The Nightingale Pledge: Nursing Ethics Oath

The Nightingale Pledge is known as a pledge that was taken by all new nurses upon first entering the nursing profession after completing an LPN program or RN program. As its name implies, it was named after the famous nurse pioneer Florence Nightingale, who was both a championed English nurse as well as a woman who laid down the foundations of modern nursing with her nursing school that was located at St. Thomas’ Hospital in London (now absorbed as part of King’s College in London).

Though named after the celebrated nurse, the Nightingale Pledge was not devised by the nurse; instead, it was named in her honor. The Nightingale Pledge was created by a committee that was chaired by a woman called Lystra Gretter, who was a nursing instructor at Detroit’s Harper Hospital.

History

The Nightingale Pledge was used for the first time in the spring of 1893, when it was used by Detroit’s Harper Hospital’s graduating class. Since its inception more than 100 years ago, though, the Nightingale Pledge has been either dropped or at least changed around by a few medical institutes. While purists and traditionalists might be offended by this lack of respect for tradition, this shifting rationale is due to the growing liberalism that is present in some graduating classes of nurses completing their nursing programs, especially those who have graduated in the 21^st century. The original pledge, while it is named in honor of the famed nurse, actually has nothing to do with Nightingale.

The Nightingale Pledge reads as follows:

“I solemnly pledge myself before God and presence of this assembly;

To pass my life in purity and to practice my profession faithfully.

I will abstain from whatever is deleterious and mischievous and will not take or knowingly administer any harmful drug.

I will do all in my power to maintain and elevate the standard of my profession and will hold in confidence all personal matters committed to my keeping and family affairs coming to my knowledge in the practice of my calling.

With loyalty will I endeavor to aid the physician in his work, and devote myself to the welfare of those committed to my care.”

How it Has Changed

The institutes that are dropping or modifying the Pledge have a problem in particular with certain aspects or lines within the Pledge, not the entire Pledge itself. According to the October 8, 2001 edition of NurseWeek, a couple of lines in particular have irked some graduating classes of new nurses, which is why they were removed from the Pledge or changed and then kept in the Pledge in an altered state. For example, the graduating class at the California State University, Los Angeles Department of Nursing, changed the word “God” in the Pledge and included the prepositional phrase “of all faiths” in their graduation ceremony in the spring of 2001. That is not all they changed around in the original Pledge. The line “to aid the physician in his work” was removed and replaced with a promise to work together with other healthcare administrators “in an atmosphere of mutual respect and consideration.”

Some of the changes to the original wording of the Pledge also are based on creeping liberalism replacing more conservative values that are more old-fashioned. For instance, the same graduating class at the California State University, Los Angeles Department of Nursing, removed altogether the reference of purity in the Pledge. Instead, they replaced it with references to social justice, which is a liberal idea that believes in the greater welfare of society based on shared sacrifice of all members of society. Some students simply attributed the change and all-out revisionism of the original Pledge as a growth in the overall nursing occupations, which had to be reflected, at least in that graduating class in Southern California.

This revisionism and rebellion towards retaining the original language in the original Pledge is something of a new phenomenon. Take for instance the school at the heart of this development: California State University, Los Angeles Department of Nursing. Before 2001, graduating students from its nursing class has used the words of the original Pledge during their pinning ceremony. However, all that changed in 2001, when school faculty allowed the then-graduating class of nurses to revise the Pledge and totally omit other parts of it. The faculty had no objections to the change, in part, because the changes would only affect the words of the Pledge during the pinning ceremony, which, technically, was separate as an event from the actual graduation ceremony. Further, the pinning ceremony was actually funded and plotted by the students themselves, thus giving them some degree of ownership over the decisions surrounding that ceremony.

Oath

At its heart, though, the Pledge is an adaptation of the Hippocratic Oath for doctors. This oath has been historically taken by doctors in an effort to symbolically swear to practice their profession of medicine with the utmost morals. The Hippocratic Oath is believed by many to have been devised by none other than Hippocrates himself, who is seen far and wide as the father of western medicine; the Oath could as easily have been written by one of his students, however. Like the Pledge, though, the Oath has also come in for significant revisionism by various cultures in an effort to suit the sensibilities of respective peoples. It is known to have been rewritten numerous times over the centuries.

How it Came to Be

The Pledge was not written by Florence Nightingale herself, but, rather, it was composed by an American by the name of Lystra Gretter, who herself was a nurse from Michigan. Nightingale herself was a religious woman, she was an Anglican, and she truly thought that God had called upon her to dedicate her life to being a nurse. In this way, it is appropriate that the original text of the Pledge made a reference to God. The Pledge has been changed and sometimes has had parts of it omitted altogether as new generations of nurses graduate from nursing schools and enter the profession. The challenge these days is to balance the honoring of the history of the nursing profession through the Pledge with what some newly graduated nurses see as an offensive representation of conservative and old-fashioned values.