Did you ever wear a nursing cap? Until the 1980s, the crisp white nursing cap represented several traditions to the wearer, the patient and the other professional staff members. Then, things changed.

History of the Cap

Florence Nightingale was the organizer of modern nursing at the time of the Crimean War in 1854. She encouraged nurses — who were typically women — to dress professionally by wearing a modest uniform (usually an ankle-length dress made from wool) complete with an apron and a cap. This was the beginning of what we recognize as the modern nursing cap.

The nursing cap style has evolved over the course of time. Originally, it mimicked a nun’s habit as a tribute to them for being the first nurses. The first caps were also veil-like in design so as to cover the nurse’s hair and keep things sanitary.

During the modern era, caps became much smaller. Most nurses wore their hair in a tight bun under the caps, again, for sanitary reasons.

Eventually, males joined the nursing workforce and did not wear caps. Also, concern started to grow the about caps being germ carriers. Slowly, the nursing cap disappeared from sight. Today, many people say that unisex scrubs have replaced the traditional nursing cap and uniform.

Capping Ceremony

For many years, the capping ceremony during a nurse’s training was a true program highlight, as well as an honor. Receiving a cap was a right of passage and represented completion of a certain milestone in the educational program.

The capping ceremony was often conducted in a church with family members and friends in attendance to witness the tradition. Nursing faculty usually presented the cap to the recipient but some schools chose to have a senior student present it.

Most programs awarded an all-white cap to the student nurse. Upon graduation, a black stripe was added, indicating successful completion of the program. Registered nurses always wore a black stripe. Some nursing schools chose to give different color stripes to their students as they completed a certain level of the program; gray, red and blue were popular choices. Upon graduation, the black stripe replaced any preceding colors.

Current Opinion

• Advantages: The main advantage of wearing a nursing cap is to easily identify the role of the caregiver. The cap has been a universal symbol of nursing for centuries.
• Disadvantages: Wearing a cap is now considered to be a carrier of bacteria from patient to patient. This is similar to the recent theory behind male physicians wearing a tie, bending over a patient bed and moving on to the next patient. It is thought that a tie carries germs between patients.

Where Does it Go From Here?

Interestingly, a cardiac step-down unit staff in Florida decided to go back to their roots and wear nursing caps for eight weeks. Their goal was to increase patient satisfaction. The positive reaction to their study was remarkable. While the final decision was not to wear caps everyday, they did decide to change their dress code. Nurses at this Florida facility, in an effort to be easily identified by patients and other staff members, now wear only white scrubs or uniforms.

The bottom line: “Professionalism comes from within, not from a cap.” However, patients do appreciate the long-held tradition of a nursing cap and the dignity that accompanies it. The nursing cap will always be the universal symbol of the nursing profession.