Lynn Houweling, a nursing doctoral student at University of Pennsylvania, has researched the historical evolution of the nursing uniform. The following are excerpts from a review she wrote for the American Journal of Nursing's April 2004 issue.

Why white? Florence Nightingale's uniform for nurses in the 1850s during the Crimean War featured gray tweed dresses with long sleeves and long, full skirts, brown scarf and white cap to distinguish them from cooks, laundresses and the prostitutes known to follow soldiers.

During the Civil War, white aprons and bonnets were worn over brown, black or gray dresses. All-white uniforms emerged in the early 1900s as a symbol of sterility in response to the growing awareness of germs and their role in spreading infection. Black shoes at first accompanied the white uniform. It wasn't until the invention of white leather shoe polish that white shoes became popular.

Scrubs were introduced in the 1960s, and during this era of feminism, the white uniform became a symbol of oppression. The cap, too, was rejected as unfashionable and cumbersome. Scientists also determined they may have carried bacteria.

When hospitals in the 1970s discontinued the practice of laundering nurses' uniforms to save money, nurses were in charge of buying and caring for their dress. As Houweling wrote: "This seemingly small change in fact created a shift in the power dynamic that had existed between hospitals and nurses for 100 years."

Pantsuits were introduced, and nurses in advanced specialties began wearing lab coats. Shirts of all shapes and colors and patterns became the norm, not only for nurses but most of the hospital support personnel.