December 7, 2017By Dr. Kim Baily

Should Uniforms Be Required for Nursing Students in Simulation?

Most Nursing Students are expected to wear uniforms in the clinical setting while taking care of patients however, should students be required to wear uniforms in the simulation lab, skills lab or just generally on campus? While most clinical facilities would expect to see students in uniform while taking care of patients, the facility may allow students to wear street clothes either with or without a lab coat while collecting information about a patient the day before patient care. Identification is always required. Institutions use uniforms to designate various employee/visitor roles. This includes students. Medical students often wear short white coats and nursing students some combination of colored scrubs.

Nursing schools vary in their policies regarding uniforms requirements while on campus. In the skills labs, students may be required to bend and move their bodies when practicing skills such as making beds, moving patients or completing assessments. Inappropriately dressed students may inadvertently provide views of their bodies they never intended. This may be distracting or embarrassing.  Some schools may require that students wear loose fitting clothes with full length pants and no sleeveless shirts. Vague guidelines often lead to vague compliance.  Many schools have now instituted policies that require students to wear uniform in any skills lab.

Medical simulation allows students to practice skills, improve clinical judgement and practice professional behaviors.  In order to encourage professional behaviors,  Nursing schools want students in simulation to copy behaviors observed in clinical practice. This includes wearing a uniform.  Uniforms help take students out of the role of student and into the role of nurse.   In an article by Prescott et al 2010, one student reported that by wearing uniforms they “felt better and looked much better”. Another stated “it was weird, it made you compelled to be bothered.  I do things in my uniform that I would just think ‘no way! I am not doing it’. But in my uniform I just think it part of my job and I just don’t think about it, no question, I just do it!

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One of the goals of simulation is to foster soft skills such as communication and teamwork.  Having simulation participants dressed in appropriate clothing helps the team to function as they would in the clinical setting. Keep a bin of jackets and scarves that can be used for confederates so that their uniform top is covered and their appearance is consistent with their role.

One Southern California ADN program required students to wear white uniforms in clinic.  Faculty were reluctant to require students to wear these white uniforms for skills labs and simulation assuming they would become dingy and worn. The school made the decision to require students to wear maroon scrubs anytime they were on campus including both lecture and lab. Students could buy any design of scrubs they wanted at any price providing they were maroon.  White uniforms would be required for simulation. The students were overwhelming enthusiastic about the scrubs.  The uniforms were convenient, inexpensive, comfortable and easy to care for. Nursing students identified with fellow nursing students around campus. This helped bond the division together. In the skills lab the students met professional standards and were comfortable and appropriately covered whatever the activity. The scrubs were so successful that other healthcare departments opted for colored scrubs. Skills labs often contain expensive equipment and with the colored scrubs, staff could quickly identify students who didn’t belong in the labs. This added to the security of the department. Students could potentially wear the scrubs when they graduated.

Requiring students to wear uniforms adds to the fidelity of the simulation allowing students to suspend reality and become fully engaged in the learning process. Do you agree? Leave a comment below and tell us what the requirement is in your simulation labs!

Today’s article was guest authored by Kim Baily PhD, MSN, RN, CNE, Simulation Coordinator for Los Angeles Harbor College. Over the past 15 years Kim has developed and implemented several college simulation programs and currently chairs the Southern California Simulation Collaborative.

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