The Importance of an EMS uniform policy

An EMS uniform policy not only presents a professional image to the public, it can protect your EMS providers and promote a safety mindset.

September 14, 2021

Article highlights

Emergency management service (EMS) responders around North America are required to wear a uniform, although the color and style of the uniform will vary from city to city and state to state. They may wear black pants and white shirts in one city, or navy blue pants and shirt in another. Still another might wear light green shirts and khaki pants.

It's important for all EMS personnel to follow the EMS uniform policy, because it presents a professional image to the public and impacts the EMS provider's mindset, which in turn affects their safety.

The EMS uniform policy should consider the provider's total appearance, not just their clothes. This means issuing guidelines on hair, facial hair, jewelry, tattoos, and other factors of a person's appearance.

In this article, we'll talk about the purpose of an EMS uniform policy, why it's important, how to choose the EMS uniform, and what to include in your department's own policy.

Purpose of an EMS uniform policy

A uniform policy will help keep your EMS providers safe, and help them to do their jobs more efficiently and effectively.

What is an EMS uniform policy?

An EMS uniform policy sets the standard for how members of your department will dress, groom, and otherwise appear on the job. It creates the expectations for what the EMS providers may and may not do, including their hair, jewelry, and even the use of perfumes and other fragrances.

An EMS uniform policy should also address how often the uniforms are cleaned and sterilized as a way to to prevent infections and communicable diseases.

Why is an EMS uniform policy important?

EMS providers need to be concerned with their safety, and their patients' safety. One way paramedics can adopt a safety mentality is with uniforms. An EMS provider's uniform is more than just clothes for the workplace, it's a reminder of all the training, education, and experience a provider has gone through in order to work in the community and save lives.

When they don the uniform, they know who they are and what purpose they serve. So a uniform can affect a person's mindset. It reminds them to be safe and to behave professionally.

When they put on the uniform, they're also saying to the public, "You can trust me, I'm a professional. I'll keep you safe." A clean, well-pressed uniform gives the public the perception of trust and protection. But some EMS providers are concerned that their uniforms look too much like other public safety members, so when you choose your EMS uniform, you want to take colors, styles, and functionality into account.

How to choose your EMS uniform

EMS responders occupy an unusual place on the first responder line. They're not quite the rank-and-file operation of a police department or fire department, and they're not full-fledged healthcare and hospital workers either.

They straddle the line with a foot in both worlds. So their uniform should reflect this dual nature, and not only follow some of the spit-and-polish professionalism of a police department, but also the functionality of the doctors and nurses in the hospitals.

Choosing an EMS uniform should involve a number of different factors beyond the color and design of a uniform. It should include safety, determining rank and position, the amount of wear and tear it will get, and even the general climate and seasonal temperature.

Apply systems thinking to uniform selection

In the medical world, systems thinking examines problems more completely before acting. It means gathering data, identifying patterns, and asking how a certain action will affect an entire system or structure.

It also means finding the underlying structures that drive certain events and patterns. It means asking, "Why did this happen when I did X?" or "What would happen if we did Y?"

So if you’re assessing EMS uniforms, you should apply systems thinking to the whole process. It can mean asking your EMS providers what they want in a new uniform. What are the problems with the old ones? Have they been confused with members of other departments? How do civilians respond to different colors?

Using system thinking also means determining whether you need an entirely new uniform or if your uniform problems could be solved with a different shirt color, or using reflective lettering on the shirts and jackets. It also means not making decisions based solely on budgets and expenditure. You can’t choose the cheapest option and expect it to provide the same protection and functionality as a more expensive option.

Uniforms should be chosen/designed to maximize safety

An EMS uniform is more than just color-coordinated clothes or everyone looking the same. Many EMS departments require special EMS-specific cargo pants. They're tougher, more durable, and the extra pockets can be used for carrying essential supplies and equipment, so it's always available on their person.

And since EMS responders are often exposed to airborne and bloodborne pathogens, even their personal protective equipment (PPE) should follow certain standards of quality and design. The uniform policy should also include the types of PPE that are acceptable or expected of each responder.

