Lab Coats vs. Scrubs: Do the Clothes Make the Nurse?

By Jay Swanson, BSN, RN, OCN

Within a nurse’s career there are many opportunities for advancement, new jobs, or a change in shift. Most startling is the move from “working the floor” to “desk job.” When I left the floor to work in a job more focused on patient education, I was treated differently. I had worked on the same unit for five years; I was an informal leader on the floor and the chairperson of the floor management council, an elected position. I am not saying that I was well liked, but I was at least trusted.

During the first few months in the new job I felt that the coworkers I had known and worked alongside wouldn’t talk to me or look at me. Had I sold out? Was I less of a nurse?

It’s true, I no longer work 12-hour shifts, or weekends or holidays. I spend most of my time gathering resources and providing educational support for our oncology patients, and I get to leave work more or less when I want (usually after 5 pm).

Yes, all that’s true . . . but what I really blame is the lab coat. I believe the lab coat suddenly put me in a different category from those who wore scrubs. How do I know? When I did wear scrubs to work one day, I was treated differently, as if all of a sudden I was “one of them” again.

So what is it about the coat? Too close to physicians or other mid-level types? Most of them now wear scrubs at my facility. So then, what is it?

(Editor’s note: Swanson, a cancer nurse navigator at a facility in Nebraska, is also the author of the Reflections essay, “Read Your Card, Mary Sue,” in the November issue of AJN.)

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Senior editor/social media strategy, American Journal of Nursing, and editor of AJN Off the Charts.


  1. Mika Miriani May 29, 2016 at 9:44 am

    I have worked for 27 years as an RN and have worn scrubs with name tag and RN but transitioned into administration. I make 3 or more rounds every day and highly visible. I wear business attire with white coat that has first and last name embroidered on it. Sometimes I wear one of those new shaped nursing jackets with name tag and large RN and other credentials. I help as appropriate setting limits to each and every unit as appropriate and as time permits. I am extremely supportive of our nurses. I have to agree that what one wears DOES make a difference in how patients and staff perceive management.

  2. M. Shannahan, RN, PhD January 22, 2010 at 3:09 pm

    I don’t think that what you wear, whether scrubs or a white coat, matters that much. Good communication with patients is key. I always introduced myself to every patient as I entered a room, or encountered one elsewhere, by stating both my 1st & last name & telling them that I was a RN. Also, name tags should not be a nurse’s 1st name only. That is not professional. Has anyone seen MDs with name tags with 1st names only?. A name tag should have 1st & last names & credentials on it. Lastly, acting competently says a lot about who you are. At age 19, working as a summer aide, a patient asked for me & referred to me as the “nursing supervisor” (even though I clearly had an aide’s uniform & name tag). I was already in nursing school & was using that knowledge in my summer job. It made me think at an early age that competence & knowledge trumps clothes, within reason, any day.

  3. Janita Fisher, RN January 18, 2010 at 1:18 pm

    I am a newer nurse (post shift to scrubs), I like them, but have incountered the “what is that persons position” look from patients many times. I work in a nursing facility that requires the nurses to wear white scrubs, which I feel does set us appart but I still have patients looking at my name tag to see if I’m a nurse. I have also had patients ask me to get the nurse. I wouldn’t mind going back to the older uniforms, but I do find it better for my position to wear pants as I have had to stoop pretty low a few times to do wound care. I wouldn’t mind seeing the caps come back.

  4. Dr.Dean January 18, 2010 at 9:43 am

    It is interesting that no one has mentioned the controversy about White Coats and infection. I stopped wearing ties and white coats after reading a couple of studies about the bacteria load.

    I have had a few comments from my older patients about missing the white coat-but it sure has saved on my clothing bill and laundry!

  5. Dee Riley, BSN, RN January 17, 2010 at 3:30 pm

    There is a movement back to white uniforms. I have heard/seen many patient comments saying that they don’t know who persons in scrubs are because EVERYONE in the hospital wears them (except physicians and administrative personnel). One frustrated woman said, “I can’t tell if someone in scrubs is a nurse, an x-ray tech, or a member of the housekeeping staff!” We as nurses should wear white or otherwise identify ourselves as nursing professionals.

  6. Marcia Smalligan January 16, 2010 at 10:13 am

    I am a retired LPN Iworked for 30 years in long term care I never wore scrubs and I never trusted the professionalism of those who did. Now I am among the geriatric population who are the receivers of care. If you are wearing scrubs and have not just come out of an operationg theater I will not trust you as much as I would a nurse who looks professional and not a member of the cleaning staff Sorry

  7. Amy Sellers January 5, 2010 at 1:24 am

    Shifting your career focus away from the bedside signals a different tier of nursing…. you lose that “grunt work” comradery. Leaving your scrubs behind signals leaving behind the days of getting pooped & puked on.

    But, that’s the beauty of nursing – there’s something for everyone. Just love what you do, no matter what uniform you’re wearing 🙂

  8. jm January 4, 2010 at 6:22 pm

    Another editor’s note: some replies to the Tweet about this post at the AJN Twitter feed

    include the following:

    I prefer nurses in lab coats. More prof

    I’d trust a lawyer in a suit than one in jeans. Same with nurses, scrubs may be superficial but it says a lot about professionalism

    White lab coats are traditionally associated with authority. It projects superiority and causes aprehension.

    yes, clothes make a difference and send important signals to patients that can impact the provider brand + or -.

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