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The Nightingale Pledge – Nursing


Since its inception in the 19th century, Nightingale pledge has been recited in various nursing schools within and outside the United States. However, the pledge has also raised controversies around the world.

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Consequently, the pledge has been modified severally since its creation in 1893. Opponents of the pledge have expressed their frustrations at its divine and feminist aspects. In the past few decades, majority of nursing schools have opted to adopt the pledge partially to avoid controversies. This paper will explain and discuss the Nightingale pledge. The paper will also explore the pledge’s function, historical role, limitations and ethical benefits (Dorman, 1995).

Nightingale Pledge

The Nightingale pledge was created in 1893 at Ferrand Training School in Michigan. Mrs. Gretter composed the pledge in consultation with Florence Nightingale’s committee at Ferrand training School. Florence Nightingale, also known as the founder of modern nursing, inspired Mrs. Gretter’s work. In fact, the pledge was considered a token to Florence Nightingale for her selfless work during Crimean war. Nonetheless, it should be noted that Nightingale pledge was extracted from the “Hippocratic Oath”.

The pledge tries to enshrine doctrines and moral codes of nursing in the profession. For instance, nurses vow to protect the moral codes and doctrines of nursing. In fact, nurses vow to desist from anything that is naughty and harmful. Moreover, the nurses vow that they would always try to find ill patients anywhere irrespective of their needs.

Additionally, the pledge sensitizes the fact that nurses would do their work enthusiastically. The pledge underwent revision in 1935 in order to advance human welfare in nursing. In essence, Nightingale pledge was modified severally by nursing schools to accommodate changes in contemporary nursing such as public health, among others.

Historical Role

Nightingale influenced nursing in a big way. In fact, she is considered the initiator of contemporary nursing. Nightingale was born in 1820 in Italy but raised in England. Nightingale dedicated her life to reforming sanitation on realizing that British soldiers, in the Crimean war, died from preventable deaths. Hospitals lacked adequate sanitation and this led to increase in diseases like dysentery and cholera, among others. In essence, Nightingale’s vision on nursing reforms led to inception of modern nursing.

Therefore, Nightingale pledge was written to articulate nurses’ purpose of discharging their functions and tasks in accordance with nursing standards. Graduates have recited the pledge in nursing schools since its inception in 1893. Mrs. Gretter, who composed the pledge, called it Nightingale pledge, to give tribute to Nightingale for her role in reforming contemporary nursing.

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Historically, the pledge has been considered a sign of nursing values. By reciting the pledge, nurses vow to uphold ethical standards as shown by Nightingale during her service as a nurse. The pledge has been utilized by most nursing agencies, in part or in full (Nutton, 2004).

Function and Purpose

Graduates from Harper hospital in Michigan were the first to use the Nightingale pledge. However, nearly all nursing schools have either changed or deleted the contents of the pledge. Interestingly, these changes have been attributed to the rise in liberalists in nursing schools. Nonetheless, it should be noted that the function and purpose of Nightingale pledge was to protect nursing values and career. The pledge was adapted from the “Hippocratic oath” which is usually taken by doctors.

Hippocratic Oath was created to encourage ethical practice among doctors in the medical field. Similarly, Nightingale pledge was created to promote nursing principles, as well as ethical values in nursing practice. For instance, nurses vow to refrain from roguish activities or harmful actions that may affect patients under their care. Additionally, the pledge seeks a selfless nurse who helps patients irrespective of their location or need. Essentially, the pledge defines a nurse as one who is selfless, virtuous, and committed to the practice of ethical nursing in accordance with nursing standards (Nutton, 2004).

Ethical Benefits

Nightingale pledge has influenced the world in many ways. Firstly, the pledge affirms nurses’ commitment to fulfill their responsibilities in the best possible manner. This resolution is significant because it promotes the spirit of nursing among nurses and potential nurses. Nursing principles are important in advancing the health sector since the role of nurses reinforces other health care professionals. In fact, nurses who are committed to their role create a safe environment for patients. In the

Nightingale pledge, nurses affirm their commitment to providing safe care to patients irrespective of their location and need. This affirmation portrays a selfless nurse who goes beyond borders to help patients. The pledge is therefore essential in encouraging nurses to be selfless whenever providing professional service to patients. The pledge also encourages nurses to uphold their responsibilities and ethical requirements in the profession. Ethics is an essential aspect of nursing since it can decide between life and death of a patient.

In this regard, the pledge tasks every nurse with the responsibility of making the best of decisions whenever faced with challenging cases. It should also be noted that the pledge is beneficial to health sector since it brings doctors, nurses and other health care professionals together. For instance, since the oath was extracted from doctors’ hypocritical oath, the spirit of professionalism is enshrined in the oath, which in turn protects professionalism in health sector.

