If modesty is the only concern for a patient they can simply put another gown on backwards - using the second gown as a robe. Not rocket science.
1
I have been a nurse for many years and I admit that hospital gowns offer minimal body coverage to patients. Patients bodies are always exposed to virtual strangers in hospitals.
My deceased mom had cancer which led to frequent hospitalizations. When I visited her, her body was always cold and exposed, the most private parts.
As the illness progressed, she was in too much pain to focus on her body being exposed; later on she was too confused to recognize she was exposed. This is the story of many patients - they lie cold and exposed in hospital.
My mom's experience led me to design Mijamaz Medical Pajama. A full pajama that accommodates medical lines and appliances, give you full body coverage and will not hamper patient care.
No longer do patients need lie cold and exposed in a cold hospital ward/unit.
Like everyone, I agree that hospital gowns are terrible. That is why I have designed a new gown from scratch. Instead of trying to make a hospital gown attractive, I have taken attractive clothes and made them into hospital gowns. I am at the phase of choosing a manufacturer, so it shouldn’t be too long until I will be able to sell them. Check out my videos and pictures on Twitter @blue_dignity. It’s time for this problem to come to an end.
1
An excellent article! Thank-you for bringing dignity to the forefront of the "dreaded" hospital experience. I designed a "wear in the shower" cover that allows care-recipients to stay covered called the Honor Guard. I used it first when caring for my mom. It changed our lives during personal care. I later started a nonprofit that helps other caregivers and care-recipients keep their dignity like my mom and me. We all desire to be covered.
1
When I was a patient for three weeks in the transplant division at Hackensack Meridian Hospital, I was allowed, and in fact encouraged, to wear whatever clothes I felt comfortable in. The nurses were incredibly helpful in making it all work, threading lines through T-shirt sleeves and skirts and disconnecting and reconnecting lines as needed. I was even able to wear my favorite blue wig. Kudos to them for seeing their patients as whole people deserving of dignity and respect.
1
The Mayo Clinic has one piece wrap-around gowns. Covers everything and quite comfortable.
Luckily, I have only been in the hospital for a stay once. I was well enough to walk around the corridors which is better than lying all day if you can move. One of the reasons that prevented me from moving more was the gown, open at the back. Why on earth would I feel comfortable walking around with my naked backside exposed? This is actually an important issue. Everyone gets the same gown, even though not everyone needs the same access to all parts of their body. It is just cheaper and easier for the hospital. Good on folks for refusing to submit to this.
5
Henry Ford Hospital had design students from the local university develop new hospital shirt and pants. They made them out of sturdy materials with good coverage, yet accessibility for a stethoscope. I encourage other institutions to look at what they developed and consider switching.
2
Most useless gown: the one I had to put on 20 times prior to breast radiation. Enter a tiny room to change into the ginormous gown (removing my T-shirt and/or jacket but leaving jeans on), walk 50 steps (trying to hold the gown at the back so it would stay on), sit in the gown for 5 minutes, enter the radiation room, and immediately remove the gown for treatment. Finally, for the last two appointments (why did it take me that long? Because I was a compliant A+ patient), I insisted I could wait with my T-shirt and jacket on, and take them off as soon as I entered the room. Many medical treatments feel dehumanizing (e.g. radiation). Little things matter.
5
I have a chronic condition, and after my first stay in the hospital, I have had a small suitcase packed with what I think is important, ready to go, if I need to be admitted again,including extra chargers for my phone and tablet,extension chord, my own toothbrush and toiletries, as well as toilet paper, as hospitals only provide the cheapest one ply.
C. Coen
1
I spent 10 days at a top NYC hospital and was shocked that the hospital gown hadn't been redesigned in the 16 years since I had last been in a hospital. It was one of the worst parts of the care experience. Not only was it uncomfortable, I felt vulnerable and exposed. Luckily a friend brought me Reboundwear gowns and I had family members who took care of my laundry for me. The gown was more like a chic lilac colored oxford cloth dress with zippers in all the right places for the doctors to easily access my drain and incisions 20 times a day. It was designed to function for both the patient's and the doctor's needs. Hospital gowns may seem insignificant or low on the priority list to some, but reading this article reminded me how valuable a sense of dignity and humanity are to the recovery process...
3
I suppose there are different ways of viewing this-- I'm a doctor at a Harvard hospital yet never wear a white coat. similarly, when I was a patient at the same hospital I didn't mind wearing a gown. both are forms of role playing but at the end of the day, what you wear reflects nothing about who you are or your value as a person.
1
@poins With all due respect, this is not an issue of "fashion." People in the hospital wanting dignity during a very stressful period of their lives are not focused on hem lengths or or the pros and cons of pattern mixing. I am disappointed that as a physician you are just projecting your own experience onto the situation instead of trying to see it through the eyes of the patient. Please try again.
