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White Coat Ceremonies for Nurses

Formal cloaking during orientation instills a commitment to compassionate care in future nurses.

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New nurses cherish their pinning ceremony and several nursing schools throughout the country, including Johns Hopkins, stepped up the formality last fall.

As part of their orientation, the incoming students at the Johns Hopkins School of Nursing in Baltimore participated in a white coat ceremony as part of a national ground-breaking pilot program this fall.

Similar to the capping ceremony a generation ago, the purpose of the cloaking ceremony is to instill a commitment to providing compassionate care among future health professionals entering nursing schools. More than 100 schools of nursing were selected to hold the white coat ceremonies.

The program, supported by the Arnold P. Gold Foundation (APGF) and the American Association of Colleges of Nursing (AACN), seeks to create a new link between nurses and physicians through humanism to support patient-centered optimal healthcare in the 21st century.

APGF and AACN funding was appropriated at John Hopkins for buying white coats, printing invitations and hosting a reception after the ceremony. The guest speaker would not accept any payment but that's also covered by the grant.

Cross-Disciplinary Collaboration

Elizabeth Tanner, PhD, RN, an associate professor at the Hopkins School of Nursing, was instrumental in bringing the ceremony to Johns Hopkins. Having heard that other nursing institutions were starting to offer white coat ceremonies, she hoped to bring it to Johns Hopkins.

When she heard of the APGF and AACN initiative, Tanner mentioned the idea of the dean, who agreed wholeheartedly on the value of the program. 

"As a leading school of nursing, it was important that we were included in this pilot program," she said. "This ceremony sends a strong message of furthering team collaboration in the healthcare field and delivering optimal patient-centered health, as a team."

Other health professions are proudly buttoning white coats as well. Though once exclusive to doctors, the white coat ceremony has become synonymous with physical and occupational therapists, dentists, pharmacists and other health professionals.

"The white coat has become symbolic for all health professions," she said. "It's a hands-on experience that underscores a bonding process for all nurses as they join the professional journey. The white coat is a symbol of faculty providing tools for lifelong learning and a tangible reminder of the contract all health professionals have with their patients."

Tanner teaches a course about interprofessional education with medical and pharmacy students. In those disciplines, students wear white coats to seminars and she noticed that wearing the garment seems to enhance the respect students show one another.

Poignant Ceremony

At the ceremony, nurses recited a student version of a Florence Nightingale pledge. As they approached a faculty member one at a time, a white coat was placed on their shoulders as a personally delivered vote of faith, confidence and compassion. During this emotional portion of the ceremony, the faculty member expressed hopes that the student would remember these gifts each time they donned a coat or uniform in practice.

"It's especially symbolic that they receive this [white coat] at the beginning of their professional journey because they will start out with a mindset of breaking down walls and working more interprofessionally to meet patients' needs."

Though white coat ceremonies have been an important rite of passage at medical schools for more than 20 years, this new collaboration between APGF and AACN marks the first time a coordinated effort has been developed to offer similar events at schools of nursing.

In this pilot year, nursing schools in 43 states plus the District of Columbia were provided financial support and guidance to offer a White Coat Ceremony, which will consist of the recitation of an oath, cloaking of students in a white coat, an address by an eminent role model, and a reception for students and invited guests. Students also receive a specially designed pin as a reminder of their oat.

"What this does is instill an understanding of professionalism as our students begin their journey," shared Tanner. "When you enter a field like nursing or medicine, it's critically important to take time to understand the commitment you're making to patient care."

AACN president Eileen T. Breslin, PhD, RN, FAAN, added that the more meaningful mindset that correlates with the white coat ceremony may have positive implications for patients as well.

"By offering white coat ceremonies, our schools are sending a clear message to new nursing students that compassionate care must be a hallmark of their clinical practice," said Dr. Eileen T. Breslin, AACN President. "Securing a commitment to providing patient-centered care at the beginning of a nurse's professional formation will help to raise the quality of care available to all patients."

In 2015, AACN and Arnold Gold Foundation plan to roll out the offering to a larger number of nursing schools nationwide.

Robin Hocevar is on staff at ADVANCE. Contact rhocevar@advanceweb.com.

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