The History of the Nurse’s Cap

When we think of nurses, we imagine women in white, their thick-soled shoes beating a fast path toward needy patients. Or we remember pictures in children’s books of Florence Nightingale’s elegant form passing through barracks of wounded soldiers; the only light in the room comes from the single lantern she carries. These traditional images of the nurse aren’t complete without one essential item: her cap.

Nurses’ caps had both practical purposes and symbolic significance. Though it’s difficult to pin down an exact time period when wearing caps became standard practice, there is a mild consensus that they became prevalent in the mid-1800s.  Some say that caps were originally donned by the Sisters of Charity of St. Vincent de Paul in Paris, where one of the first official nursing schools was established in 1864.

Since nuns were among the first women to be trained as nurses, and to train nurses in turn, the original caps were akin to habits. Social mores of the time also necessitated the caps, since women were expected to keep their heads covered – even indoors. These longer caps served more than just the dictates of fashion; they also helped to keep a nurse’s hair out of her face as she worked, which facilitated more sanitary conditions.

Below see images of our very own employee nurses caps:

[flagallery gid=22 name="Nurses Caps"]

For Florence Nightingale, unarguably one of the leading lights in nursing, the cap was inextricable from the profession itself. When she organized a mission of mercy to Scutari during the Crimean War, Nightingale required her nurses to wear a special uniform and nurse’s cap. After the war, she set up the Nightingale Training School at St. Thomas’ Hospital; there, the longer, more bonnet-like caps were eschewed, and students wore shorter, square-shaped caps with their uniforms.

In many ways, the history of the nursing cap correlates to the history of women’s social liberties. As time passed and long hair was no longer de rigueur, the caps served as signifiers for a particular nurse’s educational background and level of expertise. Different nursing programs and hospitals offered their own caps: some caps were ruffled and frilled, others were starched stiff and box-like; some were Dutch-styled, winged caps, others looked like knotted kerchiefs. For instance, if you were a patient in the 1900s, and the woman checking your pulse was wearing a cap delicately fluted with point d'esprit lace, you knew that you were in the capable hands of a graduate from the University of Maryland School of Nursing. This cap was called “the Flossie” in honor of Florence Nightingale.

Though caps like “the Flossie,” or Philadelphia General Hospital’s “double frill,” or the Bellevue Training School for Nurse’s simply — yet aptly — named “fluff” were beautiful to behold, they were cumbersome to care for. Some caps had to be continually replaced, at expense to the nurse herself. Still, the unique beauty of these caps, and the immaculate orderliness they evoked, no doubt inspired generations of future nurses.

Caps also facilitated a sense of community among nurses, no matter where they ended up practicing. In a letter to the American Journal of Nursing, dated 1931, a nurse named Julia Gardner wrote, “When entering a strange hospital, as an affiliating student or visitor, it is almost like seeing a familiar face to see the cap of one's own school on a nurse there.”

Caps were bestowed to both student and graduate nurses in a rite of passage known as a capping ceremony. Early ceremonies were conducted after three, six, nine or 12 months of training (whatever constituted a probationary period for each school). Sometimes these “probationer’s caps” were plain white versions of the graduate’s cap – in which case, completion of the nurse’s training was marked by the addition of a black stripe. Other schools opted to make their student and graduate caps entirely different. Capping ceremonies were often held in churches, where, before the students’ friends and families, they’d be “capped” by an instructor or by a mentor student, usually referred to as a “big sister.”

Being capped symbolized accruing the knowledge and prowess needed to truly serve as a nurse. Capping ceremonies were often emotional affairs with guest speakers testifying to the value of nurses within their communities. As one speaker at a 1938 graduation powerfully expressed, “the nurse's cap means to you what the soldier's uniform means to him. When this cap is pinned on your head, it means you have become a member of one of the noblest professions and have subscribed to its ideals of service. You are no longer merely an individual responsible for her own acts; you are part of the nursing profession.”