5
One of my most distinct postpartum memories was coming into the doctors office with mastistis and being asked to remove my clothes and drape myself with the stiff, papery cover they provide (worse than a gown) while I waited for the doctor. I was shivering from fever chills, my breasts were leaking milk everywhere, I was cold and alone with no way to call for a nurse other than to get up naked to yell out into the hallway. It was so humiliating and made me feel worse than I already felt. I get the convenience on the provider's end. The paper is disposable, one size fits all, etc. But really, we have got to do better.
13
Shamron Mills (www.shamron.com) has designed hospital gowns and linens that address most of the concerns expressed in this article, including two patents.
Perhaps decision makers at the top of the hierarchy need to consider feedback from patients and medical personnel on this issue, which recurs occasionally without any change.
I was admitted into the hospital two times in the last two months. The hospital gown itself was one of the worst aspects along with the inability to shower. I asked the doctors almost daily and the nurses too for a shower but nobody has the time. I was not able to lift my arms to brush my hair or teeth. It seems that hospitals do not care if inpatients feel clean but it really bummed me out to be honest. The gown would not keep on my shoulders, constantly exposing my skin and feeling unclean and gross is not the ticket to feeling better. On my second hospitalization I wore a tank top and sweat pants that allowed for constant exams and did not interfere with the I.V.s I was hooked up to, which was a very slight improvement. Can't imagine what it was like for the lady waiting weeks in there for a new heart
8
Nothing can de-humanize me without my permission.
1
So, I can’t believe you’re just now figuring this out!
2
Providers with direct patient contact don’t wear lab coats, we wear scrubs. Gowns and scrubs serve the same purposes - practicality and hygiene.
I just left work and can tell you 100% of my patients gowns today made contact in some form with their urine and/or feces, also possibly mucous and blood. As for me, I’m going home with their skin cells and flora on my scrubs. Happily, both our garments can stand up to the hot cycle and we’ll both be fresh and clean the next time we meet.
If you’re lucky enough to be continent, mobile and free of lines, incisions and drains during your hospital stay, its unlikely anyone will object to your sweats.
7
@Theresa
You get a fresh set of scrubs and shower daily. Your inpatients do not. I call you the lucky one here!
9
As Dave Barry said: Hospital gowns: the one garment that make you feel more naked than if you were actually naked.
12
While nobody likes them or wants to wear one, they are still designed for function- easy access to examine your body, easy to put on and take off when you are dealing with IV lines, catheters, heart monitors and the like. Most of the hospitals I have worked at also provide pajama bottoms and bathrobes for patients who want them. I think it's a good thing for patients to wear their own pajamas, or maybe something like sweat pants, but it also depends on why they are hospitalized. Gowns are designed to be easily changed if you have things like IV lines, and to provide easy access for monitoring surgical sites. And if you get blood, vomit, excrement, spilled Jello or any other of the nasty substances common in hospitalized persons on a gown, it's easy change it out for something clean. Trying to put on a t-shirt when you are hooked up to an IV pump doesn't really work, likewise getting those pajama bottoms over your hip or knee replacement. When I worked on a floor that did primarily elective orthopedic surgeries, patients frequently brought in their own pajamas and the like, but rarely wore them.
The sense of being dehumanized by wearing a gown, though, is very real. Good nurses and doctors (and PT's, RT's, CNA's et. al.) recognize this and take pains to treat each patient as a person deserving of respect. And yes, it's a great thing on the day someone puts on their own clothes and leaves that ugly gown behind.
5
While nobody likes them or wants to wear one, they are still designed for function- easy access to examine your body, easy to put on and take off when you are dealing with IV lines, catheters, heart monitors and the like. Most of the hospitals I have worked at also provide pajama bottoms and bathrobes for patients who want them. I think it's a good thing for patients to wear their own pajamas, or maybe something like sweat pants, but it also depends on why they are hospitalized. Gowns are designed to be easily changed if you have things like IV lines, and to provide easy access for monitoring surgical sites. And if you get blood, vomit, excrement, spilled Jello or any other of the nasty substances common in hospitalized persons on a gown, it's easy change it out for something clean. Trying to put on a t-shirt when you are hooked up to an IV pump doesn't really work, likewise getting those pajama bottoms over your hip or knee replacement. When I worked on a floor that did primarily elective orthopedic surgeries, patients frequently brought in their own pajamas and the like, but rarely wore them.
The sense of being dehumanized by wearing a gown, though, is very real. Good nurses and doctors (and PT's, RT's, CNA's et. al.) recognize this and take pains to treat each patient as a person deserving of respect. And yes, it's a great thing on the day someone puts on their own clothes and leaves that ugly gown behind.
Me? I love donning a hospital patient's robe. Free advertising never hurts no matter the situation or location.
1
Who cares about the gowns!!!
I was just in the hospital for four days (MS plus the flu)--my nurses and nursing assistants were MARVELOUS. The nutrition person was fabulous. I could have cared less about the gown and my nakedness. The people helping me get well were patient and kind and competent. Plus, they brought me warm blankets. (My dignity is much hardier than a silly hospital gown.)
