A professional oath is a solemn promise to adhere to a specific standard of conduct upon entering a profession. These declarations serve as a public commitment to the ethical principles that govern a field, establishing a moral contract with society. For nursing, this dedication is particularly meaningful given the intimate and vulnerable nature of patient care. A foundational set of guiding principles reinforces the professional integrity of nurses, ensuring trust remains central to the healthcare relationship.
Origin and Purpose of the Pledge
The nursing commitment known as the Florence Nightingale Pledge was first composed in 1893 by a committee led by Lystra Gretter, Principal of the Farrand Training School for Nurses in Detroit, Michigan. It was created as a modified version of the Hippocratic Oath taken by physicians, reflecting the desire to formalize nursing as a respected profession with its own ethical guidelines. The pledge was named to honor Florence Nightingale, whose pioneering work established the modern principles of sanitation, training, and compassionate patient care.
The pledge aimed to formalize ethical expectations for practitioners as nursing transitioned from an informal calling into a structured occupation. This public recitation established foundational ethical guidelines and provided a framework for professional conduct, marking a pivotal moment in the history of nursing.
Core Commitments of the Oath
The original Florence Nightingale Pledge contains several distinct commitments that formed the ethical bedrock of the profession. A central tenet is the vow to “pass my life in purity and to practice my profession faithfully,” positioning moral character as integral to being a trustworthy caregiver. This emphasis on integrity requires nurses to abstain from anything “deleterious and mischievous” and to never knowingly administer any harmful drug.
A foundational commitment to patient privacy is expressed in the promise to “hold in confidence all personal matters committed to my keeping and all family affairs coming to my knowledge.” This declaration established the principle of medical confidentiality, recognizing the sacred trust placed in the nurse by the patient and their family. The pledge also requires the nurse to “do all in my power to maintain and elevate the standard of my profession,” signaling a commitment to continuous self-improvement and professional development.
The pledge outlines the nurse’s role within the healthcare team, stating, “With loyalty will I endeavor to aid the physician in his work, and devote myself to the welfare of those committed to my care.” This statement reflects the hierarchical structure of late 19th-century medicine, where the nurse’s duty included supporting the physician’s efforts. Ultimately, the entire oath is dedicated to the welfare of the patients.
Modern Interpretations and Use
While the traditional Nightingale Pledge is still recited in many nursing school graduation and pinning ceremonies today, its function is primarily symbolic. It connects new nurses to the long-standing traditions and ethical heritage of the profession. The original wording, which reflected the social norms of the 1890s, has often been adapted or replaced to align with contemporary healthcare realities.
Professional nursing practice is now primarily governed by comprehensive, legally recognized ethical frameworks. An example is the American Nurses Association (ANA) Code of Ethics for Nurses, first adopted in 1950. This code is regularly reviewed and updated, providing detailed guidance on ethical decision-making in complex modern settings. The ANA Code of Ethics builds upon the foundational principles of the pledge but expands the nurse’s role to include explicit commitments to patient autonomy, advocacy, and social justice.
The most significant adaptation involves the language surrounding the relationship with physicians. Modern versions often remove phrasing that implies a subordinate role, instead emphasizing the nurse’s autonomy and accountability as an independent professional. This shift reflects nursing’s status as a distinct discipline. The focus has moved toward collaborative partnership and the nurse’s duty to advocate for the patient, even if it means questioning medical decisions.