Wednesday, April 20, 2011

The Modern Scrub Uniform

Mike, Part-time
Loretta, Recovery Room Nurse

 The Modern Scrub Uniform


Kelly, Clerical Staff
Margie, Assistant Nurse Manager

















Introduction

            Scrubs are the typical two-piece uniform for nurses, surgeons and other operation room personnel.  The standard scrub uniform consists of pants and a short-sleeve shirt, frequently in a shade of blue or green.  For my field experiment, I was interested in the ambiguity of the scrub uniform.  Not only are they gender ambiguous, but they also blur the lines between the corporate ladder.  Do those who wear scrubs feel the need to express their individuality?  I decided to take my study to PHealth Ambulatory Surgery Center in New York, to interview and observe nurses, surgeons, clerical staff and other personnel who wear scrubs daily.

Field Work
           
            Both my parents work at this particular facility, so I happen to know some of the nurses very well.  This worked to my advantage because I was able to speak to many nurses on a personal level about their past and current experiences.   My plan was to have a formal interview with each nurse, but I found that once we began speaking, I often found answers that I was not originally looking for. 

Ellen, Margie and Pat

1980s nurses uniform (nursingjobs.org)
            I began by asking them what their uniform was while in nursing school.   Immediately they reminisced about the white skirt, cap and tights they were forced to wear in the eighties.  Pat, who was wearing a flower-pattern scrub hat, seemed to miss those uniforms the most.  “I loved that cap.  I miss it! And the skirts… I always used to roll mine up. And get in trouble!” (Pat, Nurse Manager Operating Room.)  She told us an anecdote about how she shocked the audience of her college graduation by hiking up her skirt to accept an award.  Although she enjoyed the aesthetic appeal of that uniform, she realized that it was not very practical.  “We could never crawl on the floor.  Forget about laparoscopies!” (Pat). [i] Margie (Assistant Nurse Manager) and Ellen (Head Nurse of Recovery Room) did not have similar feelings about the old nurses uniform.  Ellen, who enjoyed the skirt and tights while she was younger, was happy to shed those garments for the modern scrubs as she matured.  
I noticed that neither Ellen nor Margie accessorized their uniform with anything extravagant.  I asked them whether they felt the need to articulate their gender while in scrubs.  They both laughed.  Margie replied: “Maybe if I was younger!” They continued to explain that they did notice the younger nurses did accessorize their scrubs with as much jewelry and color as they could, (PHealth happens to have a very strict uniform policy).  They told me that since they were “older” (in their fifties), they didn’t need to express their femininity.  While telling me this, they both were adorned with diamond rings, slim bracelets, small gold necklaces and perfectly manicured nails.  Margie also wore bright red lipstick.  While they may have felt their uniform was drab and un-feminine, they certainly exuded feminine appeal through their grooming rituals and subtle enhancement.

Char

Char*, an Operating Room nurse for eighteen years, was the most animated person I spoke with all day.  Wearing the regular dark blue scrub set, she distinguished herself from the other nurses by adorning herself with pink accessories.  She wore a pink heart-patterned scrub hat, pink Crocs and a personalized sweater with her name embroidered.  When I spoke to her she was enthusiastic about her outfit, boasting about her many scrub hats that she matches daily to her shoes.  In a facility like PHealth, she is exercises as much variation that is allowed within the realm of the uniform. 
Char in her pink attire


Winsome

Winsome, a registered nurse, is known among the nurses for her glamour.  Unaware of her reputation, she was very modest when speaking about her appearance.  “I always get my scrubs two sizes larger.  I do not like the look of tight scrubs.  What kind of message are you trying to send!” (Winsome).  Although her scrubs were a bit baggy, she did inform me of a styling tip if I were to ever own a pair: “wear them backwards!  They are baggy in the front and flat in the back to fit a man’s body.  If women wear them backwards, they make our butt look bigger AND flatten our tummies!” (Winsome). While I do agree with her strange styling tip, you cannot help but notice Winsome in the recovery room.  Wearing the regular dark blue scrubs, she accessorizes with Sketchers Shape Ups, fake eyelashes and diamond hoop earrings, bracelets and rings.  She told me this was one of her “boring” days, which made me wonder what she looked like when she felt her very best. 
She also told me that her night shift, (at a different hospital facility) allows more variation within the scrub uniform.  PHealth has a strict policy that all full-time nurses, surgeons and operation room staff wear dark blue scrubs, part-time wear light blue scrubs, clerical workers wear black scrubs and billing staff wear pink scrubs.  The scrubs are washed and kept on premises, and are the only permissible uniforms. Winsome said at her other facility, there are many different options for the scrubs.  She said you can choose any color or pattern, and it is common for the women to get their scrubs fitted.  She enjoyed this aspect of her other job, because she felt she could personalize her uniform and really feel like “herself at work” (Winsome). 

