When did nurses start wearing a uniform? What inspired their look? Have you ever wondered how the uniform for nurses developed? Okay, not many people have — but hopefully this post will pique your curiosity now!
Before nurses starting wearing scrubs in the 1980s, the uniform that began in the mid-1860s was relatively unchanged until about the 1940s.
Duyckinick, Evert A. Portrait Gallery of Eminent Men and Women in Europe and America. New York: Johnson, Wilson & Company, 1873. [Public Domain]
Modern nursing is largely attributed to Florence Nightingale (1820-1910). She is credited for creating “modern” techniques and developing a certain look for the job. Her name sounds like something from a historic romance novel and her biography is equally worthy of a 19th century TV drama (there actually is a movie based on her life made in 1985). She was born into wealth and could have easily accepted a life of leisure, but decided to pursue an unlikely career as a nurse.
Hospitals in the mid-1800s were considered institutions for the poor. Those with any means would have been aided within their homes. Nightingale set about changing this system. As a nurse in the Crimean War she made a name for herself working tirelessly and creating organization out of chaos. She developed nursing as a respectable profession, published over 200 books on health and nursing, and generally improved hygiene and the standard level of care in hospitals. She also established the first school for training nurses in 1860, where nurses learned such skills as bed-making, leech application, and wound dressing (Tames, 26).
Nightingale, later in life, surrounded by nurses from London hospitals visiting her, 1886, FormerBBC [CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0)%5D
Leeches may not be part of the curriculum today, but the concepts she preached like the importance of cleanliness, giving patients a bell if immediate assistance was needed, proper nutrition, etc. have become the foundation of modern nursing. It seems obvious to us today that hospitals need to be sanitary, but at the time this was truly revolutionary as a requirement.
[For more specifics on her amazing accomplishments check out this page on the Florence Nightingale Museum website]
Prior to Nightingale, nurses didn’t have a uniform as they were not a formally organized profession. They dressed as any middle-class woman normally would to go about her day. Creating a uniform helped to legitimize nursing as a career path with a recognizable look and practical attire.
Nightingale’s personal wardrobe typically consisted of a dark dress with white lace accents. Prior to any kind of uniform, Nightingale would administer to the sick in her usual garb with an apron over her clothing and a cap covering her head. The illustration is from 1855, but her personal style was relatively homogeneous throughout her life. The colors were practical and with an unusual lack of ornamentation considering her wealth.
Developing a uniform for nurses is said to have first taken place within the Miss Nightingale School of nursing, though not necessarily designed by Nightingale herself. The uniform consisted of ”grey tweed wrappers, worsted jackets, with caps and short woolen cloaks, and a frightful scarf of brown holland embroidered in red with the words, ‘Scutari Hospital'”‘ (Cook, 173). The onlooking nun that described these uniforms was not a fan, but did admit that the red uniform cape worn by Queen Alexandra’s Imperial Military Nursing Service was derived from the one introduced by Nightingale’s Scutari nurses. This red cape would become an iconic part of the military nurse uniform.
Nurse Anna Marie McMullen from World War One, 1918, Anonymous Photographer [Public domain]
The uniform also consisted of a plain apron and a cap, just as Nightingale had long been wearing. These two elements would long be a staple of the nurse’s wardrobe. They suggested cleanliness and hard work.
Judging from the pile of hair under this woman’s cap (Nightingale would not have been too happy) this photo is likely from about 1910 when the reign of the Gibson Girl look required voluminous hair. David Knights-Whittome [Public domain]
Nightingale also listed what not to do for nursing dress, which seemed to be just as important. She said “‘the nurse is required to appear at all times in the regulation dress with the badge [this designated the hospital they were associated with], and never to wear flowers in their bonnet-caps, or ribbons […]”‘ (Cook, 174). She also would not tolerate crinolines, hair-pads, or polonaise skirts as these could be cumbersome in volume. Again, things that seem commonplace to us today, like a required lack of ornamentation for nursing staff, hadn’t been given much thought prior to the mid-1800s.
The inspiration for nursing uniforms is also believed to have been inspired by nun’s habits, who had long been administering to the sick. In fact, when Nightingale was described in 1855 attending a Christmas Day party at the British Embassy, another guest mistook her at first for a nun with her “black dress and close cap” (Cook, 266). Can you spot the nun below? These two portraits, taken between 1910-1915, show the similarities between the two types of uniforms. Both have their hair pulled back for practicality, although the nun places a stronger emphasis on modesty. They also have elements of stark, clean white atop a darker dress underneath. This signifies hygiene for both and a sense of purity too for the religious wearer.
Below is an image of two nurses in 1888. Granted, this is an advertisement for foot powder in 1888 found in The Trained Nurse and Hospital Review, but I think it still gives a good idea of the uniform from that period. At this point, one is able to recognize a nurse by her white cap, apron, and utilitarian-type appearance. Her hair is pulled away from her face under the cap and her footwear is practical, like a pair of sturdy boots (with foot powder inside).
The Trained Nurse and Hospital Review, 1888, New York, Internet Archive Book Images, Gerstein Library, University of Toronto [No restrictions]
The image of the nurse soon became iconic after the nursing schools were developed in the late-1800s, and soon the wealthy were even masquerading as nurses at fancy dress balls. The image below offered readers details on how to dress up as a nurse.
[As a side note: the book this image comes from is fascinating to page through! Costume ideas are listed alphbetically and some have accompanying color illustrations > Click Here to read]
Thanks to Nightingale and the nursing schools that were to come in the mid-1800s, first her own and those founded by other nurses, a systematic approach was applied to the care of patients and a practical, recognizable uniform was established. The ensemble made sense, and it wasn’t until the 1940s that the uniform underwent any major changes. The nurses applying foot powder above in 1888 don’t seem too far removed from the graduating nursing class below in 1947 reciting the Florence Nightingale Pledge.
I’m sure nurses now can appreciate the even greater simplicity of scrubs, but the look established by Nightingale’s school in the 1860s was modern in its thoughtfulness and the practical pieces would become quintessential symbols of nursing itself.
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Cook, Edward Tyas. The Life of Florence Nightingale. vol 1. Frankfurt am Main: Macmillan and Co., 2018.
Florence Nightingale Museum, https://www.florence-nightingale.co.uk/?v=7516fd43adaa.
Tames, Richard. Florence Nightingale. New York: Franklin Watts,1989.