When Johnny Met Rosie--Women in EMS Part 5: Keeping the "Girls" in Check

Not too long ago I uttered the sentence that strikes fear and loathing into the heart of even the saltiest and most fearless EMS broad.

"Damn, I need to order new uniform pants."

If I've done my homework correctly, there was just a collective shudder in horror at the prospect--followed by a heavy sigh of resignation as you trudge off to the store/catalog/website of your choice to begin searching the options.

Why? Why is it so difficult to find well-fitting uniform items? After all there are plenty of quality manufacturers and vendors out there, what's so hard about it?

Simple, in the boys club they wear boy uniforms, so many of the folks who make those do not generally have T & A--and I do not mean Time & Attendance. No matter which way you slice it, our general body morphology is different based on gender. From the average to the not-so-average sized woman, on the whole our measurement ratios just differ from men. Unless you were born with or earned yourself a stick figure, the fact is that you very likely have yourself some hip action.

And therein lies the rub...men's pants are measured by waist, not hip. So if unlike most men, who can get their waist size, pull them on and saunter out the door (Sorry, sorry, not saunter--make that stomp.), women have to get a waist size that will actually accommodate the butt. So once you find one that fits over the curves comfortably, you are generally left with a waist that doesn't fit right no matter what you do. Or if your curves are all south of the border, maybe you can get the waist to fit but the thighs are screaming for mercy. I have rarely met a woman in EMS who hasn't had to deal with the interior of the front pockets showing, simply because the pants felt MOSTLY ok so they live with it.

Then let's talk about shrinkage! Yeah, just what I said--ew. Except the visual I'm talking about is when you get a pair of pants that fits, depending on brand you are guaranteed to run into some shrinkage with wear and washes. So what started out at an ok length is now your hem rapidly climbing your leg to get away from your boots.

Listen, they make women's sizes, just order them--that's what they're there for, isn't it?

I'm going to get a cup of coffee while the laughter subsides...

Everyone better? Good.

When you talk about providers in EMS, both men and women hit the entire spectrum in height and weight. In personal experience and review of the brands with women-sizing available, two things get noted. One is a lack of size ranges, often coupled with the fact that the existing sizes tend to run small and/or short. So the small accommodations in cut often made by these companies are often negated by the otherwise poor fit or unavailable size. I'm certain there's a decent percentage of women out there whose needs are met just fine, however of every woman I spoke or wrote to when researching this just about every one used men's uniform pants for availability, length and sizing. They just live with mismatched fit because they've become accustomed to it.

So what can be done? One is doing your homework on the brands. Read the reviews, see what's said about cut, size AND how much they will shrink when washed. Get measured appropriately; waist, hips and inseam and review the sizing charts. If you have a brand you like that you know will change with wear, factor that in to a reasonable amount. For example, the current brand that I wear comfortably are from Galls (men's) and I know from painful experience that they will shrink and I end up with really comfy floods. So I actually add an inch to my inseam when ordering. Yes it makes them a little long for the first few weeks, but in no time they are the "right" length for my leg and boots.

If your measurements have been changing (for better or for worse) then invest in a tailor. Find someone local who has a good turnaround time and reasonable prices. Let them do the hemming (if you don't want to do it yourself) and make sure they leave enough fabric in there to go up or down as needed. If it's a hip issue, they can also help by taking in the waist – up to a certain point. Obviously weight issues are directly related to any and all uniform concerns, but understand that gender and genetics also play a factor. I know of a female paramedic whose issue is not diet or exercise, but her genes (not jeans). The women in her family are wasp-waisted. Her waist is 28" and her hips are 42", yes that's a 14 inch difference. No woman's pair fits her so she has to get a man's pair that accommodates her hips but gets ridiculously bunched up at her waist. She told me that have uniform pants that fit her correctly usually runs her an additional $50 of custom tailoring per pair.

While pants aren't the only issue, they're certainly the most prevalent one. Let's travel north of the border shall we? (That would be up to the rack, for those of you who aren't following along.) Most women do not have the same complaints when it comes to using men's sizing for their shirts unless they happen to be well-endowed. In those cases we have the complaint that if you can get the "girls" safely buttoned in then because men's shirts are cut straight the rest of the shirt is very loose and overly blousy. Again a tailor can help with people worried about improving the fit of these shirts by taking them in. Women's sizes again come in a limited range here, but if you find one that fits you comfortably it is likely to look better on you than a man's cut.

Speaking of the girls, please remember that you're lugging them along through the same long shift along with the rest of you. Gravity is your friend when it comes to carrying a patient down the stairs, not so much when it comes to keeping the girls comfortable above sea level. Yes I know your Nana said wear nice underwear just in case, but take my word for it, go for comfort over fashion, your body will thank you. So will your patients and co-workers when you're not a cranky distracted mess who keeps reaching subtly into your shirt or shifting constantly to rearrange the stock.

Find a brand/style of bra that will not only keep you comfortably secure, but that will breathe as well. You will be sweating, moving, twisting and otherwise not posing for Cosmo. Not to mention the fact that inadequate coverage can catch you terribly unawares at a bad moment, especially since most of us carry an unusual sundry of objects in the front pockets of our button-down shirts. And please, I beg you; wear a t-shirt or appropriate tank top under your uniform shirt. Appropriate means things like white, black or navy, opaque, and preferably not decorated with a myriad of hearts or flowers that can be easily seen through a white uniform shirt. Not only will it keep you professional looking but it adds an additional layer of protection, both for things coming in or sweat coming out. If your shirt gets seriously damaged or contaminated on a call, you will be secure in the fact that you can rip it off to limit your exposure and not leave yourself the hot topic on Breaking News Network or have folks pulling Mardi Gras beads off their rearview mirrors to throw at you in appreciation at a scene. Plus everyone loves layers in winter, they are your friend.

Speaking of winter, what about long underwear--how can we get around wearing that extra layer and not being left unable to move well and / or looking and feeling like the Michelin Man or that poor kid from A Christmas Story who was bundled until he couldn't lower his arms.

One option is to have seasonal pants, maybe invest in just a pair or two that run one size up from your norm, something that will give you extra space for your long johns. The added layer of air can actually help insulate you. The other option is to try and find thinner options, some of the Under Armour options, or silk underwear, is really quite thin and helpful and does not take up a lot of space. One trick I learned from a friend that I've used regularly is pantyhose. When the leaves turn, go buy yourself a half dozen pairs of inexpensive pantyhose, brand does not matter. Wear them as your under layer, wash them with your normal clothes, throw them out when they finally get worn out and break out the next pair. I've had them last me weeks and often months. I would even cut the feet off so to keep my feet from sweating in my boots.

When it comes down to it we are shaped differently, those proportions (regardless of ratio) make it far more difficult for us to piece together a proper uniform set. Despite any setbacks you come across keep at it until you find a fit that works, you only get one chance to make that first impression and a clean professional image will take you far in both your clinical as well as your peer interactions.

And when all else fails, like your uniform pants surely will on a scene someday, make sure you're wearing clean (black) underwear.


Tracey A. Loscar, NREMT-P, is the training supervisor in charge of QA at University Hospital EMS in Newark, NJ. Contact her at taloscar@gmail.com.

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