Claire Dawson
The hospital gown, sometimes called a johnny gown, is a long, loose piece of clothing worn by hospital patients. The standard design of the hospital gown has been criticised for exposing patients' buttocks, causing embarrassment and discomfort. The open-backed design was initially invented for surgical patients to allow doctors easy access to the body, but it has since been adopted for all patients, causing distress and a loss of dignity. However, some hospitals are now offering alternatives, such as gowns that open at the front or side, and drawstring pants.
| Characteristics | Values |
|---|---|
| Purpose | Access to the body during medical examinations, preserving dignity, and not ruining the patient's clothes with bodily fluids |
| Design | Back-openings, wraparound styles, side openings, front openings, bathrobe-like ties, cloth laces, snaps, pockets, attractive colors |
| Advantages | Easy to put on and take off, reduces physical strain, grants easy access to medical staff, prevents irritation, ensures modesty, aids in air circulation |
| Disadvantages | Inhibits self-esteem and orientation, causes distress, discomfort, and contempt |
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What You'll Learn
Patient dignity and comfort vs. medical access
The traditional hospital gown has been a source of discomfort and embarrassment for patients for decades. The exposure of patients' buttocks and other body parts due to the design of these gowns can make patients feel vulnerable and embarrassed, affecting their sense of dignity and comfort.
Patient dignity is a critical aspect of healthcare. It involves treating patients with respect, compassion, empathy, and kindness, and recognizing their individuality. Dignity is essential for establishing an effective relationship between healthcare professionals and patients, and it can significantly impact patients' emotional well-being and recovery. Studies have shown that undignified care can lead to depression, increased anxiety, loss of will to live, and feelings of worthlessness.
While the traditional hospital gown may provide easier access for medical procedures, it comes at the cost of patient dignity and comfort. Patients have expressed dissatisfaction with the lack of respect and decency they experience while wearing these gowns, feeling exposed and vulnerable. This can negatively impact their overall hospital experience and even their recovery.
However, the use of these gowns persists due to their practicality in a medical setting. They are designed to be simple and easy to use for medical staff, allowing quick access for examinations and treatments. Additionally, hospitals often prioritize functionality and cost-effectiveness, opting for disposable paper gowns that are stiff, scratchy, and often inadequate in covering patients' bodies.
Striking a balance between patient dignity and comfort, and medical access is crucial. Healthcare providers should prioritize patient dignity by offering alternatives to traditional gowns, such as designer patient gowns or allowing patients to wear their own clothes when appropriate. By doing so, hospitals can improve the patient experience, making them feel respected, comfortable, and empowered during their stay.
In conclusion, while the traditional hospital gown may serve its purpose in providing medical access, it falls short in maintaining patient dignity and comfort. Healthcare institutions should actively seek solutions that respect patients' privacy and individuality while also considering the practical needs of medical staff. This may include exploring more dignified gown designs, encouraging patient feedback, and promoting a culture of dignity and respect within the organization.
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Cost and organisational inertia
The standard hospital gown has been a source of discomfort and embarrassment for patients for decades. Despite this, the traditional tie-in-the-back gown has persisted due to a combination of cost considerations and organisational inertia.
Cost is a significant factor in the continued use of the standard hospital gown. Manufacturers offer a range of materials, including cotton-polyester blends and all polyester options. While cotton-polyester blends are softer, polyester is lighter and less prone to wrinkling. However, cotton-based blends are heavier and thus increase laundering costs. New designs, such as those created by Care+Wear, can also be several times more expensive than standard gowns, with prices ranging from $4 to $7 per gown, compared to $3 to $4 for standard gowns. The higher cost of new designs is a significant barrier to their adoption, as hospitals often face declining reimbursements and pressure to cut costs.
In addition to the direct cost of the gowns themselves, there are also logistical considerations that impact the overall cost of implementing new designs. For example, the weight of cotton-based blends increases the cost of laundry services, which hospitals typically pay for by weight. Cotton also wrinkles more easily, requiring additional time and resources for ironing or steaming. Furthermore, new designs may require adjustments to established health care processes and procedures, resulting in additional training costs for medical staff.
While some hospitals have successfully implemented redesigned gowns, such as the Cleveland Clinic, which paid $15 per gown compared to $5 for the old gowns, the higher cost remains a significant barrier for many hospitals. The increased cost of new designs, combined with the need to align with established health care processes and procedures, contributes to organisational inertia. This inertia makes it challenging to implement changes, especially when hospitals are already facing financial constraints.
Despite the challenges posed by cost and organisational inertia, there is a growing recognition that the standard hospital gown negatively impacts patients' experiences and dignity. As a result, some hospitals are exploring alternative options, such as allowing patients to wear their own clothes in certain situations or implementing simple redesigns that don't significantly increase costs. These efforts aim to strike a balance between improving patient comfort and dignity while managing the financial constraints faced by healthcare institutions.
