What nurses can learn from the uniforms and ceremonies of other healthcare professions.
“WHAT DOES AN RN LOOK LIKE?”When I was asked that question by a student, I didn’t immediately answer because describing an RN today in terms a nonclinician understands is difficult. I’ve talked about dress codes before and nurses’ lack of compliance with them (myamericannurse.com/dress-codes-matter/). One of the most important issues is that when you walk into many nursing units, clinics, or surgi-centers, you can’t tell the RNs from any other caregivers. Nursing is losing its identity and the professionalism that goes with it, unless we individually and collectively try to change that fate.
Let me describe for you a true story that occurred in my organization and reinforced my position about the need for consistent icons and images associated with a profession.
With a grant from the Arnold P. Gold Foundation of New York, the University of North Texas Health Science Center celebrated its first White Coat Ceremony in August 1996. The ceremony has become a tradition that’s never missed and is considered a rite of passage for medicine, pharmacy, and college of health professions students. It’s described as an important component of scholarship that encourages a person’s psychological contract toward professionalism and empathy.It’s also a way to emphasize the importance of the foundations that support the entire organization’s mission: education, research, patient care, and service.
The ceremony takes place in a large auditorium in front of family, friends, and faculty. After the university president and deans welcome incoming students, an eminent role model who embodies character and integrity throughout a career in healthcare gives a speech. Students are then presented individually and “cloaked” with their first white coat, symbolizing the mantle of their chosen profession. The students recite a professional oath in front of the assembled group as a public acknowledgment of new responsibilities and a willingness to assume the obligations of their chosen profession.
The white coat is explained as a symbolic, nonverbal communication used to express and reaffirm a fundamental belief in a system. The authority of a profession’s attire is considered serious and purposeful, not social, causal, or at random. In the past, the dress of healers of primitive societies was considered an important part of the articles used for healing. And today, the“uniform” should reflect the professionalism of the person wearing it and convey to even the most anxious patient a sense of reassurance and confidence that his or her issues will be dealt with competently.The white coat is described as a cloak of compassion.
Every student who participated in that ceremony holds his or her head high and exhibits a sense of professionalism that’s indescribable. Yet that sense is dulled if their clinical rotations are in hospitals that lack dress codes. How did we let that happen?
Although nursing is considered one of the most trusted professions, we still struggle with the consistent image that depicts the trust and caring that defines us.White uniforms, polished white shoes, and caps are long gone, so let’s not make the “uniform” a source of tension. But perhaps some other standard is needed.What would standardization of nursing’s image across all 3.6 million RNs practicing in the United States look like? What is the “white coat ceremony” equivalent for all nursing programs?
If we knew the answers, then responding to the question “What does an RN look like?” wouldn’t be so hard. How would you answer that question?

Lillee Gelinas, MSN, RN, CPPS, FAAN
Editor-in-Chief
lgelinas@healthcommedia.com
Selected references
Clavelle JT, Goodwin M, Tivis LJ. Nursing professional attire: Probing patient preferences to inform implementation. J Nurs Adm. 2013;43(3):172-7.
Dumont C, Tagnesi K. Nursing image: What research tells us about patients’ opinions. Nursing2011. 2011;41(1):9-11.
Everett LQ. On changing RN uniform color: May the bridges I burn light the way. Nurse Leader. 2012;10(6):34-5.
West MM, Wantz D, Campbell P, Rosler G, Troutman D, Muthler C.Contributing to a quality patient experience: Applying evidence based practice to support changes in nursing dress code policies. Online J Issues Nurse. 2016;21(1):4.
Windle L, Halbert K, Dumnet C, Tagnesi K, Johnson K. An evidence-based approach to creating a new nursing dress code. Am Nurse Today. 2008;3(1):17-19.
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