But as women in general become more enfranchised and empowered in the workplace, the nursing profession expanded into administrative areas and caps began to feel like relics of a bygone era. The 1970s and 80s also saw an influx of men into the field, which forced a change in tradition. Caps were gradually swapped out for the more gender-neutral, easily maintained, and (some might say) elegant pins. And caps, once thought of as the epitome of sanitary care, were now seen as harbingers for bacteria and other harmful contaminants.

Though you’re far more likely to find a nurse’s cap in a glass case commemorating a hospital’s rich history before you’ll find it on a ward, for many nurses, it is still a powerful reminder of the hard work performed and the obstacles overcome to find a foothold in their chosen profession. Nurses must often be all things to all patients, yet the breadth and depth of their work is, at times, all-too-easily overlooked. These nurses find their thoughts best expressed by Bonnie Miller, an RN at the Sandra and Malcolm Berman Brain & Spine Institute: “I may never wear [my cap], but I earned it.”

-Laura Bogart

To schedule an appointment with one of our highly trained physicians and find out why LifeBridge Health is Baltimore's premier health care organization, call 410-601-WELL.

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13 Responses

  1. Karla
    I was so excited to find this story. My daughter is currently in the Drexel ACE nursing program and I relayed to her the story I heard from my mother about being able to tell where a nurse went to school by their cap, but couldn't find anything (until now) to prove that I wasn't dreaming. Too bad aother wonderful tradition has been lost, but I am sure there are new ones to learn about. Thank you for taking the time to share this information.
  2. JENS THOMASON
    Really good article. Interesting and useful. I am an engineer and transferred to Hagerstown MD from Alabama and I will really helpful to you. If anyone can suggest me an eye care specialist. As I am new here, I don’t know anything here. I searched on internet and found <a href="http://www.alleganyopticalhagerstown.net" rel="nofollow"> Allegany Optical Hagerstown </a>. Is good. Can anyone confirm?
    • Thanks for your inquiry Jens! We have a wide variety of eye care specialists at our very own Krieger Eye Institute. Please go to this link to find the right specialist for your needs: http://www.lifebridgehealth.org/Sinai/KriegerEyeInstituteatSinaiHospital.aspx Hope this helps!
  3. Sonia Bar-av
    It made me very nostolgic reading this article. It was a wonderful tradition, but, as stated in the article, we are no longer wearng them for a multitude of very good reasons. It's nice having an article written about nursing. Would like to see more.
  4. Pamela Smith
    Great article! Very informative, and so nice to see nursing's history preserved and passed down to new generations. It is also a wonderful tribute to the nursing profession. Thank you from a nurse.
  5. Nurse's caps are indeed a significant part of the history of a proud profession. Please visit my website which showcases my paintings of nurse's caps. marlyn-boyd.fineartamerica.com
  6. Sharon Estock
    I'm a 1967 graduate of an LPN School that sadly is no longer. I have often wondered when and why it happened that nurses no longer wear their caps we so proudly worked so hard for. I finally searched it and came across this very informative article, thank you. As time goes by we have to accept change, but that doesn't mean we like it, I for one like TRADITION. Sharon from Va
  7. Pat Tompkins
    I remember the nurses caps, it made me feel as though angels were coming down the hall and into the room to make me be well, and they did! Today, unfortuneatly the caps and white uniforms are replaced with streetclothes and school nurses freely handing out condoms and the morning after pill that kills the unborn. The profession of nursing has been severly reduced to much shame. Go back to helping to save lives, not destroy, kill or impare..
  8. Jimmie R. Williams
    As a male, I was going to make my 15 minutes of history as a voice major. After graduation from High School, I needed to work and save money to attend college. My grandmother was a Licensed Practical Nurse at a state Mental Health Facility. She was instrumental in helping me secure employment as a Psychiatric Attendant. From there, I found my passion--nursing. This was 1969 and I found that many schools of nursing did not admit men. There were separate schools for men. Referrred to as an "All Male" school. Now retired, the cap is very rarely worn, but as a patient, I will tell you, there is something about a female nurse wearing a cap that is very comforting to a patient. I believe it reasurres the patient that the individual wearing the cap, has graduated from a rigorous program and that the patient is in "safe" hands. In closing, regardless of the academic grade a student had, if in the opinion of the faculty the student would not make a safe practitioner, that individual did not graduate. You can teach techniques, but you cannot teach passion. Jimmie R. Williams, Ed.D. RN
