DECATUR, Ill. — It was once an iconic symbol.
Upon graduation from nursing school, a newly minted nurse would receive her cap as a symbol of her success and entrance into the profession of nursing pioneer Florence Nightingale.
The cap was fashioned to look like a nun's habit; nuns were the first nurses, and the calling to be a nurse was once closely tied to the church and Jesus' admonition to nurse the sick from Matthew 25. It was meant to keep the nurse's hair neat and out of the way, because all nurses were women for many years. The white uniform signified purity and cleanliness.
In most American hospitals today, you'd be hard-pressed to find even one nurse wearing a cap or a white uniform.
Mary Blankenship, nursing program director at Richland Community College, said caps are just not very practical.
"I started in nursing in 1978, and even at that time, we wore white when we graduated, and we wore caps," she said. "In (intensive care units), it was difficult to wear a hat, and at that time we were also wearing dresses and not pants. To wear that where you're having to run a lot, those hats would fall off."
A cursory search on the Internet for nurse's caps for sale turned up several sites that also offered bobby pins suitable for securing the caps, which aren't shaped to stay on without some assistance.
The first major change Blankenship remembers was the switch to uniform pants, though they were still white, she said. By the late 1980s and into the early 1990s, nurses started wearing scrubs. Besides being more comfortable than a starched cotton or polyester uniform, they're also low-cost, easy to wash and hide stains better than white uniforms. Also gone are "nurse's shoes," replaced by athletic shoes in most cases. And with more men entering the profession, the cap would be a bit problematic if it were a requirement.
"I have yet to have a male nursing student have his (graduation) picture taken in one of those hats," said Deborah Slayton, director of Millikin University's school of nursing, though she added that the women often do.
Ellen Colbeck, dean of health professions at Richland, said some student nurses still want to wear whites at their pinning ceremony, but it started to get confusing for the families and friends in the audience when some wanted to wear whites and some didn't, so that's fallen by the wayside. At this year's pinning May 20, the graduates wore their graduation caps and gowns and regular clothes underneath.
Health professions graduates receive pins now instead of caps, and while they're not required to wear them on the job, many do.
At Decatur Memorial Hospital, practical and registered nurses wear blue, while nurse assistants wear green. At St. Mary's Hospital, nursing staff wear navy bottoms and white tops, while certified nurse assistants wear navy blue tops and bottoms. On holidays and in pediatrics, nurses are usually allowed to wear printed tops, with cartoon characters or festive motifs.
Newly graduated registered nurse Angela Mears said a cap and a stiff white dress would be completely impractical. She's been working as a licensed practical nurse while earning her RN.
"We work so hard and move around so much," Mears said. "We need to be comfortable, and scrubs are just more practical."
Classmate Nicole Lankford said she couldn't imagine trying to perform CPR or even changing a bed while wearing a cap. It would always be falling off, no matter how many bobby pins you used.
Millikin's Slayton said that the medical profession has learned in the intervening years that the caps can harbor bacteria.
"We know more about microbes and the spread of disease," she said. "They're not easy to wash. That's one reason. Then the way the wards have changed. (In the past), a big ward had 30 people in it and maybe a little screen that comes between them. Now, with nurses ducking and in and out of curtains, those caps get caught easily."
Students learn about professional appearance and cleanliness. Their shoes, for example, should only be worn in the hospital and not outdoors to prevent transporting germs in and out. Depending on the facility, they may not be allowed to have acrylic nails and jewelry for the same reason.
"I do think that it's perplexing to a lot of people to have everyone in the hospital in scrubs — nurses, housekeepers, people who draw blood are in scrubs, the surgeons are in scrubs," Slayton said. "The best thing is to have name tags that easily discern what your job description is."
Information from: Herald & Review, http://www.herald-review.com