The History of Medical Uniforms

By Jordie Papa

Image by Uniform Destination

When it comes to modern medical uniforms, drab is out and color is in.  Today’s medical workers can choose from a wide variety of colors and style, including patterned tops and customized trim that makes scrubs and lab coats a fashion statements.  But what most people who work in the medical profession today forget is medical uniforms were not always this way.  Go back fifty to a hundred and fifty years and you would be surprised and even shocked by what doctors and nurses were required to wear.  For the sake of nostalgia, as well as to give those who labor in the profession today an appreciation for how much better they now have it, I thought I would dedicate today’s blog to reliving a blast from the medical past.

When Function Trumped Form

Go back just a couple of generations and typical hospital garb was plain Jane, with doctors sporting white lab coats and nurses required to dress from head to toe in white. We’re talking white frock, cap, socks and shoes. It’s enough to make you squint, these outfits were so bright.  The white on white nursing uniforms of the era were a holdover from the period immediately following First World War. 

Before World War I, nurse uniforms and nun’s habits weren’t all that different, since nuns back then used to routinely serve as nurses and it wasn’t unusual during that era for nurses to become nuns who served the medical profession. While nurse’s dresses of this period were tailored to provide utility by including such touches as pockets, the outfit customarily included an apron, which made nurse outfits look a lot like maids.

Medical Practitioner or Servant?

Image courtesy of wikimedia

During the 19^th Century, nurses did in fact wear servant’s uniforms, which at the time were full-length black gowns. During this era, nurses were considered little more than handmaidens to physicians and surgeons alike.  It wasn’t uncommon back then for wealthy households to have a nurse on staff, right along with the butler, maid and gardener. It wasn’t until the middle of the century that the nursing profession gained a little more respect. 

With their new stature also came new attire. Instead of wearing servants garb, nurses wore more formal gowns with white aprons and caps, denoting their profession.  Even nursing students of the era sported distinctive hats and ribbons to denote their station. Student nurses typically wore pink or blue ribbons, while more senior students wore black ribbons.

Doctor’s of the era also dressed all in black. This was done to indicate the solemn nature of the profession. Back then, the only people who wore white lab coats were researchers who toiled in laboratories. The problem was, undertakers of the era also wore black suits.  This resulted in a bit of a PR problem, which was resolved by having physicians switch to white coats at the end of the 19^th Century.

The Nurse Corps

By the time of the Civil War, while nurses still wore no gloves or masks, they began to wear white, including full-length white gowns and aprons. This was also the period where the armbands with red crosses were first used to identify healthcare workers. The ironic thing was, long sleeved, full-length gowns and aprons worn by nurses of the era were supposedly designed with the intent of warding off infection.  It wasn’t until more than a hundred years later that it was learned that these outfits were more likely to transmit contagion than to prevent it.

Image courtesy of wikimedia

By World War I, more than 20,000 nurses were assigned to active duty with the Army, Navy, and the Red Cross Overseas Service.  Shortly after the war, the ranks of nurses swelled during the Influenza pandemic that killed more than 25 million worldwide.  It was during this time that latex gloves were first developed by surgeon William Halstead.  The story behind their development is almost as interesting as the effect they had on public health.  Halstead’s gloves weren’t created with the intent of slowing the spread of communicable disease.  He invented them because his fiance, Caroline, had developed a severe rash caused by the chemicals then used to disinfect hands.  Soon, other medical professionals began wearing latex gloves which dramatically reduced the spread of infection.  The next time you pull on a pair of latex gloves you can thank a smitten surgeon with their creation.

During World War II, nearly 60,000 nurses were pressed into duty with the Army Nurse Corps. This was also the war that saw nurses working closer to the front lines than ever before. Soon nurses had to deal with being under fire as they labored in field hospitals, on ships, or in medical transport planes. The effect of having skilled nurses so close to the front saw a dramatic reduction in combat mortality.  Less than 4% of all soldiers who received care in the field died from their wounds or subsequent infection. 

MASH was More than a Movie

The Korean War saw the development of Mobile Army Surgical Hospitals, otherwise known as MASH units. Having doctors and nurses so close to the battlefield saw a 50% reduction in battle-related death than those of the Second World War.   These units were so close to the action that both doctors and nurses dressed mainly in olive drab, only donning mask, gown and gloves whenever they ventured into the ER.  While the Robert Altman film of 1970 and the subsequent TV series turned MASH into a hit comedy viewed by millions, those assigned to these front-line units thought their stint there was anything but a laughing matter.

Image courtesy of Profiles in Science

While the Korean War had MASH, the same units deployed during the Vietnam War were called MUST for Medical Unit Self-contained Transportable.  Like the MASH units that preceded them, MUST units were designed with one purpose in mind: saving lives.  Unlike their Korean War predecessor, MUST units were far better equipped, containing their own radiology, pharmacy and dental departments within the unit itself.  They were also far more mobile since there were no fixed front lines in Vietnam. 

MASH was back during the Iraq War with the 212^th Mobile Army Surgical Hospital located in An Najaf.  Since this was a desert war, the doctors and nurses assigned there traded in their khakis for what was colloquially referred to as coffee-stain camouflage.  Featuring a 3-color mottled pattern of beige, dark brown and pale green, the US military’s Battle Dress Uniform was designed in the 1990’s to blend into any sandy environment.

Who knows what kind of garb the doctors and nurses of any future conflict will wear when they serve their country.  If the President’s proposed sixth branch of the military known as the US Space Force becomes a reality, will medical personnel assigned there be required to wear black and white?  Who knows.  All we can be sure of is when it comes to keeping up with the times, medical uniforms will always keep pace with the future.

Jordie Papa is owner of Uniform Destination with four locations in North Florida.