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![McKesson Disposable Patient Exam Gown [Pack of 50] Latex-Free, Medical, Hospital, Tissue/Polyester, Blue, One Size Fits Most](https://m.media-amazon.com/images/I/71daP5mjSvL._AC_UL320_.jpg)
One size fits most
The traditional hospital gown has been a source of discomfort and embarrassment for patients for decades. While hospitals have primarily used a "one size fits most" strategy, assuming that smaller people will be adequately covered, this approach has often fallen short, with gowns gaping at the chest and back, exposing patients' bodies.
The "one size fits most" approach to hospital gowns has been attributed to cost and organisational inertia. These gowns are typically mass-produced at a low cost, ranging from $4 to $7 per piece. However, this strategy fails to consider the diverse body sizes and shapes of patients, resulting in inadequate coverage for many individuals.
In recent years, there has been a growing recognition of the need for more dignified and comfortable hospital gown designs. Clothing designers have created alternative gowns that preserve patient dignity while still providing medical staff with necessary access to the body. These newer gowns offer various improvements, such as openings down the side or front, wraparound styles, snap fasteners, and pockets.
Some hospitals have enthusiastically embraced these designer patient gowns, understanding the importance of maintaining patient self-esteem and respect. The Cleveland Clinic and Hackensack University Medical Center in New Jersey are examples of medical institutions that have implemented such initiatives.
While the traditional "one size fits most" hospital gown may still be prevalent, there is a growing movement towards adopting more patient-centric alternatives. By recognising the negative impact of inadequate gowns on patient experience and mental health, hospitals are taking steps to improve this aspect of patient care.
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Post-hospital syndrome
The risk factors for post-hospital syndrome include sleep deprivation, malnourishment, pain, discomfort, cognition and physical function-altering medications, deconditioning from bed rest or inactivity, and the stress of hospitalization. Elderly patients are particularly vulnerable to the effects of post-hospital syndrome, with nearly one-fifth of Medicare patients discharged from a hospital developing an acute medical problem within 30 days that requires rehospitalization.
To prevent or minimize the effects of post-hospital syndrome, patients and their loved ones can take certain actions during and after hospitalization. These include enlisting a family member or friend as an advocate to help with care and support, requesting a list of healthcare professionals involved in their care, and planning meeting times to ensure the advocate can be included in discussions. Additionally, creating an "in case of hospitalization" plan with a doctor, assigning a health care proxy, and ensuring timely follow-up appointments with primary care doctors and specialists are all recommended strategies.
Furthermore, hospitalists and healthcare providers play a crucial role in reducing the risk of post-hospital syndrome by targeting stressors that contribute to patients' vulnerability. This includes reducing disruptions in sleep, minimizing pain and stress, promoting good nutrition, optimizing the use of sedatives, emphasizing physical activity, and enhancing cognitive and physical function. By addressing these factors, hospitalists can actively promote health and contribute to patients' physiological reserves.
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![Disposable Patient Exam Gown [Pack of 50] Latex-Free, Medical, Hospital, Tissue/Polyester, White, One Size Fits Most](https://m.media-amazon.com/images/I/61wF0M6niML._AC_UL320_.jpg)
Alternatives
Hospital gowns have long been a source of embarrassment and discomfort for patients, with their butt-baring design and scratchy, thin fabric. While hospitals have been slow to replace the traditional tie-in-the-back gowns, there are now several alternatives available that offer more coverage and comfort.
One alternative is the use of disposable paper gowns, which are becoming more common in hospitals. While these gowns may be more convenient and hygienic, they often adhere to a "one size fits most" approach, which can still leave smaller individuals exposed. Additionally, disposable gowns are often criticized for being stiff, scratchy, and uncomfortable.
Some hospitals are now offering designer patient gowns that provide better coverage and comfort. For example, the Cleveland Clinic and Hackensack University Medical Center in New Jersey have introduced designer gowns that have received positive feedback from both patients and clinicians. These gowns are designed to be aesthetically pleasing and provide full coverage while still allowing easy access for medical examinations.
Another alternative is the kimono-style gown designed by New York City's Parsons School of Design. This gown wraps around the patient and ties in the front, providing more coverage and security. The back of the gown splits just below the buttocks, with overlapping fabric to prevent accidental exposure. This design not only offers more dignity to patients but also considers the needs of medical staff, requiring no complicated user manual.
Lastly, a simple solution proposed by some physicians is to encourage patients to wear their own clothes more frequently during their hospital stay. This can help maintain patients' self-esteem and remind medical professionals to recognize them as individuals rather than anonymous patients.
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Frequently asked questions
Hospital gowns expose patients' buttocks because they are designed to give hospital staff easy access to the patient's body for treatment and examination.
Traditional hospital gowns are cheap, durable, and can be easily washed at high temperatures. Alternatives can be more expensive, and hospitals have been slow to change.
Yes, there have been several attempts to redesign hospital gowns to preserve patients' dignity while still giving medical staff the access they need.
New designs include wraparound styles that resemble robes, gowns with snap fastenings, pockets for medical devices, and attractive colors. Some hospitals offer gowns that open down the side or front, drawstring pants, cotton tops, and boxers.
Patients and healthcare professionals have generally responded positively to the new designs, finding them more comfortable and dignified. However, some nurses have expressed concerns about the functionality of the new fastenings, and the cost of implementing new designs remains a barrier for many hospitals.
