This document discusses whether the traditional white nurses' uniform is appropriate for child-friendly healthcare services. It provides an overview of the history and evolution of nurses' uniforms, standards for child-friendly healthcare, and several studies that found white uniforms increased child anxiety while colorful uniforms improved nurse-child relationships and reduced child distress. The document recommends that nurses working with hospitalized children use child-friendly colored uniforms instead of white to help reduce fear and anxiety in patients.

1. Nurses’ white uniform: Is it
an issue in Child-Friendly
Health Care Services?
ERIC CHISUPA
PRINCIPAL LECTURER - RPN
14/10/2019 1

2. Presentation outline
• Introduction
• Child-friendly health care
• Standards
• Evolution of nurses’ uniform
• Nurses’ uniform and the child
• Recommendations
• Conclusion
• References
14/10/2019 2

3. Introduction
• Hospitalisation causes fear and anxiety in
children.
• Nurses play major role in alleviating the distress
and anxiety.
• Characteristics of nurses and their clothing are a
factor in child’s environment.
• They affect quality of care through child-nurse
relationship
14/10/2019 3

4. Source: (Kuralayphotography, 2012)14/10/2019 4

5. Child-friendly health care
• It is about ensuring best care of children at every
level of health care provision (Coetzee, 2010).
• Health care providers, organizations and
individual health care workers, share a
responsibility to advocate for children and to
reduce the fear, anxiety and suffering of children
and their families (Nicholson & Clarke, 2005)
14/10/2019 5

6. •Guided by 12
standards
14/10/2019 6

7. Standards
1. Keeping children out of hospital
2. Supporting the “best possible” healthcare
3. Giving care safely in a secure, clean “child
friendly” environment
4. Giving “child” centred care
5. Sharing information
6. Equity and respecting a child as an individual
with rights
14/10/2019 7

8. Standards….cont
7. Recognising and relieving pain and discomfort
8. Providing “appropriate” emergency care
9. Enabling play and learning
10.Protecting children (recognizing and supporting
a vulnerable or abused child)
11.Monitoring and promoting health
12.Supporting the “best possible” nutrition
14/10/2019 8

9. Source: (Nicholson & Clarke, 2005).14/10/2019 9

10. Source: (Nicholson & Clarke, 2005).14/10/2019 10

11. Evolution of nurses’ uniform
• Derived from the nun's habit, before the 19th
century, nuns took care of sick and injured people
• Van Rensselaer Euphenia (1840-1912) designed
the original nurses’ uniform for Florence
Nightingale School of Nursing and Midwifery 9
July 1860 (Mosby’s Medical Dictionary, 2009).
14/10/2019 11

12. Evolution of nurses’ uniform ….cont
• Before the 1940s minor changes occurred in the
uniform (Clarke, 2012), hospitals were free to
determine the style of the nurse uniform.
• Nurses continued to wear white until the 1960s,
when feminists decided white symbolized
diminished power (Tobin, 2006).
14/10/2019 12

13. Evolution of nurses’ uniform ….cont
• 1980s brought many changes in many places
around the world, nurses uniforms were not left
untouched (Blanche, 2010).
• During the 1990s and today, nursing dresses have
been replaced with much more user friendly
scrub suits.(Blanche, 2010)
14/10/2019 13

14. Beth Israel Deaconess Medical Centre - 1897
Source: (Beth Israel Deaconess Medical Centre, 2014).14/10/2019 14

15. Beth Israel Deaconess Medical Centre - 1916
Source: (Beth Israel Deaconess Medical Centre, 2014).14/10/2019 15

16. Beth Israel Deaconess Medical Centre - 1953
Source: (Beth Israel Deaconess Medical Centre, 2014).
14/10/2019 16

17. Beth Israel Deaconess Medical Centre - 2012
Source: (Beth Israel Deaconess Medical Centre, 2014).
14/10/2019 17

18. Beth Israel Deaconess Medical Centre - 2012
Source: (Beth Israel Deaconess Medical Centre, 2014).
14/10/2019 18

19. Nurses’ uniform and the child
• The emotional and psychological well-being of
the child and family is not always considered
(Coetzee, 2010).
• The atmosphere created by staff is essential
and goes beyond communication to
appearance, friendliness and competence.
14/10/2019 19

20. Nurses’ uniform and the child cont.
• In a study - Impact of nurses clothing on anxiety
of hospitalised children, (Roohafza et al., 2008).
• Children exposed to white nursing uniforms
showed higher anxiety levels compared with
children exposed to coloured nursing clothing
14/10/2019 20

