This post looks at some of the issues around the wearing of uniforms in mental health nursing, as usual we would welcome any comments that you may have.
Currently, although most mental health nurses do not have to wear uniforms this is under review at our local trust – (Birmingham and Solihull Mental Health NHS Foundation Trust ). According to Deputy Director of Nursing Martin Herriott, the Trust are looking at re-introducing uniforms in some areas such as acute in-patient and older peoples services.
Feedback from both service users and carers indicate that staff are often very hard to identify, uniforms might make this less of a problem as well as making staff appear more professional? Of course, there are ongoing concerns around infection control in areas where staff are likely to be exposed to bodily fluids of any sort.
In some areas it is likely that the Trust will avoid uniforms, such as for example long term residential areas where service users are likely to live for any length of time in home like environments. Also, staff going outside of care areas with clients (for instance escorting people to hospital appointments etc) will need to cover up uniforms.
Obviously, this is a potentially controversial idea – although some people are in favour of wearing uniforms, others are likely to be less keen. I found a recent survey amongst patients in a US mental health unit (Miller,T. Mann, N. Grim, R 2010). This study set out to examine patients attitudes about what nurses wore and whether their attire made nurses appear more approachable, competent and professional. Whilst most did have any particular preference what staff wore there was a lot of concern that nurses were difficult to identify. Interestingly, whilst over half of the respondents felt that attire made no difference to approachability, 29% felt that ordinary clothes made nurses seem less approachable!
Another, earlier study conducted in London (Tham, S & Ford, T 1995) concluded that it was other staff who had difficulty identifying nurses whilst 36% of patients felt that uniforms made staff less approachable. For some reason, patients in ‘old age wards’ were excluded from this study – (old age = ‘assume that everyone has dementia?) a shame as this is a client group most likey to encounter nurses wearing uniforms. This aside, it was generally agreed that identification of some sort was really important.
Across at Mental Nurse blog there was a discussion about uniform – most contributors were opposed although there was a contribution from a service user who flagged up the issue of nurses being identifiable (although in fairness, uniform/ identification might not have been at the top of my list of priorities to sort out in this example).
We did a quick (and totally unscientific survey) with a BCU student group and asked them what they thought about this issue.
(thanks to Kate Hopley, Oliver O’Connell & Kimberley Zilke for filming and BCU pre reg MH group Dip HE 0409 for appearing in the film)
Miller, T. Mann, N. Grim, D (2010) Clothes Encounter: Patient Perception of Nursing Attire in a Behavioral Health Unit. Journal of the American Psychiatric Nurses Association. 16(3):178-183, May/June 2010
Tham, S & Ford, TJ (1995) Staff dress on acute psychiatric wards Journal of Mental Health 4, 297-299