General Observations

example of a patterned scrub-hat
            Even though PHealth has strict guidelines regarding who wears what color scrubs, I often found that many of the patients were not aware of this hierarchy.  In the recovery room, many patients began speaking with operating room staff thinking they were nurses and vice versa.  I did not notice these mishaps between staff members, but it seems that similar confusion could arise with the lack of identification.
            One of my observations was the abundance of patterned scrub hats.  Both men and women wore all colors and variations.  I was curious to whether this was a fad within hospital facilities.  I asked one of the nurses who told me exactly who had started the trend several years ago.  She continued to tell me that this surgeon also introduced clogs to the staff, making them the current footwear of choice.   

Analysis

At PHealth, there is a strict policy regarding the scrub uniform because they believe that the homogeny among the garments will bring unity to the facility.  However, as I have found through my observations and interviews, this is not necessarily true.  Giles Lipovetsky in his published work The Empire of Fashion: Dressing Modern Democracy, agrees with these findings.  “How can such a society institute a social bond when it is constantly broadening the sphere of subjective autonomy, increasing individual difference, emptying social regulatory principles of their transcendent substance, dissolving the unity of life-styles and opinions?” (Lipovetsky 226).  While the world outside is experiencing the cycles of fashion, the ambulatory surgery center must stay with their mundane attire.  Even though nurses like Char have found tiny ways to enhance their uniform to express their individuality, it is nurses like Winsome who have access to other hospital facilities that begin to resent this particular job.  “[At my other hospital] I can really be myself at work” (Winsome, RN).  People desire the agency to be able to dress however they want, whenever they want.  With the options that are available in the real world, nurses want those options available for their uniform as well.  “Consummate fashion marks the mature stage of the democratic social state,” (Lipovetsky 226).
One of the only ways these nurses can adorn themselves is with their scrub hats.  Since the nurse that I spoke to could tell me exactly who had started this trend, it is evident that this was an act of imitation.  “Fashion is intrinsically imitative. It may be prompted by reverence for one imitated, or it may be prompted by the desire to assert equality with him,” (Spencer 329).  Since it was a surgeon who first wore one of these hats, one can guess that the nurses soon followed in reverence.  Once they saw that their superior could express his individuality with a flame-covered scrub hat, it gave them permission to do the same.  “Imitative, then … little by little, fashion has ever tended towards equalization,” (332).  While the nurses imitated the surgeon out of admiration and respect, they unknowingly weakened the corporate class distinction.  The surgeon may have been expressing himself, but he also may have been trying to distinguish himself from those beneath him.  Even Char, who felt proud of being unique, was just a product of these fads. “In most areas, individuals are engaged in a passionate quest for novelty; veneration of the immutable has been replaced by the follies and fads of fashion,” (Lipovetsky 229).  While she felt individual and unique, she was just wearing her version of what those have worn before her.
This tendency in fashion to always look towards the future shows how customs are dissolving.  As Ellen and Margie were speaking about the older nurse uniforms consisting of the dress, cap and tights, we see that the tradition has quickly evolved to an androgynous scrub suit.  “The reign of the present reflects the collapse of the demiurgic ideologies, the accelerated invention of tomorrow, the capacity of our societies to criticize themselves,” (230).  Fashion is an ever-evolving life cycle, and even in the workplace it must be edited and tailored to fit the needs of the future.  As Pat was telling me “she could never crawl on the floor” to do procedures like laparoscopies.  With new surgical technologies developing, it is not unlikely that the scrub uniform will evolve to fit those needs as well. 
In conclusion, while the uniform is used to neutralize conflict, many felt unable to express their true selves.  This was said without considering that fashion in general is a never-ending cycle, constantly evolving to fit the needs of those who wear it.  While the nurses were currently unhappy, they failed to realize that maybe in a few years, their uniform will allow them to express themselves in a way that is unique and practical, like the scrub hat. 

*names have been changed



Works Cited

___________.  "Uniformly Speaking, Part II: Roll With the Changes » Nursing Jobs Blog – Nurses Insights at Nursing Jobs.org." Find Nursing Jobs and RN Jobs at Nursing Jobs.org. 8 July 2007. Web. 18 Apr. 2011. <http://www.nursingjobs.org/blog/uniformly-speaking-part-ii-roll-with-the-changes.htm>.

Lipovetsky, Giles.  The Empire of Fashion: Dressing Modern Democracy.  Princeton: Princeton University Press, 1994.  Pp. 3-17, pp. 226-241. 

Spencer, Herbert.  “Fashion.”  In The Rise of Fashion by Daniel Leonhard Purdy.  Minneapolis: University of Minnesota Press, 2004.  Pp.328-332.

           


[i] A Laparoscopy is a medical procedure that requires a camera be inserted in the patient’s abdomen through a small incision.  I am assuming, because of Pat’s comment, that it requires some physical maneuvering of the camera, which would cause the nurses to “crawl on the floor.”