21. Nurses’ uniform and the child cont.
• In a study - Examining the effect of multicoloured,
nonconventional attire on hospitalized
children (Festini, 2009).
• Multicoloured uniforms improved the
relationship between the nurse and the child, and
this helped obtain the child’s compliance to the
treatment and reduce anxiety and fear.
14/10/2019 21

22. Nurses’ uniform and the child cont.
• In the study - Identification Required: Public
Perception of Nursing Uniforms (Brock, Metaferia
& Sumner, 2012).
• Public preferred a nurse to wear colorful, printed
uniforms over solid or white, especially true
when a nurse wants to appear friendly and
approachable
14/10/2019 22

23. Nurses’ uniform and the child cont.
• In an article Child-friendly uniforms add lighter
touch (Caelers, 2005)
• "The children love them. These outfits are much
less intimidating, but the patterns and pictures
also distract the children when you're trying to do
some procedure on them, which helps us too“.
14/10/2019 23

24. Nurses’ uniform and the child cont.
• In a survey What Meets the Eye: An Examination of
the Nursing Uniform (Clarke, 2012).
• “Nurses should wear white in healthcare settings
involving older patients”.
14/10/2019 24

25. Source: (Lusaka School of Paediatrics and Child Health
Nursing Class, 2014).14/10/2019 25

26. Source: (Lusaka School of Paediatrics and Child Health
Nursing Class, 2014).
14/10/2019 26

27. Nurses’ white uniform: Is it an
issue in Child-Friendly Health Care
Services?
14/10/2019 27

28. Thank you for promising to create a
child-friendly environment for us
Source: (Kuralayphotography, 2012)14/10/2019 28

29. Recommendations
• All health workers working with children should
be oriented to Child- Friendly Health Care
Standards.
• Nurses working with hospitalised children should
use child friendly colours to reduce fear and
anxiety.
• White uniforms should be used when working
with hospitalised adults
14/10/2019 29

30. Conclusion
• The nurses’ white uniform is an issue in Child Health
Nursing as it induces fear and anxiety in children.
• Providing a child-friendly environment is cardinal in
child health nursing.
• Concerted efforts are required to bring change and
create child-friendly environment that would help
promote quality child health nursing care.
14/10/2019 30

31. References
• Blanche, J. (2010). Nursing 50 Years Back and Today:
How the Nursing Field Has Changed Over the Last
50 Years | HEALTHeCAREERS. Retrieved July 18,
2014, from
http://www.healthecareers.com/article/nursing-
50-years-back-and-today-how-the-nursing-field-
has-changed-over-the-last-50-years/158432
14/10/2019 31

32. References …..cont…
• Brock, D., Metaferia, F., & Sumner, E. (2012).
Identification required; Public perception of
nursing uniforms. LaGrange College. Retrieved
from
http://www.lagrange.edu/academics/citations/2
014/index.html
14/10/2019 32

33. References …..cont…
• Caelers, D. (2005). Child-friendly uniforms add lighter
touch - South Africa. Retrieved July 18, 2014,
from http://www.iol.co.za/news/south-
africa/child-friendly-uniforms-add-lighter-touch-
1.244845#.U8jq3_mSyr8
• Clarke, A. (2012). What meets the eye: An
examination of the nursing uniform. Journal of
Student Writing, 1(34), 1–7.
14/10/2019 33

34. References …..cont…
• Coetzee, M. (2010). Towards child and family-friendly
health services. University of Cape Town.
• Festini, F. (2009). Study finds multicolored scrubs
brighten pediatric care. Retrieved July 18, 2014,
from
http://www.healthleadersmedia.com/content/H
OM-231175/Study-finds-multicolored-scrubs-
brighten-pediatric-care.html
14/10/2019 34

35. References …..cont…
• Mosby’s Medical Dictionary. (2009). Van Rensselaer -
definition of Van Rensselaer by Medical
dictionary. Retrieved July 18, 2014, from
http://medical-
dictionary.thefreedictionary.com/Van+Rensselaer
• Nicholson, S., & Clarke, A. (2005). Child friendly
healthcare: A manual for health workers. CFHI.
14/10/2019 35

36. References …..cont…
• Roohafza, H., Pirnia, A., Sadeghi, M., Toghianifar, N.,
Talaei, M., & Mahmood Ashrafi. (2008). Impact
of nurses clothing on anxiety of hospitalised
children. Journal of Clinical Nursing, 18(13), 1–7.
• Tobin, S. (2006). American Nurse Today: How do you
look? American Nurse Today, 1(1), 38–39.
14/10/2019 36

37. Special Thanks
• Rogers Gift Benkele
• Principal Lecturer
• Arthur Davison's Children Hospital School of
Pediatrics Nursing
14/10/2019 37