The pledge also helps to strengthen nursing institutions throughout the world through its inspirational links to Florence Nightingale who is credited with the emergence of modern nursing. In essence, the pledge helps nursing professionals to uphold ethical standards in workplaces (Nurse Groups, 2014).

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Although the pledge received resounding support in the 19th and 20th centuries, its support has declined in the past few decades. This decline is mainly because of sociological changes. That is, people have moved from being traditionalists to being liberalists. Moreover, the number of conservatives has also reduced which points to the increase in democrats. The pledge has drawn serious criticism from liberalists and democrats in the recent past. Critics of the pledge have cited the mention of “God” in the pledge as an obstacle. In a world where some people do not believe in God’s existence, placing God in the pledge seems to leave them out.

In essence, the divine nature of the oath is a limitation in itself since atheists and Islamists, among other religious sects, find it hard to vow by Florence Nightingale’s God. Additionally, some expressions in the pledge look ambiguous. For instance, there seems to be no clear definition of selflessness in the pledge. In theory, a nurse can seek to help people zealously but in practice, this is difficult since many aspects play out in the field. For instance, the pay scale for nurses usually acts as a motivation rather than the zeal to provide services to all patients wherever they are. This alone, depicts a gap between theory and practice of the pledge in the contemporary world.

Arguments in favor of the Pledge

Traditionalist and conservatives advocate for the pledge since they believe in the fact that man can only fulfill his/her oath if it is taken before God. Additionally, proponents of the pledge cite Florence Nightingale’s reforms and contributions in the field of medicine and statistics as adequate proof of an individual’s ability to follow into her footsteps if driven by Nightingale’s vision, the pledge.

Proponents of the pledge also argue that it promotes and protects nursing ethics and standards as defined by the author of modern nursing. Proponents of the pledge also argue that it has the basic tenets of nursing, which promotes ethical behavior in nursing. In this regard, proponents of the pledge believe that it enshrines nursing values in nurses when they begin their profession as nurses. Additionally, proponents of the pledge believe that it supports nursing tradition.

Proponents of the pledge also believe that it works to unify health care professionals with nurses since the pledge is derived from doctors’ oath. Proponents of the pledge also believe that it helps health care to have a strong team that works within the required standards. The pledge also ensures that ethical virtues are held high in nursing environment. Moreover, the pledge ensures that nursing sector is advanced in accordance with its original vision and mission (McBurney & Filoromo, 1994).

Arguments against the Pledge

Arguments against the pledge have been on the rise. However, it should be noted that most nursing institutions have resorted to adopting the pledge in part. Specifically, most opponents of the pledge have cited the use of “God” as an obstacle to its adoption in full. Interestingly, wide criticism of the pledge has come from liberalists who cite the use of “God” in the pledge as an obstacle. According to the liberalists, divinity is relative and faith depends on different religions.

In this regard, liberalists believe that those of them that have no God should not be forced to recite the pledge. Furthermore, those with other gods should also be exempted from reciting the pledge, which gives allegiance to the Christian God. This also brings ambiguity when it comes to other faiths like Baha’i, Islam and Buddhism, among others since they give their allegiances to other gods. To this extent, some nurses would feel uncomfortable when forced to recite the pledge to God.

Additionally, some phrases in the pledge have caused controversies. For instance, feminists have considered it unjustifiable when told to aid male physicians in their work. Opponents of the pledge believe that the above named phrase demeans women in nursing environment as people who work for men. Additionally, it sets a bad beginning for women and their male counterparts in workplace. In essence, opponents of the pledge believe that it does not support women suffrage (Fry & Veatch, 2005).

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Mrs. Gretter and her committee composed the pledge in 1893 in Michigan. The pledge has since been used either in full or in part since its inception 1893. Mrs. Gretter credited her work to Florence Nightingale because of the latter’s contribution in modern nursing. However, the pledge received mixed results as proponents and opponents debated on the issue.

Specifically, arguments were centered on “God” and feminism because they were contentious to liberalists and feminists, among others. However, it should be noted that the pledge was composed with a good intention, to promote nursing profession and to uphold moral standards and doctrines of nursing.


Dorman, J. (1995). “The Hippocratic Oath”. Journal of American College Health 44(2), 84–88.

Fry, S.T. & Veatch, R.M. (2005). Case Studies in Nursing Ethics. Sudbury, MA: Jones and Bartlett Publishers.

McBurney, B.H., & Filoromo, T. (1994). The Nightingale pledge: 100 years later. Nurse Manage, 2(1), 72-74.

Nurse groups (2014). The Nightingale Pledge: Nursing Ethics Oath.

Nutton, V. (2004). Ancient Medicine. New York, NY: Routledge

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