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The Nightingale Pledge: Nursing Ethics Oath


The Nightingale Pledge was used for the first time in the spring of 1893 by Detroit’s Harper Hospital’s graduating class. However, since its inception more than 100 years ago, the Nightingale Pledge has been either dropped or altered by some 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. Much of the controversy surrounding the Nightingale Pledge is its mention of "God."

At its heart, the Pledge is an adaptation of the Hippocratic Oath taken by doctors. This oath has been historically taken in an effort to promote the ethical practice of medicine. The Hippocratic Oath is believed by many to have been devised by none other than Hippocrates himself, who viewed to be the father of western medicine. Like the Nightingale Pledge, the Oath has been revised. It is known to have been rewritten numerous times over the centuries.

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 with certain aspects or lines within the Pledge, rather than the entire Pledge. According to the October 8, 2001 edition of NurseWeek, a couple of lines in particular have irked some graduating. For example, the graduating class at 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. In addition, 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 are based on modern values replacing more conservative ones. For instance, the same graduating class at the California State University Los Angeles removed the reference of purity in the Pledge. Instead, they replaced it with references to social justice. These changes are an attempt to modernize the Pledge and to remove any religious affiliation in order to make it more inclusive to all nurses.

This rejection of the original Nightingale Pledge is a recent phenomenon, similar to the backlash against forcing children to say the Pledge of Allegiance in schools. For example, until 2001, graduates of the California State University Los Angeles Department of Nursing used the original Pledge in their pinning ceremony. The faculty voiced no objection to the change, and similar ones have since occurred at other institutions.

Additional Links

The Nightingale Pledge in Full

Nightingale Pledge Explored (PDF)

Nightingale Pledge Revisited

Text of Nightingale Pledge

Nightingale Pledge Explained