Few undergraduate programs pay as much attention to attire as nursing. At every clinical orientation, dress code policies are reiterated with the familiar warning: failure to comply may result in being sent home from the unit or the simulation lab. In my school, the dress code stipulates: “Clothing must be neat, clean, professional, and appropriate in length. No see-through fabrics, denim pants, capri pants, shorts, sweat suits, midriffs, t-shirts, halters, or t-shirts with written statements.” Even with clear rules, lapses continue to occur.
Some time ago, one of my students arrived at a pre-conference for clinical wearing the prescribed scrub top paired with a white skirt trimmed with cascading ruffles, ending well above the knee. When I pulled her aside to privately discuss her wardrobe transgression (not being in professional attire for bedside nursing), she explained that she thought white skirts were allowed—adding with an eye roll, “I got mine from Ann Taylor.” As if a brand label could transform an outfit into clinical wear. Can you imagine?
Wearable danger
This tension between personal expression and professional dress isn’t new. Since the 1850s, nurses have been told what they should—and should not—wear. In Notes on Nursing, Florence Nightingale criticized the impracticality and indecency of the crinoline, warning of the dangers of skirts that could catch fire at the bedside: “Fortunate it is if her skirts do not catch fire—and if the nurse does not give herself up a sacrifice together with her patient, to be burnt in her own petticoats.” Her words remind us that clothing in healthcare isn’t about fashion, but rather safety and professionalism.
The debate today is less about fire hazards than hygiene. A study showed that bacterial contamination of healthcare workers’ white coats can potentially spread methicillin-resistant staphylococcus aureus (MRSA). Evidence indicates that bacterial counts from hospital physicians’ ties are higher than those from shirts. The U.K. introduced its “bare below the elbows” policy in 2007: no long sleeves, wristwatches, jewelry, or ties — garments thought to interfere with hand and wrist hygiene.
When in doubt, don’t wear black
Appearance also shapes perception. A 2019 study asked participants to view a set of eight photos of clinicians wearing scrubs of various colors. The subjects were then asked which clinician they most strongly associated with the role of surgeon, and then to rank these individuals on knowledge, skill, trustworthiness, and compassion. Findings revealed that scrubs color shaped perceptions of professionalism and credibility. Green was most often linked with surgeons, although some participants associated it with janitorial staff. Blue scrubs, by contrast, were consistently viewed across age groups as conveying care and trustworthiness. Black scrubs carried the most negative associations, frequently perceived as signaling a lack of knowledge, skill, or compassion. For some they even evoked comparisons to mortuary attire.
If black scrubs carry such baggage, why are they so popular lately? I worry that because dirt and stains are less visible, wearers may have less incentive to change or launder them. I once overheard a man explain his resolution to wear only white underwear, so its soiling would force him to change more often. The same logic applies to clinical attire—what shows gets washed. Anyone who has seen a white coat with grimy collar and cuffs or scrub pants with frayed hems, caked with dirt, knows the unsettling impression these leave. It raises more than aesthetic concerns; it prompts unsettling questions about the microbiological ecosystems thriving in unwashed clinical attire. The image alone undermines both hygiene and professional credibility.
Say “yes” to dress up
Professional attire has always been more than a matter of fashion; it’s a social code that communicates seriousness of purpose and respect for the roles we occupy. Nursing faculty and administrators, in particular, should resist the cultural drift toward dressing down. Social etiquette has long held that different tasks require different attire—the tracksuit belongs in the gym, not the office. The erosion of professional dress sends a subtle but powerful message that professionalism is negotiable. It’s not.
Clothing also shapes perception and behavior. A growing body of research in psychology suggests that what we wear influences not only how others view us but also how we view ourselves. Known as enclothed cognition, in a small study, this phenomenon demonstrates that professional attire can heighten confidence, focus, and a sense of responsibility. For nursing faculty and administrators, this means that attire isn’t simply a matter of appearance, it’s a tool that reinforces professional identity and better performance.
Employers can encourage professional dress by framing attire as a shared standard of respect rather than a rigid rule. Policies should be developed with input from staff, so expectations feel collaborative rather than imposed. Culturally sensitive guidelines recognize diverse traditions and expressions of identity, allowing flexibility while maintaining professionalism (for example, permitting head coverings, cultural dress, or modest attire within professional parameters). Organizations should ensure dress codes are realistic, affordable, and appropriate to the work setting. For in-person roles, this may mean clear guidance on cleanliness, fit, and safety. For remote work, attire expectations can emphasize presentability rather than rigid formality.
In the end, professional attire isn’t an anachronism; it’s a cultural signal of responsibility. For nurses, faculty, and administrators alike, what we wear affirms the dignity of our work and the seriousness of the profession we represent.
Fidelindo Lim, DNP, CCRN, FAAN is a Clinical Associate Professor at New York University Meyers College of Nursing.
