Nursing Uniforms Past and Present: A Brief Look at the History of Nursing Fashion

Until quite recently, there were traditionally three parts to a nurse’s uniform: a cap, a dress, and a pinafore. The cap and pinafore were usually made of white cotton and were expected to be heavily starched and pristinely clean. Even this far back people understood that there was a correlation between hygiene and health – it’s this correlation, and the need for a functional, yet visually appealing uniform that have influenced nursing uniforms of the present day.  In this blog post, we’re going to go on a whistle-stop tour of British nursing uniforms through the ages and their place in the fashion (and vintage fashion) world.

Initially, nuns were the people who took care of the sick. Therefore, early nursing uniforms largely mimicked the nun’s habit. They featured weighty, shapeless linen dresses, long sleeves and a floor-length hem. Shortly after the turn of the 19th century, hygiene and aesthetic came to the forefront of debate, and the nurse’s uniform began a transformation into the one we recognise today. In the time of Florence Nightingale, uniforms began a regime of standardisation that coincided with nursing coming to be considered a genuine and admirable profession. One of her students designed an outfit which prioritised hygiene and functionality – it had shorter hems which wouldn’t drag along the floor collecting dirt and germs, and used white as a means to emphasise the importance of cleanliness. In addition to this, white has long been a symbol of purity, making these early nurses appear more like the angels they were compared to by their patients. What’s more is that Nightingale’s uniform was much lighter. She did not allow anything which may be too weighty and impede the nurse’s work – especially not the hefty polonaise skirts and crinolines which were popular amongst young women at the time!

An illustration of Florence Nightingale for The London News, February 1855

Nursing uniforms didn’t change much during the first world war, although large utility pockets began to appear on those starched aprons – a useful feature for busy nurses with lots of sick patients to care for. Many were eager to contribute to the war effort, and this led to the inception of Voluntary Aid Detachment which trained men and women to perform certain duties under the supervision of a qualified nurse. It was important to distinguish between these different roles quickly in a field hospital, and so the uniform of these VADs had a red cross emblazoned across the chest of their pinafore. Though actually symbolic of nursing assistants brought in by the Red Cross charity, this red cross has now become symbol of the WWI nurse, and features on almost all fancy dress costumes.

Now a coveted piece of vintage fashion, an original VAD uniform on display in a museum

During the second world war, the uniform worn by nurses underwent a series of dramatic changes. Motivated by the need for durable, more practical uniforms which would provide ease of movement, nurses were issued with thick green khaki battle dress. It was at this point that some nurses on the frontline began to wear trousers, much before they became commonplace in a lady’s wardrobe! There were a great many revolutionary technologies were necessitated by the war, and nursing uniforms were no exception. They began to be supplied with insecticidal chemicals imbedded in the fabric to reduce the transmission of infection and lice – now there’s something we could do with on our favourite dresses!

WWII Nurses wearing military issue khaki trousers, or battle dress

At the birth of the National Health Service in 1948, the UK decided to create a standardised version of the nursing uniform to be worn nationally. This would show a unified front and help people to correctly identify who was a nurse, who was a student, and what ranks people belonged to. However, at the inception of the NHS there was already an outcry from nursing and medical staff. In a similar vein to the present day, they were concerned that the already insufficient number of medical professionals would come under an almighty strain once the public began to fully utilise the new NHS. Perhaps in a bid to glamourise the nursing profession for prospective apprentices, some of the nationalised nursing uniforms of the 1950s onwards were designed by Norman Hartnell, who was well known for dressing the Queen. These uniforms featured a pinafore which was attached to the uniform using pins, and big, puffy sleeves which were much shorter than previous uniforms, placing less emphasis on modesty and more on functionality and aesthetic.

A group of fresh nursing graduates from The London Hospital circa 1980 – the Norman Hartnell design was still in use well into the 80s

Soon, the NHS realised that lighter, synthetic fabrics were better for the nursing profession owing to their resistance to repeated washing with strong chemicals (nurses get all manner of bodily fluids on their uniform… we won’t go into it). Pinafores were also replaced by single-use plastic aprons which are more resistant to fluid and germs. Except in surgical environments, which must be kept sterile, the familiar nurse’s cap has all but disappeared. It evolved from an imitation of the nun’s habit, with a large piece of circular fabric, to a square of starched cloth, and finally was removed from the uniform due to hygiene and practicality concerns.

One thing that has remained constant is the use of blue in the nursing uniform. It is a fairly neutral and calming colour which tends to remind people of cleanliness, and it has the added benefit of distorting the colour of blood so that it looks much less alarming.

The fob watch is one of the only constants in a uniform which has undergone so many chops and changes. Fob watches were traditionally gifted to newly qualified nurses by their families, and this is something which has become a rite of passage for many nurses to this day. As lovers of fashion, we know the importance of accessories, but for nurses, who are only permitted to wear a plain wedding band, the fob watch can be used to make a statement.  Many nurses will have themed watches or super glitzy ones which would make a magpie swoon!

The nursing uniform of today usually comprises of a tunic and navy-blue trousers, or a simple dress with a boxy A-line skirt. Nowadays, rather than entirely different uniforms or fiddly adornments, most NHS trusts use a colour system to denote rank, or band, as it is now known. This system varies between trusts but generally employs various hues of blue and different coloured piping for patient-facing nursing staff, and other colours, such as lilac and red, for matrons and heads of nursing. In a dizzying turn of events which resonates strongly with the nationalisation of uniform of the late 1940s, there have now been fresh calls for a national standardisation of the nursing uniform and its colours in a bid to aid patient safety and make job roles more easily identifiable. We certainly hope they will make room for some frills and a petticoat... but we won't get our hopes up!

         
Most Nursing Uniforms are now supplied in standard sizes and lengths by Alexandra Workwear, who also have a made-to-order service, Boyd Cooper

So, there we have it, a (very) brief overview of nursing uniforms through the years. Whilst the nurse’s uniform has always had modesty, simplicity, functionality and hygiene at its core, it has somehow become an iconic and instantly recognisable attire. Genuine vintage nursing uniforms are highly collectible and coveted items and dressing as a nurse is still one of the most popular fancy-dress outfits around. It’s clear that we are fascinated, not only by the profession, but by the way it is represented through deliberate and clever style choices which have become both an iconic statement, and a go-to dress up idea!