  9. Shari Davenport, A.A.S., CST
    Thank you so much for an informative article about one of my own personal passions. When I was about 5, I fell in love with nurses' caps. This was in the early 1960's and ALL nurses wore white from head to toe. I adored all the wonderful designs and pretty elements ~ frills, lace edging, wide cuffs that reminded one of angels' wings, pretty stripes, and so forth ~ and I decided one day I would becoe a nurse and take care of people like I had been cared for during several trips into the hospitals, and doctors offices I experienced as a child. The devotion and caring part appealed to me on a deeper level as well, and I was always found "caring for" dolls, pets, my friends who were neighbors who would play "hospital" with me, and so on. After a less-than-optimal childhood and teen years, my grades were not what they should be to get into nursing school, nor was my bank balance. But I did not give up on my dream ~ I just delayed it a while. To make a long story somewhat shorter, after marriage in the middle 70's, and relocating to my husband's area of the country, I found myself eligible for a now-defunct government education program that would pay all my expenses, and provide an income for me to go to school. I chose a local community college and after testing and interviews, was admitted into their LPN program. I was walking on air the day I got my acceptance letter! We worked very, very hard to make it through our probationary period ~3 1/2 months I think ~ culminating with the much-anticipated goal of capping! It was a day I will never forget, and I still have plenty of photographs to prove it! Completing each quarter after that allowed us to add a corner-to-corner blue stripe on the left side. Graduation got a whole light blue stripe all the way across! Unfortunately, I was unable to go past adding one short blue stripe, due to some health issues created by the unexpected discovery of the pending arrival of our first child, and had to leave the program. The unusual part of this was that when I went to the hospital a few months later to deliver our daughter, some of my own classmates, along with my favorite clinical instructor, were doing their OB rotation! After about 15 years, I made my way back to school, this time after having discovered the occupation of surgical technology. It became my real passion, and I spent 15 wonderful years working in surgery, elbow-to-elbow with surgeons, and this time wearing a different kind of cap! I loved it dearly, but had to retire early, due to a combination of injury and resulting disabilities, and I miss it terribly. But, I still have my original white cap with the blue stripe across one corner, and quite a few years ago, thanks to the internet and ebay, have been collecting many others! I have at least 2 dozzen different caps in my collection. Sure beats making them out of any piece of white paper that was big enough when I was a girl! I also miss the days when nurses wore their caps and their "whites" but I understand the reasons behind the changes. But it surely was easier to tell the players in the game when you knew if they wore all white, and a lovely cap, it was going to be a nurse coming in your room.
  10. Greetings from Los angeles! I'm bored to tears at work so I decided to browse your site on my iphone during lunch break. I enjoy the information you provide here and can't wait to take a look when I get home. I'm shocked at how fast your blog loaded on my mobile .. I'm not even using WIFI, just 3G .. Anyways, great site!
  11. Laurie B
    This is the history I pretty much remember learning about in nursing school. At CLC, our white cap had a navy blue stripe with a gray thread in its center.
  12. Very interesting article, wish I could pull up the photos. I always wondered what the function of the cap was. Nowadays all you see are scrubs but it was something to see nurses in all white with caps back in the 70's, I hate that this has gone, I understand the reason but like an army uniform couldn't the nurses keep the formal attire for ceremonies and other formal occasions? Police still wear their caps in these instances...I wonder do fireman still wear their hats? Well, it would be nice to preserve this tradition.

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