5
As a PA in an a academic medical center, I have often cared for people who e d up staying for a very long time in the hospital. Some have long and difficult recoveries and end up becoming demoralized up the time we are ready to get them strong and home. During this difficult time I INSIST those folks put on pants. Any kind of pants. I call it the Monica Protocol.
The costumes we wear inform the roles we play- and folks who are ready to discharge do not need to be in gowns. I am convinced it holds them back and adds to the demoralizing experience f being in hospital and depends the on others. Pants are empowering. They should be worn more often.
10
I have long wanted radiology depts. and hospitals in NYC to be more humane about women's hospital gowns. When you go to get a mammogram, you're given a pink, loose, gaping top that you have to hold closed with your hand as you wait for what you assume is a cancer diagnosis in a waiting room with blaring TVs and if there are magazines they are golfing ones you assume were discarded by the male physicians (or I've seen Guns and Gardens!) and other men's magazines left out for women to read. It's time for someone to design gowns with dignity and to design a patient waiting room experience that isn't frustrating and awful.
11
Gowns are the least of our problems in hospitals; when my father had a protracted hospital stay, his clothing was stolen anyway. I once had a psychotic nutcase wander into my room in the middle of the night, but that wasn't as bad as the c.diff. infection they gave me, which recurred five times. The medication for the infection gave me permanent nerve damage. Absolutely nothing is safe in a hospital - certainly not the patient; some patients have even been raped in hospitals. I'm sure in the end that they killed my father, but they kill a lot of people in hospitals. We are worried rightfully about gun violence, but a lot more people are killed by negligence, unsanitary conditions and medical malpractice in hospitals. I just don't have time to worry about gowns, when there are bigger issues to worry about once one goes into these unsafe places. You know you're going to walk out with more problems than you had coming in.
5
Please, please tell me you’re joking about the perfume. For a hospital stay? This isn’t a night on the town, and I’ve no doubt the medical staff and fellow patients have no interest in breathing in your perfume (particularly the latter who are unwell).
13
@suz
Thank you! Was in the hospital for nausea and scented lotion made me wretch. My greater plea is for everybody to learn to wear perfume sparingly.
13
Absolutely. And totally vulnerable.
Lighten up with the silliness.
Patients need to be gowned if an exam is going to be performed.
If not, they can wear whatever they are comfortable with.
2
The gown's purpose is not to make things easier for medical personnel. It's to remind patients that they're just chunks of meat without any rights, so that they'll submit passively to every indignity inflicted on them by arrogant authoritarians.
Two years ago, I was hospitalized on emergency basis. My clothing was replaced with a flimsy, cold, gown. I now have a go kit with loose cotton clothing and warm clothing. Never again will I wear a gown, or subordinate my right to dignity to the convenience of the medical personnel who stick, poke, jab, hurt, and try to humiliate patients, and then submit bills that could trigger a medical bankruptcy. Never again. Never, never, never.
8
It should be a section in everyone’s living will: the right to wear comfortable attire, that protects one’s dignity.
1
This is a very cultural question. Here one almost always wears their own pjs, loungewear, nightgowns, etc in the hospital. People are also responsible for their own towels, washcloths and laundry. (But not sheets) The first thing your true friends do when they hear you will be going to the hospital is offer to do your laundry for you. Never once did anything I wore in the hospital seem to bother the nurses, doctors, or nursing assistants. It definitely gave people a sense of normalcy and comfort. Another big difference in France is what you don’t wear compared to the US. Realizing that going to the gynecologist, for example, meant being completely naked, no gowns, at all, was a surprise in the beginning for me. Getting a mammogram involves sitting topless in a private cubical until called, doing the exam, privately, but topless the whole time, then returning to the private cubical. The difference here is that no one cares at all if you are nude. Once I got used to the idea, it even has certain benefits. People like the physical therapist are trained to notice suspicious moles, etc, on your bare skin and refer you to get them checked.
6
One size fits all means there is no way it will stay on without using at least one hand to grip it tightly around oneself.
4
The gowns in the various hospitals I’ve been to end up everywhere but where they’re supposed to be—most often up against my neck “strangling” me. Something is wrong here. I’m not moving much in my hospital bed, because I’m sick or just had surgery, and I’m always hooked up to an IV or more, so movement is limited. Just sharing.
Last time, I took my own clothes. Much better. Then I read previous comments about not wanting to wear ones own clothes because the clothes will come home bacteria-ridden. I was confused. Many many people work in hospitals and—I figure—just throw their clothes in the wash, like I did with mine when I came home. Any comments regarding this appreciated—preferably by people who work in hospitals. My thoughts are, if some microbe is so nasty I run the risk of contaminating my home with it, it’s too late to worry: I would’ve already marinated in it at the hospital.