What’s your climate, and does your uniform need to include multiple layers for cold vs. hot weather?

EMS responders work 365 days a year, in all kinds of weather. Some people need some extra protection beyond just long sleeves in the fall and winter. An EMS uniform policy should also include standards for long-sleeve uniform shirts, sweatshirts, jackets, and even gloves and hats, as well as rain gear and even extreme cold weather gear.

If some people prefer wearing a thin long-sleeve shirt under their uniform shirt, or they want to roll up the sleeves on their long-sleeve uniform, the policy should address this as well. The uniform policy will need to straddle the fine line between adhering to the uniform code and helping responders be comfortable in their work.

Items to include in an EMS uniform policy

An EMS uniform policy should give clear, strong specifications on other aspects of the EMS providers' appearance. It starts with the very first section of every policy: the purpose.

Define the purpose of your uniform policy

The purposeis an important part of every policy, not just the uniform policy. It helps your staff understand what the policy is and why it matters.

For example, the Orange County (North Carolina) EMS uniform policy says,

It is the intention of OCES that each employee’s dress, grooming and personal hygiene be appropriate to their work environment. All employees are expected to present a professional uniformed appearance to the public.

It's short and simple, and it explains exactly what the policy will cover. It's the 30,000-foot view of the overall policy: That paramedics must present a professional image to their public. After all, paramedics are first responders, just like firefighters and police officers, and they're held to a standard of expectations by the community. A uniform helps them reach that standard.

Other requirements in an EMS uniform policy.

An EMS uniform policy should be more than just "wear your uniform, make sure it's ironed." It needs to cover a lot more items.

Personal grooming habits are also a part of a uniform. That means a uniform policy should also address each person's hair, beard and mustache, tattoos, jewelry (rings, necklaces, and bracelets), fingernails, and makeup.

The Virginia Beach EMS has issued directives for each of those areas in their EMS uniform policy, describing what is considered required and/or acceptable. For example, all hair must be clean, neat, and combed. Jewelry is limited to one ring per finger, a single bracelet is allowed, necklaces are advised against, and every EMS provider must wear a watch that displays time in seconds. There are even requirements that no one may wear strong perfume or cologne while on duty.

Your uniform policy should even cover areas like whether and how your paramedics should wear a name tag and badge. The Virginia Beach EMS policy says badges are worn above the left pocket, and name tags are worn centered above the right pocket. They're even very specific about how name tags shall be worn and aligned with pocket seams on dress uniforms.

How are uniforms affected by a EMS infection control policy?

Paramedics are already exposed to myriad germs, bacteria, and viruses, all of which can make you sick or kill you. During the pandemic, there is an even greater risk of catching COVID. This is why every EMS department should have an infection control policy.

That's why paramedics are strongly encouraged to wash their hands after every case. However, according to a 2014 study, only 25% of paramedics wash their hands after every patient.

That's a problem because, as another study found two years later, EMS providers were 10.5 times more likely to test positive for methicillin-resistant Staphylococcus aureus (MRSA) colonies when they didn't wash their hands after removing their gloves.

And if only one in four paramedics are washing their hands after removing their gloves, what are they doing or not doing to their boots, their radios, their stethoscopes and other equipment after each shift? And how often are they washing their uniforms in hot water (140 degrees) for 10 minutes?

Ideally, EMS providers should be disinfecting their gear and boots between patients as well, so it may be necessary to include that in both the EMS uniform policy and the EMS infection control policy.

Final thoughts

A uniform policy sets the standard for your department’s outward image. Requirements on tattoos, jewelry, and placement of a badge and name tag all influence how your department is perceived by the community. And because EMS providers are in a position of trust in the community, they need to live up to the expectations that community members have for their local first responders.

PowerDMS has worked for years to help EMS departments to create and manage policies for issues like uniforms, infection control, and drugs and alcohol use. Learn about other policies your EMS department should have in writing today.

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