In 1893, Lystra Grettter led a committee at the Farrand Training School for nurses in Detroit, Michigan, which came out with the Nightingale pledge for nurses. The name “Nightingale” was meant to honour Florence Nightingale. Nightingale is the famous British founder of the nursing profession, commonly known as “the lady with a lamp”. Although the original version of the pledge has undergone several variations to fit the modern field of nursing, the pledge retains its original purpose- to make the graduating nurses swear and express their intentions to uphold good values in their profession and fulfil their responsibilities. According to American Nurses Association (2006), the Nightingale Pledge has been a symbol of the values upheld in nursing. Noteworthy, the pledge has attracted debate over its applicability in the modern field of nursing, especially because the field has changed from its initial status as a “female-only” field of practice to a modern area that involves both genders. Arguably, although there is some need for students in the medical field to express their intentions of fulfilling their responsibilities in the crucial field (pledging), the original pledge is outdated and needs restructuring and rewording in order to fit the modern context.
What is the purpose Nightingale pledge?
The nightingale pledge, written by Gretter-led committee, was meant to ensure that nurses uphold good values and take their responsibilities with dedication in order to serve the sick. According to Domrose (2001), by reciting the statement, nurses were expected to commit to practice their professions and to ensure that they practice ethical values. According to American Nursing Association (2006), taking an oath is a symbol of a person’s promise to abide to ethical values and rules. Therefore, some sources argue that all licensed workers should pledge as a way of assuring the public of good values, ethics and the appropriate behaviour in their work. In addition, Fry and Veatch (2005) argue that nursing is one of the most critical professions because it involves dedicating services to the sick and doing everything possible to maintain someone’s life. Consequently, Fry and Veatch (2005) have argued that the profession needs a pledge because it relies heavily on the personal values of the individual nurse.
After the foundation of nursing as a relatively new field after the death of Florence Nightingale, the medical profession realised the need for values, skills and personal dedication of professionals in the new field, following the example of Lady Nightingale. Thus, the was need for these new professionals to pledge by word of mouth that they, like physicians, will uphold ethics and personal dedication in taking their responsibilities in the field. Therefore, to follow the long-held custom of training physicians, a nursing pledge was necessary. The Gretter-led committee at Michigan was inspired by Florence Nightingale’s work and dedication. They modified physician’s Hippocratic Oath in order to fit in the field of nursing. One of the main vows in the pledge is “…to abstain from all harmful and/or mischievous actions in the field…” In addition, it makes the nurses vow to “…passionately seek to help and nurse the patients in any location and any form of need…” (Fry & Veatch, 2005). Another role was included in the pledge by Gretter’s commission in 1935, which included the oath to become a “missionary of health” dedicated to “advance human welfare” and “expansion of the nursing profession”
Ethical benefits and limitations of Nightingale Pledge
The pledge has been an imperative guiding tool in the field of nursing, which makes professionals in the field dedicate their life and service to the sick. It has always encouraged or forced nurses to provide services to the ill, regardless of their location, needs or conditions. In fact, some proponents of the pledge have argued that it was one of the guiding and motivating factors behind the dedicated work of European and America medical missionaries in some parts of the world, especially in Africa during the 20th century. In addition, the words and phrases of the pledge have contributed significantly to the work of nurses in various international organizations, including the Red Cross/Crescent association, Doctors without Boarders and St. John’s Ambulance, which have worked to bring medical and nursing services to people in remote areas of the world, including Asia, South America, the Caribbean and Africa. In addition, the pledge has also been instrumental in encouraging and motivating nurses to work in dangerous conditions such as serving in times of war, civil and military violence, disasters and other dangerous events.
Despite this, the Nightingale pledge has a number of limitations, some of which have attracted debate on its applicability in the modern context. For instance, it was written when the nursing field was purely a field of female professionals. In fact, men were not allowed to take career in nursing. Thus, the original pledge restricts the field to the female-only profession.
Secondly, the original pledge written by Gretter’s committee in 1893 has the phrase “…to pay loyalty to my physicians…” This phrase has been a form of limitation to the pledge because it has an effect of rendering the nursing field inferior to physicians. In addition, it makes nurses appear less independent because they have to “pledge loyalty to the physicians. It seems that the pledge assumes that nurses still take orders from physicians.
The Nightingale Pledge controversy
Over the decades, the pledge has received criticism as well as appraisals. As mentioned above, two major areas of concern arise from its restriction of the nursing field to women and rendering the field less significant and inferior to medicine.
According to Demrose (2001), several ambiguous words are evident in the original pledge, which is forcing nurses to seek to update the pledge. For instance, the meaning of the word “purity” is controversial since it can have a number of meanings depending on the interpretation and interpreter.
Therefore, some nursing schools have altered the pledge. In addition, others have decided to drop it altogether. However, this has also raised another concern because nurses will be pledging differently. Others will fail to pledge. If they interpret their roles, then they will be doing things differently. This phenomenon is likely to cause gratuitous conflicts among the medical practitioners.
According to McBurney and Filoromo (1994), the qualifications of Florence Nightingale are doubtable. For instance, it is arguable whether she deserves such an honour. For instance, she prevented a mixed-race nurse in Britain by the name Mary Saeacole to work with her in her hospital during the Crimean War (Encyclopaedia Britannica, 1999). This behaviour suggests that Nightingale must have been “a racist”, which is one of the negative behaviours discouraged in the modern practice.
Nightingale pledge is an essential way through which nurses express their ability to take responsibilities. It shows their intention to be dedicated in their work, uphold good values and ethics and apply patient-friendly behaviour. The pledge is also necessary in ensuring that nurses tend to the sick, regardless of their location, needs and conditions. In addition, the pledge has motivated nurses as well as other practitioners in the medical field to work with dedication, humility and in areas where such threats as war, violence and disasters are evident. However, it is worth noting that the original pledge has a number of limitations, which makes it very controversial. For instance, it has a number of ambiguous words and phrases that make it less applicable in the modern field. Although the original version of the pledge has undergone several variations to fit the modern field of nursing, the pledge retains its original purpose- to make the graduating nurses swear and express their intentions to uphold good values in their profession and fulfil their responsibilities. From this analysis, it is worth arguing that the pledge is important in the modern field, but it needs rewording and restructuring in order to update it and make sure it fits the modern context of nursing. Students in nursing should express their intentions of fulfilling their responsibilities in the crucial field by pledging. However, the original pledge is outdated and needs restructuring and rewording in order to fit the modern context.
American Nurses Association. (2006). Florence Nightingale Pledge. Web.
Domrose, C. (2001). A fresh tradition: Students, schools usher Nightingale pledge into a new era of nursing. NurseWeek, 123(3), 15-16.
Encyclopedia Britannica. (1999). Women in American History: Nightingale, Florence. Web.
Fry, S. T., & Veatch, R. M. (2005). Case Studies In Nursing Ethics. Sudbury: Jones and Bartlett Publishers.
McBurney, B. H., & Filoromo, T. (1994). The Nightingale pledge: 100 years later. NurseManage, 2(1), 72-74.