I see the writer’s point. I remember my very vain, always-stylish mother looking utterly deflated in her rumpled hospital gown, after a major surgery. She was uncharacteristically compliant, too, while in hospital. However, I think that the effect that a hospital gown might have on a patient must depend at least somewhat on that patient’s comfort with his or her body, and their self image. I have spent a lot of time in locker rooms (I am a swimmer), walking around in the buff, and in art studios painting and drawing nude models. I am not modest about my body, nor am I uncomfortable around nudity. I am also not vain enough to think that any one cares how I look in a goofy backwards shirt, or whether my undercarriage is visible. It’s a medical environment, after all. So when I have to wear a skimpy, thin hospital gown, I don’t feel diminished, dehumanized, embarrassed, disempowered or undignified. Sometimes I just feel chilly and a little itchy. The gowns are certainly not very comfortable. And since cozy comfort is key for feeling safe and nurtured, and nurture is critical for healing, it makes sense that a patient in hospital might feel better in her or his own nightgown, jammies or oversized tee shirt. Freshly laundered.
Now can we talk about those scratchy sheets?
4
When I went to the hospital to give birth to my second child I took my own oversize long t-shirt and sweater. I learned from my first experience giving birth that I was not going to be wearing a hospital gown. I wanted to feel at home (as much as possible)...and one’s own clothes are a great start. Great article!
4
Thank you for this article! It is far from frivolous. I am afraid of hospitals, and the stress and anxiety I feel inside them was an issue when I was about to give birth. Part of the fear stems from the violation of modesty and privacy—you’re helpless, captive, and prone while strangers prod you. Refusing to wear the hospital gown really helped. Labor ready heightens your senses, so having soft material instead of that awful scratchy stuff, and something that smelled familiar instead of foreign, and being mostly covered—it helped me relax enough to deliver my babies without intervention.
3
Maybe things are changing. When I had my hip replacement, I had an IV and a catheter, but they had me in my clothes from home almost as soon as I woke up. Even for the short time I was in a gown, they had one on me the regular way, and then another on me like a robe, thus covering my front and back.
6
When I was a medical student and resident, the VA hospital issued pajamas rather than gowns to patients. It wasn't any harder to care for them, and it was much more dignified for the patients.
Today my white coats are gathering dust in my closet, but we're still waiting for the rest of the country to catch up with that good old VA hospital and send the gowns to the incinerator where they belong.
10
I didn't know patients had the option to wear their own sleepware. Good to know.
Since one of my big fears with hospitalization is exposure to perfumes, I wish patients wouldn't bring in perfume to wear unless they're sure they won't have roommates. Breaking into uncontrollable coughing after surgery wasn't great, but the night nurse was wearing enough that I couldn't stop. Hospital policy is that it's their right to wear what they want. Tattoos must be covered up, but perfume is A-ok.
14
After a medical emergency, I had a couple of weeks of inpatient therapy. My husband brought me comfortable, low maintenance clothing from home and that’s what I wore as I kicked a ball, climbed a small flight of stairs to nowhere, etc.
Also, for religious reasons I dress conservatively. Understanding health care providers have at least allowed me to wear two gowns, leaving one with the opening in back and the other with the opening in front. It’s better than one but far from ideal.
Finally— for anyone with balance issues, let them wear their own low heel shoes. Those socks with the rubber dots are useless for preventing a fall.
12
I can see the point here but, frankly, I was thinking hospital gowns were helpful because they guarded against people bringing in germs from their illnesses and kind of "living" with those germs while in the hospital. But I may be wrong.
15
One size does not fit all! I am less than 5 feet and weigh 110 lbs. I always feel like i am wearing curtains before they have been measured. I don't care where the tie is as long as it stays shut. I recently had surgeries at two different hospitals. Hospital 1--same old gown. The second hospital (HSS) actually made me smile as i walked into the operating room. the addition of paper boxer shorts under my gown was WONDERFUL. So simple but so rare.
12
Although I’m only 55, I have spent way too much time in hospitals over the past few years: first with my teen daughter as she went through testing and treatment for epilepsy, and then as a patient myself as I was treated for aplastic anemia. Except for my daughter’s surgery and the following night in the ICU, neither of us have ever slept a night in a hospital gown! I researched the clothing that would be compatible with her EEG leads (loose fitting button front shirts and pajama or sweat pant bottoms) and my PICC line and IVs (short sleeved tees and pants). The hospital experience is stressful and you surrender so much of your identity and dignity. At least we were enduring it in our own, comfortable and discreet clothing!
17
I think it is possible to underestimate the power of the status quo !
3
I’m amazed the article didn’t mention the huge market of labor and delivery gowns and dresses. One patient wearing sweats or ordering their own gown barely scratches the surface when describing the accessible clothing industry. There’s clothes out there that allow for ports and allow access just to the areas being treated. If only medical insurance covered some portion of these, patients would be able to maintain more dignity and comfort.
6
When I had to undergo surgery and a waited on bed with nothing but a paper smock to shield me I felt very vulnerable. My mind immediately turned to how people in hospital must feel during a war or an environmental catastrophe. To me these gowns symbolize helplessness.
