Major British hospitals like St Bartholomew’s (Barts), London, originated with the medieval religious houses that cared for the sick, their nursing sisters being issued from 1555 onwards with livery in the form of blue gowns. During the 1700s more modern hospitals were established, serving only medical needs, but most did not yet provide their nurses with standardised garments. As late as 1858 Guys nurses were only identified by a round tin medal worn around the neck, bearing the wearer’s position and ward. However, reflecting wider uniform trends across the services, it became more common for Victorian hospitals to develop distinctive uniforms, fashioned in specified colours and with varying details that identified the different ranks within their nursing hierarchy.

Nurses entered as probationers and were instantly recognisable from their novice uniforms. The colour of their dresses, often their belts and even the garment fabric then changed as they passed exams and advanced to become staff nurses and eventually sisters. For example, in 1895 probationers at the Middlesex wore black or grey cotton gowns, progressing to blue cambric or grey gingham dresses as nurses and, finally, a violet serge dress as sister. In some hospitals colour even denoted a nurse’s specific role: for instance, at the Norfolk and Norwich Hospital the late-Victorian monthly nurse wore fawn-coloured cotton, the medical nurse black serge and the fever nurse blue zephyr. A bonnet tied with strings and cloak or cape were also provided for outdoor wear, while matron was always set apart by her appearance: often she wore a stately black gown with a white cap – but no apron.

Broadly, hospital nurses’ outfits echoed fashionable dress, but during the 1800s acquired the large protective starched white apron and white cap, collar and cuffs that defined their role, creating a formal uniform that closely resembled that of domestic servants. Apron and cap shapes gradually evolved, the apron gaining a bibbed front c.1880s, while diverse headdress styles represented nurses of different ranks and individual hospitals. Initially dresses were often fabricated from dark wool or worsted materials such as serge, zephyr and alpaca, which, being un-washable, were not very practical: only in the early 1900s was hygiene given more consideration and lightweight, washable dresses became customary. Hemlines shifted over time, rising gradually during the 1910s, fluctuating between the wars and set just below the knee during the 1940s. Private nurses and midwives usually donned aprons when visiting patients’ homes, but generally did not adopt formal uniforms until around 1900.