Patient_gown_also    No, the photo at left is not the answer (although its length has some appeal.) I know this isn’t the answer because I spent ten years trying to solve the problem of patient gowns with new designs. As President & CEO of Riverside Methodist Hospital and the OhioHealth System in Columbus, I even hired a part time staff person to create a better solution.
   We came up with some incremental improvements. But a nagging problem remained. No matter what design we came up with, there was still the issue of how patients felt wearing one of these strange garments which, in turn, was based on how they were treated!
   No one wants to be a patient. No one says on Saturday night, "Hey, I know what would be fun. Let’s check into the hospital."

   As I have been saying for thirty years, the experience of hospitalization is far more humiliating than it needs to be. In fact, hospitalization still bears too much resemblance to another form of institutionalization – imprisonment. But there is an answer to the patient gown problem…

   And the answer has to do not with gown design, but with the culture of health care. Sick people are diminished by illness or injury. So long as they have their regular clothes on, they are often able to hold on to a modicum of dignity. But take our clothes away and put us in a gown that marks us as sick and respect from others will often sink – no matter how nice the gown is.
   Consider prison uniforms. Unlike a patient gown, prison uniforms cover the wearer quite well. But an orange uniform (or a striped one) with a number across it signals that I am a criminal. For some, this provides an excuse to look down on another human being. Raise the idea that prisoners should be treated respectfully as humans and the lPrisoner_unifikely response from many will be: "No, prisoners should to be treated disrespectfully."
   As a former federal prosecutor and judge, I believe that dangerous prisoners deserve to be walled off from society. But, beyond that, they have not been sentenced to be treated as subhuman.

   Whenever we degrade another human being or another group we degrade ourselves.

   What about patients? What have they done to deserve a humiliating garment branding them as weakened, vulnerable, and (as in the photo) exposed? They have simply fallen ill. Their weakness and vulnerablity should entitle them to our highest level of respect and caring not subconsious scorn. Patient gowns should be viewed as robes of suffering calling us to give an extra measure of compassion and love to the wearer.
   I’ll admit that some design improvement might help. A courageous leader namPatient_gownsed Rosemary Gibson, a member of the staff at the Robert Wood Johnson Foundation, has taken on the project of improving patient garb. When she started the effort more than three years ago, I wasn’t very encouraging to her. I gave her all the devil’s advocate arguments I could think of. To her credit, she has persisted. God bless her if she suceeeds and I admire her for even trying.
   Meanwhile, a hospital, clinic, hospice, nursing home or doctor’s office can change patterns of disrespect by developing cultures that display the deepest regard toward the sick.
   In an effort to humiliate him, Jesus’ captors stripped away his clothes, dressed him in the humblest and most limited cloth, and mocked him with a crown made of thorns. In this humiliating garb, nailed to a cross, taunted by onlookers, he founded a faith based on love.
   People of all faiths respect the image of Christ on the cross. People of all faiths and of no faith say they believe in love. For caregivers, it’s time to change our mental image of people in patient gowns. It’s time for patient gowns to be seen as robes of respect.

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3 responses to “The Answer to Patient Gowns?”

  1. Karen York Avatar
    Karen York

    Don’t forget the beautiful plastic bracelet everyone gets on admission as well that issues a particular number to them for identification. If you could provide a coordinated outfit with matching gowns, bracelets, and maybe a necklace, then many fashionistas would love to be admitted. I’m joking of course, but the stripping down of our clothing is a degrading experience. It is in the mental model around the garment. If we as caregivers, as you suggest, change the mindset toward this garment and honor it as a robe of love, that will go a long way in easing the fear and embarrassment of many patients.

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  2. liz Wessel RN, MS SJHS Home Health Network, Orange, CA Avatar
    liz Wessel RN, MS SJHS Home Health Network, Orange, CA

    Home care and hospice offers a very unique practice setting as caregivers venture out into our community. Varied experiences provide for an education in life as one encounters the best of and the worst of peoples’ worlds. The focus of control is very different as compared to all other healthcare settings. As caregiver, we are invited as guests into the homes of our patients. They are in control and can choose to accept or refuse our recommendations for their healthcare. We have an opportunity to enter into their private lives and the sacred space of their home. We get to see their family history through photographs and memorabilia, meet family members, even pet the dog. Often patients and families view their caregiver beyond usual roles and describe their caregiver as friend or “like family.”
    Yesterday I taught an 8-hour palliative care class to a group of new employees. Caregivers were a mixed group of nurses, home health aides, an occupational therapist, scheduler, hospice social worker, and chaplain. One nurse shared a story about her dad when he was dying and in a hospital setting. She tearfully said, “The only one who showed my family any compassion was the housekeeper.” She described a kind and sensitive woman who reached out and said to her, “You look so sad, is there something I can do for you?” Responding to the needs expressed this housekeeper offered spiritual support and prayer. Our nurse said, “She is the only person who I remember from this experience.”
    I thought you might appreciate this story, as I think it illustrates that culture shift you speak of.

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  3. Diana Gallaher Avatar
    Diana Gallaher

    Thank you for the reminder of the power of images to invoke thoughts and feelings. So often, when I see a hospital gown, my first reaction is one of embarrassment. Instead, when I see a hospital gown I am going to cultivate mindfulness of Matthew 25, “for I was sick and you cared for me.” Matthew 25 is already why I visit a man in prison. Thank you for the technique on a meaningful way to cultivate mindfulness to responding to suffering with compassion and wisdom.
    Diana Gallaher
    TN Justice Center
    Diana Gallaher

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