Few professions are as instantly recognised by their clothing as nursing. For more than a century, the nurse’s uniform signalled trust, discipline and skill. It also carried messages about gender, class, religion and hierarchy. From the habits of religious nursing orders to starched caps and aprons, colour-coded dresses and today’s scrubs, the history of the uniform is the history of nursing itself.
This guide traces how nurses’ uniforms evolved, why caps disappeared in many countries, how infection control changed what nurses wear, and why debates about uniforms continue today.
Imagine a graduation ceremony decades ago. Each new nurse kneels as a senior matron pins on a starched white cap, its unique folds announcing which school she trained at. Her family weeps with pride. Today, her granddaughter graduates in navy scrubs with a name badge and a lanyard. The symbol has changed. The pride has not.
Religious roots
For centuries, much organised nursing in Europe was performed by religious orders. Nuns and deaconesses wore habits and veils, which symbolised devotion, modesty and service. When secular nursing schools emerged in the 19th century, many borrowed these symbols. The nurse’s cap is often traced to the veil and to the caps worn by women in domestic service at the time.
The Nightingale era
When Florence Nightingale opened her training school at St Thomas’ Hospital in London in 1860, she wanted nursing to be respectable, disciplined and distinct from the untrained hospital attendants of the past. Uniforms helped: plain dresses, aprons and caps signalled cleanliness and order. Read more about Florence Nightingale and Mary Seacole.
The age of caps, capes and aprons
Through the late 19th and much of the 20th century, uniforms followed a recognisable pattern:
- Dress: long, then shorter, in white or colours that showed rank.
- Apron: white, to protect the dress and show cleanliness.
- Cap: each school had its own design; students earned caps or stripes as they progressed.
- Cape: for warmth outdoors, often navy with a red lining.
- Belt and buckle: sometimes silver, marking qualification.
- Badges and pins: school or registration pins worn with pride.
Uniforms marked a strict hierarchy: students, staff nurses, sisters and matrons each looked different. “Capping” and “pinning” ceremonies became rites of passage, and many nursing schools around the world, including in Africa and Asia, still hold them.
Why caps disappeared in many countries
- Infection control: caps were rarely washed and could carry bacteria.
- Practicality: they fell off, caught on equipment and got in the way.
- Men in nursing: caps were designed for women; as more men entered nursing, gendered uniforms made less sense.
- Professional image: many nurses felt caps symbolised servitude rather than professional expertise.
Caps largely disappeared in the United States and United Kingdom from the 1970s to the 1990s, though they remain in use in some countries and ceremonies.
Infection control and “bare below the elbows”
From the late 20th century, concern about healthcare-associated infections shaped uniforms further. Many hospitals adopted policies such as short sleeves, no wristwatches or jewellery other than a plain band, short nails, and hair tied back, to support effective hand hygiene. Uniforms are laundered at high temperatures, and some organisations provide on-site laundering.
The rise of scrubs
Scrubs began in operating theatres, where green or blue reduced glare and showed blood less. Over time they spread to intensive care, emergency departments and eventually whole hospitals, especially in North America. Scrubs are comfortable, easy to wash and gender neutral. Our guide to nursing scrubs covers fit, fabric and care.
Colour coding: who is the nurse?
As uniforms became more casual, patients struggled to tell nurses from other staff. Many health systems introduced colour-coded uniforms (for example, different colours for registered nurses, healthcare assistants, students and managers), along with large name badges such as “Hello, my name is”. Research and patient surveys suggest that clear identification helps patients know who is caring for them.
Uniforms around the world today
| Region | Common features |
|---|---|
| North America | Scrubs in many colours; often unit- or role-coded |
| UK and Ireland | Tunics and trousers, colour-coded by role; bare below the elbows |
| Africa | Many hospitals retain dresses, caps or headpieces, belts and epaulettes indicating rank; scrubs in theatres and critical care |
| Middle East | Scrubs or tunics; modest dress and head coverings accommodated |
| Asia | Varied; some countries retain caps, others use modern tunics or scrubs |
Faith, modesty and inclusion
Modern uniform policies increasingly accommodate religious dress: hijabs (often disposable or tucked in), long-sleeved options that can be pushed up for hand hygiene, turbans and patkas, while maintaining infection control. Inclusion in uniform design reflects a diverse global workforce.
Should nurses wear uniforms outside work?
Many organisations discourage wearing uniforms outside work for infection control and safety reasons. It is a long-running debate; see our discussion of uniforms outside work.
Frequently asked questions
Why did nurses wear caps?
Caps derived from religious veils and domestic caps, and came to symbolise a nurse’s school, training and status.
When did nurses stop wearing caps?
In the US and UK, mostly between the 1970s and 1990s, though some countries still use them.
Why do nurses wear scrubs?
They are comfortable, easy to launder, practical and gender neutral.
What is bare below the elbows?
A policy of short sleeves, no wrist jewellery and short nails to support effective hand hygiene.
But does the uniform still matter?
Yes. It helps patients identify nurses, supports infection control and expresses professional identity. The best uniforms today are practical, inclusive and clearly labelled, honouring the past without being trapped by it.
Your next step: Ask the most senior nurse you know what she or he wore as a student, and share the story with your colleagues. Our history lives in those memories.
Related: Nightingale and Seacole · Nursing scrubs guide · Uniforms outside work debate
Sources: Histories of nursing from the Florence Nightingale Museum and nursing history archives; national guidance on uniforms and workwear for infection prevention; published research on patient identification of nurses.
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