16
As a cancer patient going to a doctor's appointment, my sister would always have her face made up and wear pretty jewelry. Eventually she was hospitalized, but insisted on wearing her own fashionable clothes - shorts and t-shirts with spirited slogans. I had a sisterly struggle with her to get into the hospital gown when she went to the operating theater. She just wanted to be seen as a powerful woman under her own agency not as a patient.
17
I agree that hospital gowns don't have to be so depersonalizing and could be designed to look more interesting and unique, especially for our adolescent patients who are forging their identities. But as a nurse, it is so important that I have easy access to a patient's body in times of emergency. What if we need to give a bolus of fluids because the patient's blood pressure has tanked and s/he doesn't have a good arm vein and we have to go for something in the leg? Do we really want to struggle with sweatpants or have to go looking for scissors while the team is busy doing chest compressions and trying to count the minutes between shots of epinephrine? (I've actually been in this very situation with a patient who just hours earlier seemed ready for discharge - luckily he was wearing a gown.) For patients stuck in bed and anyone with mobility issues, it's so important to monitor the skin for pressure ulcers. The nurses need to have easy access to the patient's skin without hurting their backs trying to turn patients and manipulate clothing. I get it: gowns make patients feel vulnerable and exposed. But there must be a better solution than street clothes and sweats, because the medical professional's first responsibility is the the patient's body. Number two is the mind, and that's important. But remember airway, breathing, and circulation - corporeal issues come first.
32
My husband is a physician and stopped wearing the white coat years ago to stop looking so authoritarian. Have you, Dr. DeFilippis, taken that simple step at making your patients feel more at ease?
I’ve only been hospitalized once after an emergency c-section. I’m not a modest person to begin with, but after that experience, I have no problem with letting it all hang out. My dad has been in and out of hospitals and that’s been the least of our worries.
I wonder why Americans have such hang ups about the human body? I have been to Iceland 4 times and used the public hot pools there daily where everyone must bathe thoroughly before entering the pools. All the females and males are fully naked in their respective locker rooms and it’s no big deal. It’s glorious seeing the little ones not bat an eye at seeing the naked human form, whether in good shape or not, old and young.
10
@AL respective locker rooms are fine. It’s the semi-public areas that are an issue for many of us, especially those from certain religious backgrounds. Please remember that this is a diverse society.
15
@AL, stop judging, and generalizing about “Americans.” We Americans come in all stripes, you know. Many colors, many cultures. Many beliefs, many ways of regarding the human body. Personally, I could walk down the street naked. That is not true for others. Both attitudes are okay. One is not better than the other.
4
I spent all too many days and nights in hospitals in 2019 for at least six different maladies. Of course they immediately put me in one of those obnoxious uncomfortable gowns. I never understood why. The next morning I always had my wife bring me a short sleeve base layer (jockey Patagonia or north face) and a pair of gym or regular shorts. I was comfortable and was able to receive every treatment and examination. If there was a problem it was the jealous gawking from other patients who weren’t aware that, they too, could dress like a normal person. I’m all healthy now. PB
13
As a nurse and midwife I argue gowns are particularly absurd for persons during labor & delivery. Encouraging childbearing parents to wear their own clothing (and fully disclosing the likely muckiness of most births so they can choose wisely) would not only promote dignity and autonomy, it would discourage the ubiquitous and rarely necessary vaginal exams to which patients are routinely coerced to accept. Gowns be gone.
32
Well said Dr Warren!
@Nicole Warren
I have to appreciate your view, but must say as a physician and a first time mother, I only used a few swaddle blankets out of a million things I packed. Thank god for the hospital gowns and those ugly infant hats.
Oh come on. I’m reasonably healthy at 66 with a couple of genetically acquired chronic diseases. So I’m in and out of doctors’ offices quite a bit and for a time way too often. I’ve had many kinds of diagnostic procedures and such. I’ve had surgeries of varying degrees of aggression. I gave vaginal birth to 3 children. I’ve seen a gown or three, And I never once cared what they felt, looked, or functioned for walk about. If you’re in hospital for more than a few days, pack a bag of clean, low lint, no static sweats. For elective surgery, ask ahead.
9
I have always thought it wise to bring underpants to the hospital. Tops are problematic if there are electrode wires, etc. While wearing my black briefs, a nurse took grave offense that she could get a glimpse through the opening in the back. I told her this was no worse than what one sees on the beach. This did not placate her and she tried to tighten the belt to the point that it was uncomfortable. It gave me some joy when I heard her screaming at the patient opposite her nurses' station, "Mr. Rodriguez, I can see everything."
3
I refuse to wear these gowns when I’m having a physical exam. For one, I literally cannot figure out how to wear them. Who thought having to tie something behind you was a good idea?
8
The last time I was in the hospital in September 2019 after being hit by a car while crossing the street in the crosswalk, I was so injured with multiple fractures in my knee and pelvis and many contusions all over my body, I couldn’t have cared less what I was wearing, but I will say the gown was so uncomfortable around my neck and arms when I tried to move in the bed. The gowns need a material that comforts the body not a material that restricts movement. Gratefully I survived my injuries and am now home determined to walk my two miles a day again!
