maine moving in this direction.
“We have not been told by CMMC that our students will be required to wear certain colors,” Meinersmann said.
USM nursing students now wear blue tops and white bottoms when doing their clinical rotations at Maine hospitals, a “standardization so our students look professional,” Meinersmann said. She said that is similar to nursing schools across the country.
At Maine Medical Center, the nursing staff does not wear uniformly colored scrubs, but members of the clinical maintenance staff all wear blue scrubs and members of the housekeeping staff wear concierge-style uniforms, according to Mary Saucier, a hospital spokeswoman.
These specific uniforms let patients know who is a health care worker and who is not. And, she said, “a lot of the departments are using name tags that are color coded” to promote patient recognition of nurses, doctors, CNAs and lab technicians, among other hospital employees.
According to Jodi Galli, vice president and chief nursing officer at Eastern Maine Medical Center in Bangor, “our policy states that print scrub tops must promote a professional image. In departments where scrubs are required, the colors must be approved by the department head.”
St. Mary’s Regional Medical Center did not return a message seeking comment.
Seilman acknowledges that not all members of the nursing and CNA staffs at CMMC are happy about the change.
A hospital employee who contacted the Sun Journal said some employees are angry that they'll lose freedom of choice in selecting their work clothes, and others are worried about the cost of new uniforms.
Seilman said the hospital has offered each employee in the pilot program a $75 stipend to help defray the cost of new scrubs, because “we don’t want this to be a financial burden.” She said the stipend could pay for “up to three sets” of scrubs.
At the end of this week, when the pilot program ends, Seilman said, “We’ll get everybody back together and make some decisions.” In the meantime, staff at the Bridgton and Rumford hospitals have been informed “so that we can be consistent in nursing,” she said.
An employee at Tally’s Uniforms in Auburn, who declined to identify herself, said she was aware of the change at CMMC and is working to have merchandise ready.