Nursing is one of the world’s oldest and most respected professions, with the first known documents describing their duties dating from the Roman Empire in 300 AD.
Today, nurses' uniforms are an important part of their identity, both for functionality and professionalism. However, the attire was standardised into an official uniform as recently as the 19th century. Prior to this, nurses were often nuns who wore their full religious habit. As the profession evolved over the centuries, so too did the uniform, with rapid advances during the 20th century leading to the practical, hygienic and smart “scrubs” worn today.
Nurse Uniform History
During the time of the Roman Empire, which spanned from 27 BC to 476 AD in Europe, leaders built a hospital in each town under their rule. This led to a need for nurses to provide healthcare alongside doctors and surgeons. However, the hospitals weren’t built to serve the local population: on the contrary, they were crucial for soldiers of the Roman legions who were injured in battle. Known as a valetudinarian, each infirmary was initially set up within military camps to treat wounded soldiers.
Archaeological digs unearthed surgical instruments, suggesting the medical staff had good knowledge. In 46 BC, when Emperor Julius Caesar came to power, one of his first pieces of legislation was to grant Roman citizenship to local physicians and employ them at the hospitals, which were used by the general public too over time. Ancient artwork suggests all medical staff wore traditional Roman garb of a toga and tunic, possibly with slight adjustments to make them look more formal and professional. However, there were no specific uniforms.
Over many centuries, nursing sick and elderly people was commonly a family responsibility. Established by King Henry I in 1123, the first hospital in the UK, and one of the first in Europe, was St Bartholomew’s Hospital for the sick and poor in Smithfield, London. There was no uniform as such, as nuns and lay sisters provided the care, with their simple, modest attire reflecting their status in life.
Hospitals weren’t commonplace, and in the 13th century, the sick were often taken to monasteries and convents, where medical facilities were staffed by monks and nuns as part of their religious duties. They didn’t have a specific uniform and wore their usual clothing, consisting of long tunics. In the nuns’ case, this often included headwear of a wimple and veil, which wasn’t practical, comfortable or particularly hygienic.
By the 16th century, although uniforms had evolved slightly, they were still based on religious garb. Traditionally, the women wore long ankle length dresses, an apron and head covering.
Birth of Modern Nurses’ Uniforms
Variations of the same style continued for a further 300 years. When it came to official uniforms, nurses' garments didn’t have a standard design until the mid-19th century. This changed during the Crimean War, fought by many of Europe’s greatest powers between October 1853 and February 1856. Florence Nightingale, born in Italy in 1820 and educated in England, became the founder of modern training during the conflict.
In the mid-19th century, Euphemia van Rensselaer, a trainee at America’s first nursing school, Bellevue, in New York, designed a new, more daring uniform. She produced sketches of a smart blue and white dress, with white apron, cuffs, collar and cap. It was revolutionary due to its shorter ankle length skirt, and deemed more hygienic because it didn't sweep dirt from the ground like its floor length predecessors. Unanimously approved, the new uniform was manufactured for all Bellevue nurses within a week.
The basic design was adopted by nurses across the US and Europe, representing greater functionality and professional style.
20th Century Nurse Supplies
The biggest revolution in nurse uniforms came during the 20th century. While they remained relatively conservative, featuring ankle length skirts, high collars, long sleeves and hats at the start of World War I in 1914, the introduction of the now-famous red cross emblem signified the wearer was providing medical aid. This was due to the launch of the Voluntary Aid Detachment, where civilians were trained to care for soldiers under qualified supervision. Initially used to distinguish medical volunteers from professionals, the cross became a lasting symbol of nurses in the Great War, including those deployed by the Red Cross charity.
The first man to train for the official role of State Registered Nurse was George Dunn of Liverpool, formerly of the Royal Army Medical Corps, in September 1922. Around 20 more male nurses qualified the same year. Their uniform was a white jacket with epaulettes indicating their grade, with plain trousers. Over the next 17 years, before World War II started in 1939, there were 528 male SRNs in the UK, only 0.5% of the total nursing population. During the war, the nursing uniform underwent one of its most dramatic changes with the introduction of the thick green khaki battle dress - a practice that started in the US, with many women on the frontline wearing trousers for practical reasons.
In the 1960s, nurses’ uniforms became short sleeved, but still the aprons and caps continued for women, while men wore a shirt, tie and white coat. The biggest change was the abolition of hats in the 1980s, preceding the widespread adoption of scrubs in Britain in the early 1990s, which were practical, cheap and hygienic. Easier to sterilise, they helped manage infection control, particularly in the operating theatre.
21st Century Uniforms
Basic gloves were first worn by doctors and nurses in the late 19th century, initially to protect their skin from irritation due to contact with chemicals. Only in modern times did they start to play a major role in hygiene and bacteria control.
Today, rubber gloves in the medical sector have an estimated global value of £7.5 billion, with nurses commonly wearing latex gloves due to their tactile sensitivity and flexibility. Nitrile gloves first began appearing in hospitals in the 1990s as a synthetic alternative to latex, helping to solve the issue of latex allergies. Also making their appearance in the 1990s, vinyl gloves have become a more economical option for routine tasks such as lower risk medical procedures, food service and basic cleaning.
Modern nurse uniforms address infection control and hygiene by using antimicrobial fabrics combined with PPE such as disposable gloves, masks and gowns to further reduce cross contamination risks. Gender has played a role in the design and perception of uniforms, with modern attire, such as unisex scrubs, reflecting greater inclusivity and equality in healthcare.
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