Re: confused? what happens then?
Yes. Pinning ceremonies date back to the day when the vast majority of nursing programs were hospital-based diploma programs, and the "pinning" was the school's graduation ceremony, at which you received your diploma and the school pin. Now that the vast majority of nursing programs are based in colleges and universities (although there are still some diploma programs around), the nursing students in those programs receive their degrees in the same commencement ceremony as all the other graduating students in the school. Some college and university nursing programs still do a separate pinning ceremony in addition to commencement, some don't (some newer programs never started doing a pinning ceremony, some schools have stopped doing them).
There's some controversy about continuing to do pinning ceremonies in college nursing programs, and there are some older threads on this site discussing that issue, if you're interested in reading more about it. In my experience, they are pretty unpopular with the larger, general administration of colleges/universities, who, understandably, have a hard time understanding why the graduating nursing students deserve a separate, special ceremony of their own (in addition to commencement) when the students graduating from other departments don't get special treatment. Also, lots of nursing students attend the pinning ceremony and skip commencement, which makes the nursing programs (and esp. the pinning ceremonies) unpopular with the general administration and other departments of the school.
Nursing News