Ugly Hospital Gowns: Not Just An Aesthetics Issue

Tonight, I stumbled upon this awesome post by Kairol Rosenthal on her Everything Changes blog regarding the atrocious backless, pants-less design of current hospital gowns we are all used to seeing. Ugh, who decided that a thin, scratchy piece of cloth with two strings was to be the official patient uniform? The author brings up the issue of patient moral effected by the gowns, particularly with those who must stay at a hospital long term. I've copy and pasted Rosenthal's hospital gown post at end of my post for reference.

But, I'd like to bring up the possibility that the hospital gown as we know it could be a restraint. I am sure there have been plenty of times where patients felt they could not leave their bed or room due to modesty issues. Moreover, how many of them never told their nurses that this was even an issue? Perhaps patients felt/knew that not a whole lot could be done to solve the gown dilemma during their stay. Maybe it has been generally excepted by both staff and patients alike that these tragic excuses for garments are apart of staying in a hospital. If this is so, then why would patients speak up? Let's further explore this concept of gowns as restraints and what that means for the healthcare community. Take a look at a few definitions below...

The American Heritage Dictionary defines restraint as:

1. The act of restraining or the condition of being restrained.

2. Loss or abridgment of freedom.

3. An influence that inhibits or restrains; a limitation.

4. An instrument or a means of restraining.

Additionally, the Health Care Financing Administration (HCFA) defines a physical restraint under the Interpretive Guidance in the State Opporations Manual as:

"any manual method or physical or mechanical device, material, or equipment attached or adjacent to the individual’s body that the individual cannot remove easily which restricts freedom of movement or normal access to one’s body."

For obvious reasons, the gowns' function flaws posses a hindrance to patient mobility, which may in turn slow recovery. Nurses know how important early ambulation is to patient recovery time. As a part of nearly every post-surgical nursing care plan, we encourage everyone once they reach the med/surg floor to get up and start walking around. Ambulation prevents muscle atrophy, respiratory issues such as pneumonia, venous thrombosis, and promotes the return of proper bowel function. Not to mention all positive psychological benefits that come with having control over one's own body after so much invasive stuff has been done to the body while unconscious.

Now, as Rosenthal's post goes on to explain, the most apparent obstacle in truly solving the janky gown issue is, well, the tremendous expense that goes into redesigning and producing new patient hospital garb. It's a challenging undertaking, especially in a day and age where hospitals are financially hanging by a thread as it were. However, if hospitals take in consideration that better patient garments may increase patient mobility, ergo decrease the amount of non-reimbursable "never events" (such as pressure ulcers and embolisms), ergo speed recovery time, ergo result in a higher bed turnover rate. Thusly, all these factors will ultimately help increase hospitals' profit margin. Additionally, gowns that actually cover the cash and prizes will drastically improve patient satisfaction, which is always good for business. Besides, patients with less complications and who are more satisfied mean less work, less stress for their nurses. As I see it, all parties involved with this issue will benefit from not having their hindquarters hanging out!

By now, those of you who have read through this entire post are probably thinking "Well, that's a great vision, Haute Nurse, but what are we going to do about this problem right now?" I am so glad you asked! My suggestions are as follows:

1. Professionals- Give your patients two gowns whenever possible. One to put on traditionally and another gown to put on like a coat over the first.

2. Patients- If you can, visit hospitals that do have decent patient attire. Other hospitals will catch on quick if that is apart of the reasons you are giving a particular place your business.

3. Patients and Professions- Speak up! Yes, nurses must advocate for their patients' interests, but remember dear patients, your voices will be the strongest. You are essentially the customer and your dollars have the greatest influence over the people who make the decisions.

4. Nursing Student- Conduct some studies, write a paper, get it published on the effects of patient hospitals gowns and health. No evidence like scientific evidence to facilitate change.

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Below is Kairol Rosenthal's inspiring post:

MAY 11, 2009

Fashionable Hospital Gowns?

I like my body and I have no problem wearing short skits or low cut shirts. But as a young adult cancer patient I shudder at the exposure of a hospital gown.

I excel at finding new fashionable ways to tie on a hospital gown, using excess fabric to craft fancy bustles, pleats, and empire waistlines. My creations are often inspired by beat up copies of Vogues sitting next to me in the ladies waiting room.

Despite my loathing for hospital gowns, I recognize that those fly-away openings and simple, barely-there closures exist for easy access. In the end, forget designer garbs, I’d rather docs be able to access my body – especially in case of emergency.

An article in the Wall Street Journal today describes a new grant by the Robert Wood Johnson foundation that will support the creation of new hospital wear. They also report on the Hackensack University Medical Center in New Jersey that commissioned new hospital wear by designer Nicole Miller. The argument exists that new privacy promoting gowns that will boost patient morale.

None of us want our asses hanging out as we stroll the unit with our poles. And, I think patient moral is incredibly important – it helps us comply with doctors orders. But, I think our moral suffers way more from administrative issues, cost issues, and lack of face time with doctors. Given that these new fashion gowns will cost more money to produce and purchase, I say the Robert Woods Johnson foundation and hospitals find other ways to spend their time, dough, and new discovery resources.

What do you think? How important is it to you that we design new hospital gowns? What do you think about current gowns? If you were to redesign an new gown what would it look like? Share any good hospital gown stories you have.

Info Sources for Haute Nurse's post:

http://everythingchangesbook.com/kairol/hospital-gowns

http://www.springerlink.com/content/bt730m1u4l16q332/

http://www.thefreedictionary.com/restraint

http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/GeneralHospitalDevicesandSupplies/HospitalBeds/ucm123678.htm