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What Difference Does a Uniform Make?

What Difference Does a Uniform Make?

Recently Katie Carey, a graduate of the Eastern Kentucky University Paramedic Program, posed a Facebook discussion question that generated many responses.  Her question as posed was “If and/or when you need EMS does it matter to you if the provider is wearing a regular t-shirt?”  I thought it was a great question and apparently, so did others.  To date, it has generated almost 50 responses. 

As I thought about her question it took me back to the time when I worked for Whitfield County EMS in Dalton GA.  Dalton is traditionally known as the “Carpet Capital of the World”.  At that time, it also was the home to one of the most progressive agencies that I had ever been a part of.  John Hitchens, the EMS Director at the time, once told me, “When you get on the scene of an emergency, you have about three minutes to take control of it or it takes control of you!  Patients don’t know that you can intubate with one hand tied behind your back or that you can start an IV with both hands tied.  What they do recognize is your courtesy and respect and the cleanliness of your uniform and vehicle.”  Hitchens was not saying that clinical skills were not important.  On the contrary, our agency had a very aggressive training program as well as a thorough QA/QI process to ensure the delivery of care. 

What Hitchens was advocating was that the treatment of your patient BEGAN with your first interaction.  If a person presents themselves as being professional and capable as evidenced by how they dress and interact with the patient, the patient’s anxiety level begins to subside.  I try to emphasize this in my classes in that just this attitude will not only be good public relations but good medicine as well.  Reducing the anxiety that a patient having and AMI is critical as it goes directly to the reduction of the workload on the heart as well as decreasing the extension of the infarct. 

But, these are just to opinions of two people.  I wondered what the research said regarding the use of uniforms and how that might be applied to EMS.  In one study of nursing, Albert (2007) discovered that “Traits of nurse professionalism (by patients) were highest in white uniforms.” In a different study that looked at the effect of uniforms on the impact that they have on employee satisfaction, Peluchette (2007) learned that “Respondents felt most authoritative, trustworthy, and competent when wearing formal business attire.”  In a third study of physicians, Petrelli (2014) revealed that, “Preference for formal attire and white coats was more prevalent among older patients”. 

In summary, we like to say that we are in EMS because we enjoy helping other people.  I think that it is imperative that we study and determine what makes our patients at ease and focus less on what we “think” might make us more comfortable while working.  We all have our opinions about what might be comfortable for us, but shouldn’t we at least begin to think of what the patient needs first?  After all the third word in EMS is SERVCE. 

About the author:

Bill Young began his EMS career in 1975 with a small fire department near Williamsburg, KY. They began running first responder calls long before the phrase ever existed. In addition to Kentucky, his career has taken him to Tennessee, Colorado, Georgia, and Kansas. He has served as a street medic, training officer, supervisor, state regulator, and educator. He is enrolled in the University of the Cumberlands where he is seeking a doctorate degree in education. Currently, he is an Assistant Professor and the Program Director at Eastern Kentucky University in the Fire and Paramedicine Science Department.


Albert, N. M., Wocial, L., Meyer, K. H., Na, J., & Trochelman, K. (2008). Impact of nurses' uniforms on patient and family perceptions of nurse professionalism. Applied Nursing Research, 21(4), 181-190. doi:10.1016/j.apnr.2007.04.008

Peluchette, J. V., & Karl, K. (2007). The impact of workplace attire on employee self-perceptions. Human Resource Development Quarterly, 18(3), 345-360. doi:10.1002/hrdq.1208

Petrilli, C. M., Mack, M., Petrilli, J. J., Hickner, A., Saint, S., & Chopra, V. (2015). Understanding the role of physician attire on patient perceptions: a systematic review of the literature-- targeting attire to improve likelihood of rapport (TAILOR) investigators. BMJ Open, 5(1). doi:10.1136/bmjopen- 2014-006578

Published on February 13, 2017

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