The Nightingale Pledge

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.

These are the actual words of the Nightingale Pledge that created an ethical controversy in the nursing community (Florence Nightingale Pledge, 2008).

Text: The Controversy

This article explores and addresses the issues and the main concern with the Nightingale Pledge.

The Nightingale Pledge, written by Lystra Gretter in 1983, is the nurses' way of expressing their intentions of fulfilling their responsibilities. It is an oath recited by graduating student nurses. Because Florence Nightingale is the founder of modern nursing, Gretter named the pledge after her as a sign of respect. This pledge has been the symbol of a nurse's values (American Nurses Association, 2006). In reciting this, a nurse commits to “faithfully practice” her profession and to practice proper ethical values (Domrose, 2001). However, the nursing community has been debating this oath, arguing about its importance to nursing.

The controversies surrounding the Nightingale Pledge must be resolved because this issue compromises each nurse's integrity. If not addressed, it can negatively affect the reputation of nursing as a profession. It also has an undeniable importance because many nursing organizations have adopted its principles in their own code of ethics (American Nurses Association, 2006).

Some consider oath taking as a symbol of a person's professionalism and promise of abiding by the ethical rules (V. A. B., 1910); therefore, some claim that it is crucial for all licensed workers to make a pledge to assure the public that they are dedicated and committed to serve and to help those who are suffering. Nursing, consequently, needs a pledge because it is a profession that relies on a nurse's personal values. The goal of this pledge is to be the foundation that guides a nurse's personal values (Fry & Veatch, 2005).

Because of the ambiguities of the words in the Nightingale pledge, many nurses are requesting that the pledge be updated to fit the modern times (Demrose, 2001). For example, many nurses wonder about the meaning of “purity,” which can be interpreted in many ways. Nevertheless, some feel that preserving its original words is representative of a nurse’s loyalty to the profession, to the patients and to the public (Demrose, 2001).

As a result of these requests to have it updated, many nursing schools are either dropping or altering it to suit their graduation ceremonies (Domrose, 2001). This poses two new issues: the nurses' obligation to make a pledge and to recite the same pledge. As health-care providers, nurses need to assure the public that they are competent of helping and capable of serving. Likewise, nurses also need to recite the same version of the pledge to endorse the same interpretation. If the pledge is altered and if different versions exist, nurses can interpret their roles differently, causing unnecessary conflicts and stresses among nurses.

Some also doubt Florence Nightingale's qualifications that make her deserving of this honor (McBurney &Filoromo, 1994). Although she is the founder of modern nursing, Nightingale exemplified undesirable qualities. For example, Nightingale failed to allow Mary Seacole, a mixed race British nurse, to work in her hospital during the Crimean War (Encyclopedia Britannica, 1999). This refusal suggests that, perhaps, she is not as deserving of this grand recognition as once was thought.

The Nightingale pledge is currently posing problems within the nursing community because of its history and words. Although it has an undeniable influence in nursing, it is a problem. To maintain nursing's reputation, this issue must be immediately and carefully addressed. The nursing community must find a solution that will preserve the original beauty of the pledge while resolving its ethical conflicts.

Pictures

The Nightingale Pledge. This is an image of a poster that states the actual words of the Nightingale Pledge next to a photo of Florence Nightingale, the nurse who is honored by this pledge. This poster has two purposes: (1) informing and reminding nurses' of their professional promise and (2) advocating the use of this oath in commencement practices (Advance Healthcare Shop, 2008).

The Traditions of the Ceremony. This photo exemplifies the traditional graduation ceremonies of nurses, depicting the tradition that may no longer exist in some of the current graduation ceremonies. Furthermore, it also shows how the ceremonies were initially held, allowing current nurses to compare the traditional and contemporary commencement practices (Civilization Museum, 2008).




The Recital. This image shows a graduating class of Filipino nurses, who are photographed reciting the Nightingale pledge. It depicts the recital of the Nightingale Pledge, which is now optionally used by nursing schools and recited by graduating nursing students (Nguoi Viet Online, 2008).



The Author of the Pledge. This is a photo of Lystra Gretter, the writer of the Nightingale's Pledge. This honors the woman behind this meaningful pledge that is now being questioned by the nursing profession (Florence Nightingale Museum, 2008).

