Islamic dress code in professional life : a narrative study of nurse uniform transformations in four healthcare institutions in Malaysia

Abstract

The issue of culture and religion within the professional sphere is a common polemical global issue, including the case of the dress code for Muslim female healthcare personnel. Nurse uniforms in Malaysia have evolved tremendously since Malaysia gained its independence in 1957. Yet, there is a dearth of literature on the transformation of nurse uniforms in Malaysia vis-à-vis its cultural and religious context. In this qualitative historical-comparative cross-institutional case study, content analysis was conducted to examine the issue of nurse uniform transformation based on primary and secondary data retrieved from official records, books, newspaper reports, photos, videos, exhibits and interview transcripts of key informants identified through purposive and snowball sampling. The study was conducted at four selected institutions in Malaysia: Ministry of Health, Ministry of Defence, Hospital Universiti Sains Malaysia and Hospital Pusrawi Sdn. Bhd. The Malaysian nurse uniform manifests the maintenance of the colonial heritage in the early three decades of post-independent Malaysia followed by the gradual revival of the Malay-Muslim identity. The religious-related factors were the dominant motivation fuelling the transformation of nurse uniform in Malaysia. During the course, the strategies that the advocates of the uniform transformation used were manifold to resolve diverse deterrents related to the opposing parties, the potential problems of the proposed changes, and the morale of the advocates of the nurse uniform transformation to remain in the cause. The thesis postulates that the realisation of the transformation of nurse uniform ensued the combined efforts of numerous parties at various levels (from the individual level to the national level) using assorted strategies. The effects of the nurse uniform transformation were felt at the individual, institutional, and inter-institutional levels. Despite the principal concern on the infringement of hygiene and infection control standards due to the use of long sleeves and headscarves, no worsening of infection rates was observed by the participants succeeding the implementation of the long-sleeved ankle-length uniforms with headscarves. Although there are limitations due to the use of the qualitative approach and the use of interview as one of the data collection methods, thick description and triangulation of sources help to ensure reliability and validity of the findings and their relevance to other groups who share similar background and culture to the cases in this study. Based on the findings, a proposed framework for the decision making on the accommodation of religious rites or cultural norms is formulated. The decision-making matrix recommends weighing the tangible effect of the accommodation to the institution against the standing of the religious rites and cultural norms. The findings highlight the feasibility of assimilating the professional healthcare dress code with the local culture and religion without jeopardising the delivery of good practices in healthcare services.