22
In 1983 I spend two weeks in the hospital following a radical hysterectomy. Frustrated by the numerous bottles and tubes safety pinned to my gown (and then told to walk), I changed into running shorts and a t-shirt, and with the help of my hospital roommate managed to make it all the way down to the employee-visitor snack bar in the basement. (It helped that my wonderful oncologist cheered me on. Unusually permissivel circumstances before or since.
8
I think gowns are a subtle dexterity test, to see if you can tie a bow behind your back.
12
@David Rose I always tie the bow before putting a hospital gown on--then I just slip it over my head. (I learned how to tie a bow behind my back at age 8; I'm just lazy!)
4
I don't care what I wear in an exam room. Just
keep the price down, please.
19
@dafog Only men seem to complain about the tie in back. If you have a female partner, now you should understand why we need you to button or zip the back of our clothes.
True story from Canada: Unfortunately things being what they are in hospitals here, wards with as many as 4 beds can be mixed gender/mixed sex. I was in one for a knee replacement I had waited 2 years for. I'd mastered the technique of the fore and aft two gown wrap. But I hadn't counted on nurses forgetting to bring the sheets up over me and leaving the "privacy" curtains around my bed open. This left my private parts exposed to the breeze for everyone to see including a multitude of visitors. As per instructions I was knocked out from narcotics, aware of the violation of my privacy, but incapable of doing anything about it. I'm old enough to have acquired some grit, but this was beyond the pale. I don't need to wear my own clothes but I do need to not be humiliated.
54
Sorry to hear that. I would have felt the same as you. I especially like the warm cotton sheets.
1
I have been in and out of hospitals in Austria for the last 18 years. Yes, the hospitals use gowns here, too. However, the doctors always regard the moment when I put on my own clothes and get out of bed as a major step foward in my healing. I have even had doctors say things like, "Finally, you're dressed! Now we're making progress!" But I like to wear them to sleep in at night. If I sweat, they are easily changed, with no washing at home!
10
In defense of the gown: easy on and off. Easily moved to examine various body parts when necessary. Snaps on the shoulders to work around protruding tubes and wires. Ties on the side or back for easy removal if imaging needed emergently. Provides coverage for people likely lying on their backs. Maybe not the best design for less ill patients. But its ergonomic design is keeping very ill people covered and humanized at their most vulnerable.
14
I’ve never understood why anyone actually follows the instruction to put them on opening in the back. I just put them on like a robe. No one has ever told me to turn it around.
16
@BBB Rather depends on what the doctor needs to examine, no? Some of my visits require the gown open in the front, others that it open in the back.
7
When I taught medical students one of our first sessions would be everyone wearing a hospital gown. The students would huddle around the table- cold and embarassed - and get a sense of the de-personalization and humiliation we inflict on patients daily.
132
@Honeybee
Like there's something wrong with putting student doctors in the position that they will be putting their patients in? so maybe they gain some understanding of how it feels to be the patient. We're asked to don those things often when our lives are not on the line.
58
@Honeybee Nor do you enjoy it. Or feel supported. Or feel like a person - these gowns, an exercise in humiliation, dehumanize people by making their backs visible to all. That's the idea. Dehumanized people are far less likely to advocate or participate in their own health care - this benefits the provider not the patient. You may not whine about it, but it also is possible to change it, improve it and let people be reminded that our humanness matters, even in a hospital.
20
People sleep more soundly with familiar smells. One of the most frequent complaints about hospitals is that patients are unable to sleep. If wearing their own clothes (when practical) means they can sleep better then they will probably recover more quickly. If they are not robbed of their dignity, they will recover more quickly. I could go on, but you get the idea.
27
@Judith
People sleep more soundly if they aren't awakened every couple of hours to take their vital signs. Of course some fragile patients need that much monitoring, but most times the schedule is set for the convenience of the hospital staff.
12
@Martha Shelley
People sleep more soundly when the nursing staff is not congregating outside the patient's door as if it were happy hour at the local pub.
13
Yes, these gowns rob us of dignity as well as creating a relationship imbalance. So does calling us “patients.” Truth is, I am a person.
23
@Steven Pollak
I've been an RN a loong time. Now we call the people we assist "clients". But it doesn't change the way hospital administrators (you know, the only employees making six-figure salaries that don't have to pay malpractice insurance) view the bed occupants-they still won't hire enough qualified, trained and licensed personnel to adequate take care of you....no matter what you wear.
18
@NYCSANDI
Ugh - clients. That's nasty. Really gets at the profit motive doesn't it.
4
I've been in situations where the gown was appropriate but they they should be longer. I'm medium height and size so standing around is OK, no major exposure. But sitting, reclining, or lying down they ride up and pretty soon they're bunched around your middle, undignified and uncomfortable too.