Outside Links

These are the links that are relevant in learning more about this controversy. Below each links are its importance and significance for this issue.

1.Web address: http://www.florence-nightingale.co.uk/index.php
Importance: This is the website of Florence Nightingale Museum in London, England, which contains relevant information about the founder of modern nursing, photo documentaries of influential people and memorabilia in nursing with detailed descriptions, and a library filled with collections of primary and secondary sources that can further characterize the role of nurses in its early development.

2.Web address: http://www.countryjoe.com/nightingale
/index.html
Importance: This is a website created in honor of Florence Nightingale and the profession of Nursing. It is filled with a detailed biography of Nightingale's life with a time line that highlights the major events of her life. Similarly, it contains several versions of the pledge, with the two modern adaptations of the Nightingale Pledge that is sometimes used in graduation ceremonies. This allows the readers to compare the original pledge to the Hippocratic Oath and to other modern translations.

3.Web address: http://www.youtube.com/watch?v=jg6hI_I9bTU
Importance: This is a link for a video that shows the preparations of graduating nurses as they start the ceremonies. This is important because it shows the emotions of nurses as they become professionals, showing that, perhaps, the actual tradition of reciting the Nightingale pledge is merely a trivial detail in the ceremony. This video will also help the readers to visualize the actual events, formation, and emotions felt and conducted in a graduation ceremony.

4.Web address: http://www.youtube.com/watch?v=cbSBo5aFnD8
Importance: This is a video link that shows thousands of graduating Filipino Nurses in Davao City, Philippines reciting the Nightingale Pledge, showing that this pledge is universal and that it applies to all nurses regardless of their race. Moreover, this video also contains footage of the graduates also making a professional pledge to the country, which might be a solution to this controversy about the pledge.

5.Web address: http://www.mollieb.us/florence.html
Importance: This website contains the Nightingale Pledge and another poems written by Florence Nightingale, allowing the readers to also see the poetic value of the oath. It also contains inspirational stories of nurses, nurses' prayers, and poems, inspiring continuing nurses to pursue a career in this profession. It shows the poetic beauty of the oath, emphasizing that one must be careful in creating a modern translation of the pledge.

Related UCLA SON Blogs

This blog or article is linked to three other blogs written by UCLA SON students. It is linked to blogs that all address nursing's professional and ethical problems.

Title: Causes of Stress and Methods of Coping in Nursing
Authors: Samantha Cajucom and Marisol Fernandez
Web Address: http://www.nursingstress.blogspot.com/
Importance: This blog expounds on a nurse’s job stresses and physical strain. Furthermore, it also provides methods of coping with these problems to prevent harm to the nurses themselves, to the patients, and to their co-workers.

Title: Nursing Safety: Safety Issues on the Job
Author: Sara Lui
Web Address: http://nursingsafety.blogspot.com/
Importance: This describes the safety issues and the ethical issues involved that nurses need to be aware of to prevent harm to others and to practice ethical principles and theories.

Title: Nurses and the Law
Author: Kristen Wilson
Web Address: http://lawandnursing.blogspot.com/
Importance: This blog addresses the unnecessary legal complications and dilemmas that nurses and the entire profession can face and encounter.

References

American Nurses Association (2006). Florence Nightingale Pledge. Retrieved December 2, 2007, from http://nursingworld.org/FunctionalMenuCategories
AboutANA/WhereWeComeFrom_1/FlorenceNightingalePledge.aspx.

Domrose, C. (2001). “A fresh tradition: Students, schools usher Nightingale pledge into a new era of nursing”. NurseWeek, 123, 15-16.

Encyclopedia Britannica. (1999). Women in American History: Nightingale, Florence. Retrieved December 1, 2007, from http://search.eb.com/women/art
icles/Florence_Nightingale.html.

Fry, S. T. & Veatch, R. M. (2005). Case Studies In Nursing Ethics. Sudbury; Jones and Bartlett Publishers, 66-68.

McBurney, B.H., & Filoromo, T (1994). The Nightingale pledge: 100 years later. NurseManage, 2, 72-74.

V. A. B. (1910). The Hippocratic Oath and the Nightingale Pledge. The American Journal of Nursing, 10, 270-271.