Nursing caps are making a comeback at graduation ceremonies. Year after year I hold my tongue as graduates cross the stage wearing them. My personal bias against them was informed by a mentor of mine who was never shy to voice her opinion on various issues. Ironically, nursing student council announced in my class that they were organizing the purchase of nursing caps on the day I went to her celebration of life ceremony. While I do not yet have a firm stance on if students should wear them or not, I feel the need to explore the issue.

Some History 

Historically, nurses wore caps which distinguished them from others in the workplace. Derouen (2011) indicates that they were intended to pay tribute to the earliest nurses who were nuns. While the true origins of the cap are unclear (Stokowski, 2011), it was part of a strict nursing uniform. One of the reasons for wearing a cap was to keep hair covered, which helped to keep client care areas clean. Over several years many different types and styles of caps were used. They served to identify a nurses’ status and education. Students who survived a probationary period would receive a cap during a capping ceremony (Canadian Association of Schools of Nursing [CASN], 2012). Markings on the cap would signify the student’s level in the program (CASN, 2012). Different schools had different markings for students (Stokowski, 2011). Student aspired to achieve the end goal – the black stripe – which served as a symbol of their achievement in becoming a registered nurse (Stokowski, 2011). They would also receive a pin, distinguishing where they were trained (CASN, 2012). Men, however, did not wear caps and were excluded from many of the early nursing uniforms (Stokowski, 2017).

sasint / Pixabay

Experiences of Wearing it 

While they may have been a status symbol to the public, actually wearing them has been reported as difficult and impractical. Stokowski (2011) reports that there were quite strict guidelines on how a cap needed to be worn. They were very difficult to keep in place. Nurses developed several tricks to compensate for these difficulties. Over time they no longer contained the nurses’ hair and lead to concerns of baldness (Stokowski, 2011). Caps were not only difficult to keep in place, they were hard to keep clean and maintain (Stokowski, 2011). They were also a dangerous occupational hazard as they “became tangled in privacy curtains, croup tents, monitoring wires, intravenous tubing, and children’s fingers. They dropped onto sterile fields during procedures. They were uncomfortably hot” (Stokowski, 2017, p. 6). To me, wearing a cap sounds like an awful experience. One I am happy I never had to endure.

Symbolism 

Stokowski (2011) puts it well when she states “Ask 10 nurses what their caps meant to them and you’ll get 10 different answers” (p.7).  Some nurses I have spoke to despise the cap for the image of servitude and oppression it conjures. Others take great pride in the hard work required to earn it. Stokowski (2011) outlines many positive symbols it may represent for some including respect, dignity, knowledge, skill and professionalism. While I can see how the cap represented these things the cap itself was impractical and excluded men.

 

Respect or Oppression? 

In critical examination of some of the quotes Stokowski (2011) uses to support the above positive symbols I question the hierarchical attitude of nurses wearing the caps. When I read that nurses enjoyed the respect that was afforded them because “You knew who was getting off the elevator first” (Stachniewicz & Axelrod as cited by Stokowski, 2011) I see a hierarchical attitude. This attitude has caused many problems for the nursing profession including horizontal violence and oppression from those viewed as above nurses on the hierarchical ladder. Just as the cap signified a sense of deserved respect from those “below” the registered nurse, I would imagine it served as a visual reminder that nurses had a place below physicians. While I am speculating, this view is informed by discussions with nurses who lived and worked during this time.

 

Unfortunately I cannot finish this post at this time. I welcome opinions and suggested resources from readers to help me move towards a more informed view of nursing caps at graduation.

 

References 

Canadian Association of Schools of Nursing. (2012). Ties that bind: The evolution of education for professional nursing in Canada from the 17th to the 21st century. Retrieved from http://www.casn.ca/wp-content/uploads/2016/12/History.pdf

Derouen, S. (2011). About the cover: The history of nursing caps. KBN Connection, 27(10), 10.

Stokowski, L. A. (2011). What happened to the cap? The dawn of the cap. Retrieved from  https://www.medscape.com/viewarticle/741581_2

Stokowski, L. A. (2017). Nurse uniforms: Who cares what nurses wear? Retrieved from https://www.medscape.com/viewarticle/878174_6

 

 

Further references to explore:

https://health.uottawa.ca/nursing-history-research/education/bibliography-canadian-nursing-history