11
I encourage my patients to wear two hospital gowns; one tied in the back and the other tied in front. I can examine them without difficulty; gain access to their intravenous lines and allow them to maintain coverage. If they want to wear knickers under their two gowns, no problem if they are more comfortable. Personally, as a physician who frequently sleeps in the hospital during on-call nights (surgeon), I wear sweat pants over my scrubs because I am cold. I always like for my patients to be as comfortable as they can. It's just good care.
85
@Natalie J Belle MD Yes, the two-gown solution totally works!
3
@Natalie J Belle MD : Another vote for 2 gowns. I often forget, but the good nurses will do it for you automatically, at least once it's clear you are ambulatory.
1
I think the issue is that all patients are given gowns on admission to the hospital. Depending on what your illness is, what tests and treatments are going to be done, what care the nurses need to give you (and what information they need to gather, quickly), a gown has a lot of advantages for the patient. The two gown solution is a place to start. You can improve comfort, dignity and express individuality (important elements of personhood, instead of just being a diagnosis), with socks, sweats, hats, lap blanket, etc.
4
And there are plenty of Hollywood films which use the indignity of the hospital gown exposing the patient’s backside as comic relief in scenes where characters are hospitilized. It’s hard not to laugh when Jack Nicholson exposes his rear end while walking in a hospital corridor in the film “Something’s Gotta Give,” but when you think about it, it isn’t really that funny for the patient.
42
I lived the first 28 years of my life in Germany (I am in my 40s now) and let me tell you, I was pleased to learn that hospital gowns are a thing in the US. In Germany when you go to your doctor, you undress to your underwear and that's that. Even worse when you have an OB/Gyn appointment they ask you to completely undress at the bottom first and then dress that part again before undressing the top half. Some OB/Gyns will even have you undress completely, no gown, no sheet nothing. And then you sit there naked and exposed. I love the gowns and while not perfect, they are better than nothing.
46
My biggest problem with hospital gowns is that they only seem to come (or are only purchased) in two sizes: XL and XXL. I'm a small person and have never, ever been given a hospital gown that fits.
15
@Rupert No, the two sizes are small and utterly impossible. I got so annoyed at being handed a scrap of cloth to wear that invariably did not cover at least one third of my body that I went online and ordered up a plus size gown which I now take to every physical exam from yearly to full-body dermatological. Mine also features a delicate lavender-hued print. Nurses think its funny; I sense that doctors think, though they don't say so, that it's not according to hoyle and that one must be wary of this outside the box behavior.
11
These silly gowns are the reason I always take a large overcoat with me to doctor's offices (where I invariably wait long periods in chilly offices for people to show up because 15-minute appointments are unrealistic and things are always backed up, something that I know annoys the docs because they tell me so.)
But the first thought that always occurs to me in putting them on my 6'1" weightlifter's body is that the medical community never encounters people like me. It's like putting on a straitjacket (even though I'm only a moderate lifter.) I can't imagine that looking at a patient busting out of a gown provides doctors any real medical insight into the patient, except to provide the impression (not always correct) that "there's nothing wrong here."
11
@Paul B Lol, Paul, I am the polar opposite. I am a 5'5" woman who drowns in their gowns. I spend all my time trying to keep the darned thing on and covering something.
2
There was also this in a 2016 Times’ design issue:
Six Designers Take On Some of the World’s Toughest Redesign Challenges
https://www.nytimes.com/interactive/2016/11/13/magazine/design-issue-redesign-challenge.html?referringSource=articleShare
8
So this didn’t work out?
The Hospital Gown Gets a Modest Redesign
https://www.nytimes.com/2018/01/03/style/hospital-gown-parsons-care-wear.html?referringSource=articleShare
3
I opted for hospital gowns during hospital stays because I would receive a new, clean gown each day and because I didn’t want to carry home possible “hospital-infected” clothing that needed to be laundered upon arriving home.
33
Hospital gowns are terrible but the three-armed gowns are the best of the lot. Put your arms through two arm-holes and wrap the extra fabric around and put the first arm through the extra arm hole. You are completely covered with no embarrassing back exposure. These gowns are rare, I don't see them very often.
25
Sorry, but I find this a little silly.
I've spent almost three years total as an inpatient (4 lung surgeries including transplantation, 8 abdominal surgeries and about 15 minor surgeries), and I always sleep in the hospital gown, and if I'm so sick that I can't get up, ditto. I do always have a robe along, so I can cover up when I get up. But why in the world would I wear my own clothing? Somebody would have to wash it, and it wouldn't be me. In contrast, I get a fresh hospital gown every day, more often if I need it, and all is good. My emotional well being doesn't suffer nearly as much from a hospital gown as it would suffer if I had to wear my stinky old clothes two days in row. :-)
34
Good point about bacteria ridden clothes. I volunteer at a hospital and change out as soon as I get home.
8
Whatever helps a patient hold on to his or her identity helps to relax the patient in often intimidating situations. This includes wearing personal clothing when possible, and being addressed by name, and being offered choices, along with some relevant pros and cons. When possible, eye contact also helps.
