Handbags and glad rags: You are what you wear, aren’t you?

Last Friday evening, I was out with some friends and colleagues from the Wrightington, Wigan and Leigh NHS Trust to celebrate Christmas 2018. Our meal was in a wonderfully cosy little bistro named the Red Door (there are other eateries in Wigan). Walking to the restaurant on what was a bitterly cold and windy evening I was surprised at the number of young men and women who were on the street dressed as if it were the middle of summer. I was well wrapped up in my winter coat and glad to get into the warmth of the restaurant. I wondered what the motivation might be to forgo the comfort and warmth of a proper coat while out and about during the evening. I also wondered about the wisdom of wearing very high heels whilst walking on cobbled streets. 

Perhaps I’m turning into a ‘Victor Meldrew grumpy old man’. I do know that in my retirement I think less about the clothes I wear or what ‘should’ be worn for certain occasions. However, this is a personal foible, and not something I always apply to others. For example, I can remember being mildly surprised the first time I met our local vicar and he was wearing jeans under his Sunday best robes. Somehow it just didn’t seem right. Last week, I also pondered about the green uniforms worn by the staff in the control room of the North West Ambulance Service, who were featured on the fabulous BBC programme ‘Ambulance’. I can understand the ambulance personnel on the front line responding to 999 calls wearing uniform, but do those in the call centre also need to wear a uniform? 

They are not seen by anyone other than their colleagues (well, unless a BBC film crew turns up) and they are not engaged in activities where the uniform might offer some form of protection. Of course, there is plenty of research that has explored how the way a person dresses can influence how others might view them. This perception will, in turn perhaps, afford you status or determine how you might be communicated to and the nature of interpersonal relationships and perhaps even career-related opportunities and successes. In professional life, the uniform occupies a particular place in these perceptions. For example, there is also much research that shows professional identity is an important issue in many health care professions, particularly in those that have been in the past ‘contested professions’ such as nursing. 

I know I will probably get lots of comments about the use of ‘contested’ from my fellow nurses. And yes, I know Amitai Etzioni’s seminal work on the subject was a long time ago now. A paper (and one I consider to be a great piece of writing) I published in 2002 along with some wonderful colleagues, explored these issues further. Having reread it recently, I would argue that here we are in 2018, and those issues about what makes a profession are still there. Uniforms perhaps provide nurses with a very clear (and non-verbal) indication that they have the skills, knowledge and experience to provide the best possible care for others. It’s possibly why so many health care providers have invested in drawing patients and their family’s attention to the different grades (and by implication) the skills of different levels of nurses. 

Such a perception comes at a cost though. In a former role I was forever reminding student nurses that standing outside the University smoking, whilst wearing their uniform, was not the greatest advertisement for the profession. And this was not just an anti-smoking comment. There is a deeper implication, which again some of my nursing colleagues might not like me saying. I think the act of ‘putting on’ a uniform, presses the psychological switch that allows them to assume the role of a nurse. Likewise, when they take it off, it symbolically allows them the opportunity to leave the nurse role and ‘take on’ their other life roles. The wide awake amongst you will notice that there is a glaring contradiction here, but it is an intellectual sacrifice I’m happy to make in order to move the blog narrative along. 

To where, you might be asking? Well there is a whole army of fabulous health and social care providers out there who don’t wear a uniform at all, but we couldn’t do without them. This army are the 7.9 million carers (approximately 12% of the UK population) who provide care to others in their family. In July 2018, it was estimated that these carers save the UK economy the equivalent of £139 billion a year. This is close to the £144 billion a year it costs to run the NHS. Most of these looked after folk have long term, complex and life shortening conditions. As such, the number of unpaid carers is likely to grow exponentially over the next 10 years. If I were wearing one, I would take my hat off to each, and every one of this incredible army of carers.