The Nurses Oath, formally known as the Nightingale Pledge, serves as a foundational ethical commitment for those entering the nursing profession. This declaration establishes the professional standards and moral obligations nurses accept upon graduation or licensure. It acts as a moral guide, emphasizing integrity and dedication to patient care, much like the Hippocratic Oath provides an ethical framework for physicians. By publicly affirming this pledge, new nurses formally acknowledge their role in upholding public trust and the high ethical requirements of their vocation.
The Historical Origin and Purpose
The creation of this oath is often mistakenly attributed directly to Florence Nightingale, but it was developed decades after her pioneering work. The text was written in 1893 by a committee at the Farrand Training School for Nurses in Detroit, Michigan, chaired by nursing instructor Lystra Gretter. The committee deliberately named it the Nightingale Pledge to honor Florence Nightingale’s revolutionary contributions to modern nursing.
The oath’s original purpose was to establish nursing as a respected and legitimate profession grounded in moral principles. Nursing was transitioning from a voluntary calling to a disciplined occupation, and the pledge provided a concise summary of the required ethical standards. It was modeled after the Hippocratic Oath to standardize professional ethics and provide a formal commitment for new nurses entering the field.
Core Tenets of the Nightingale Pledge
The original 1893 text of the pledge outlines specific promises detailing the commitment of a newly graduated nurse. The nurse vows to practice their profession faithfully and maintain a high personal and professional standard of conduct. This includes a commitment to abstain from anything “deleterious and mischievous,” such as administering any harmful drug.
A core promise is to hold in confidence all personal and family matters learned during practice, establishing an early standard for patient privacy. The pledge also included a commitment to “maintain and elevate the standard of my profession” through dedicated work. Furthermore, it contained a promise of “loyalty” to the physician, reflecting the hierarchical structure of healthcare at the time.
Evolution and Modern Ethical Application
Since its inception, the Nightingale Pledge has undergone various modifications to reflect the changing nature of nursing practice and societal values. Outdated language, such as religious references and gender-specific pronouns, has been removed in many contemporary versions to make the pledge more universally applicable. Modern nursing schools frequently adapt the pledge to incorporate current ethical concepts not explicitly named in the 19th-century text.
This evolution has emphasized principles like patient autonomy, recognizing a patient’s right to make informed decisions about their care. Modern application also focuses on patient advocacy, where the nurse actively works to safeguard the health, safety, and rights of the person in their care. The historical commitment to physician loyalty has largely been replaced by an emphasis on interdisciplinary collaboration, reflecting the nurse’s role as an independent professional.
The American Nurses Association (ANA) Code of Ethics now serves as the primary ethical framework guiding modern nursing in the United States, often superseding the formal pledge. The ANA Code, formalized in 1950, provides comprehensive provisions for ethical decision-making, professional boundaries, and accountability. While formal recitation of the Nightingale Pledge may vary by institution, its core principles of patient welfare, integrity, and ethical practice remain the foundational backbone of the profession.