25
I agree that the "classic" hospital gown is frustrating and embarrassing. It's not just the breezy flap in the back, but also the incomprehensible series of snaps around the shoulders. However, I can understand that the hospital wants to be certain the patient is in clean clothing, and the medical personnel need to be able to easily access whichever body part is being treated.
It does seem like some better designs could be attempted, however.
9
Thank you for writing this thoughtful and necessary piece, Dr. DeFilippis.
After three recent visits to the hospital for emergency surgeries, I can attest to just how uncomfortable the hospital gown is and how utterly unnecessary it is for patients to have their rear ends exposed.
It is a dehumanizing feature of a visit to the hospital, some medical tests and a yearly wellness exam with your PCP. While I absolutely understand its necessity during some tests and visits to the hospital, it helps to create a feeling of vulnerability and illness.
And, then there are the paper gowns we women get to wear when we have breast exams, or pap smears. Lovely!
We can do something about this and we really should. No one's posterior needs to be shining in the fluorescent glow of hospital lights or feel the cold, hard stare of strangers.
70
There’s no requirement that a patient wear a hospital gown. When I was in the hospital for surgery, I wore shorts and a t-shirt post op.
When people wear a gown they get into a “sick role” and end up behaving “sick”. Wearing ordinary clothes changes the patient’s mindset to the positive and they may recover faster.
37
As a retired physician and now an intermittent patient the gown was to allow physicians easy access to the whole of the patient's body.
Young physicians today who seem to lack the basic skills of the physical exam and the importance of it have no problems with not looking at all of the patient's skin, feet , feeling pulses, listening with a stethoscope through layers of clothes etc.
The gowns were not meant to demean but to help with diagnosis.
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@Edward B. Blau
As a physician myself who has undergone surgery, I agree.
You can be wearing a tuxedo or a ball gown and by the nature of how hospitals are structured, you're going to have your dignity impaired to a certain degree.
And I always tell people who are curious about the ancillary things like meals, the beauty of the rooms, or even how the gowns looks, when considering what hospital to go to for care, that you go to a hospital for one reason: to be treated for an illness. If I have a doctor whom I trusted with my life I wouldn't care what I had to wear. I wonder if Dr. DeFilippis has a different view of this.
9
@Steve This is the kind of myopia of the medical establishment. Hospitals are comfortable places for you. They are where you work. You don't get the problem. For the rest of us, not so much. So other issues like presentation, decent food things to make them seem friendlier do matter. A lot. Sure the first thought is the doctor but after that how we feel while in them is crucial.
43
@Steve Compared a patient who feel exposed and helpless and is stressed to one who feels at home with some measure of control, who would fare better in making a full recovery ? You know the answer to this.
The answer is thinking about patients as people with complex emotions and vulnerabilities instead of a 'case.'
Nurses know this and the doctors need to know it too.
34
I’ve had numerous spine surgeries, five decades, three states, the rude, crude hospital gown was oft required, but occasionally I wore two, each facing a different direction for modesty or draft reduction. A few times I dared to wear sweats and a t-shirt before surgery, though the lumbar incisions made sweats a no no to surgeon and nurses. The two gown ‘fore and aft’ as I called it, was the most widely accepted as it allowed access to lumbar dressing as I laid face down or on my side.
I understand the necessity, as I also now know why it’s called a ‘practice’ (12 surgeries, 7 weren’t failures)
15
Couldn’t agree more. Nurses are required to do multiple head to toe assessments, including skin assessments, per shift. On the geriatrics unit where I worked, we needed easy access to older patients’ posteriors in order to continually assess their sacrum/hips for skin breakdown. Additionally, it is highly challenging to try to efficiently clean up an incontinent patient wearing pants.
For patients who can walk and talk and who need less assistance with activities of daily living, wearing their own PJs or a newer type of gown that is more comfortable and less revealing sounds good. For the elderly who are easily confused, including those on cardiac monitors or who have several peripheral IVs and tons of lines/tubing attached to their bodies—the gown is actually safer than regular clothes because of the easy access it warrants. Ever try to stop a delirious older person from jumping out of bed in the middle of the night, connected to several lines, to prevent an injurious fall and a bunch of ripped out IVs? I have. And it was made easier because I could unsnap and untie the gown in 2 seconds. So to recap—the gown is really more for safety, accessibility, ease of physical exam, and efficiency of the nursing staff (which, if you’ve ever waited on a nurse or nursing assistant to come help you in the hospital, you’d appreciate the need for that efficiency).
12
My comment was not threaded correctly. It was meant as a reply to Edward Blau.
2
When I had to go straight from the airport to the hospital in Johannesburg, SA I got to wear whatever I felt comfortable in - t-shirts and bermuda style sport shorts were fine. No one batted an eye and my clothing certainly didn't interfere with exams or CT, MRI. My stay was 2-3 days.
17