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The Nightingale Pledge - Still relevant today?

Posted

Specializes in Pediatric Critical Care.

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Leave us break this down like fraction. The whole Nightingale oath is a direct rip off of the Hippocratic oath taken by physicians. It represents probably one of the first but not the last things "taken" from the medical profession and adapted for nurses.

Hippocratic Oath - Wikipedia, the free encyclopedia

Not to give pains but until *very* recently there was the "medical" profession (physicians) and then there was nursing. You didn't include the latter with the former and certainly not vice versa (at least within ear shot of doctors).

To further elevate nursing as a profession from the reputation of harlots and the *other* sort of women Mrs. Lystra E. Gretter penned the "Nightingale Pledge" .

Florence Nightingale Pledge

When you consider how near many capping and pinning ceremonies then resembled taking religious vows (even for non-church affiliated programs), you begin to see where this was going. Nice, clean and respectable females promising to be virtuous and to conduct themselves to the highest moral standards. A "trained" nurse embodied all the qualities of a decent, ethical, righteous, true, moral and whatever female thus someone who could be trusted.

This armor of purity gives in theory anyway nurses clearance to go and do things that ordinarily "nice" girls did not have social license otherwise. Everything from having intimate knowledge of the human body and its functions to attending male patients comes under this banner. It also allowed nurses to enter slums, taverns, military camps and a host of other places where "good" women simply didn't venture.

You want any proof of this watch the PBS series "Call the Midwife". Those nurses sail in and out of the most appalling dock side slums intervening in a host of social matters that ordinary women of their class would avoid. Everything from homosexuality, incest, child rape, prostitution, STDs and so forth. They do so in uniform (including cap) and are able to dispense advice with the moral backing that they are "nurses" and thus must know about such things.

How relevant is the Nightingale pledge? Well physicians still take the Hippocratic oath so that is something. It certainly is no worse then say other things borrowed from the medical profession like nursing care plans/diagnosis.

suanna

Specializes in Post Anesthesia. Has 30 years experience.

Ever read the Hippocratic Oath? It is even more outdated and useless. We honor the F. Nightingale because she was one of the first to define Nursing as a career requiring dedication, training, intelligence and skill. Before Nightingale (and often after) bedside care was provided by hookers, or Sisters(Nuns). Neither may have had any health care training. Many of the principals in the Nightingale Pledge are consistent with even todays practice. The "morality clauses" in the pledge aren't too different from what many states BONs require. "Those who cannot remember the past are condemned to repeat it." From what I've seen, the push in todays health care market to diminish the important contribution Nursing makes to patient outcomes because we are expensive. If we are not careful hookers and Nuns will be the ones providing the bedside care again. After all- a floor of 40 patients could function with one nurse as long as all they did was make phone calls and check/take orders.

PG2018

Specializes in Outpatient Psychiatry.

I come from a family of Christians and am myself one. However, I think the pledge is largely hooey. The universities I attended for both bachelor's and master's did not require it.

A couple of points; nursing is not my calling (not a vocation but rather an occupation), and I have no desire to aid the physician. I am not striving to be politically or practically independent, but I am not pursue this to aid the good doctor, lol. I am a realistic man and never pursued the indoctrination of nursing and have been fortunate to dodge this "pledge." In fact, I've never actually read it before.

cjcsoon2bnp, MSN, RN, NP

Specializes in Emergency Nursing.

I think that the Nightingale Pledge remains as an interesting piece of nursing history and should not be removed but it wouldn't hurt to have it updated either. As a future nursing educator I plan on making it a brief assignment for my students to re-write the pledge and explain why they chose the words that they chose just to get them thinking about what nursing means to them. I published a post on my nursing blog a few years ago where I rewrote the pledge just for the heck of it and here is what I came up with...

I solemnly pledge myself before the presence of this assembly to practice my profession ethically and legally.

I will do all in my power to maintain and elevate the standards of nursing at all times.

I will remember that there is an art to nursing as well as a science and that compassion and empathy are just as important as any medication I administer or intervention I perform.

I will respect the privacy of my patients and hold in confidence the information of personal matters that they share with me.

With skillful hands and an analytical mind I will work with physicians and other healthcare professionals in partnership, and devote myself to the welfare of those committed to my care.

Feel free to share your thoughts about my Nightingale Pledge (revisited).

!Chris :specs:

OCNRN63, RN

Specializes in Oncology; medical specialty website.

I really like this topic.... it defiantly brings an idea to the table that I have never have thought of before. I agree with a few things that the pledge says and there are a few things I disagree with! It should be revised. It's 2015.... our profession has changed drastically over the years and NURSES everywhere deserve to be respected as professionals with Autonomy!!

Why is it defiant? ;)

hppygr8ful, ASN, RN, EMT-I

Specializes in Psych, Addictions, SOL (Student of Life). Has 18 years experience.

Did you know that many medical schools no longer require Physicians to recite the Hippocratic oath when conferring the MD for the same reasons...

pmabraham, BSN, RN

Specializes in Hospice, Palliative Care. Has 3 years experience.

Good day:

Code of Ethics is a good read. I personally feel the pledge is still valid today.

Thank you.

gypsyd8

Specializes in TELE, CVU, ICU. Has 10+ years experience.

This might be TL; DR for most people but I wanted to actually take this issue line by misogynist line.

"I solemnly pledge myself before God and in the presence of this assembly, to pass my life in purity and to practice my profession faithfully."

First, I do not pledge before G-D. G-D has better things to worry about, it is not my place to invoke deities in pledges.

Second, I never vowed to be "pure," "chaste," "faithful," or like a nun in any way, shape or form. I did however pledge to practice my profession to the best of my ability and to continually seek to improve my practice and by extension (I hope) the profession as a whole.

"I will abstain from whatever is deleterious and mischievous, and will not take or knowingly administer any harmful drug."

Whatever that means. I refuse to "abstain" or adhere in anyway, shape or form to nineteenth century standards of how a professional woman should behave. I am mischievous by nature.

*However* I fully support the ideal of refusing to knowingly administer any harmful drug, and by extension knowingly perform any harmful procedure.

"I will do all in my power to maintain and elevate the standard of my profession, and will hold in confidence all personal matters committed to my keeping and all family affairs coming to my knowledge in the practice of my calling."

Absolutely agree with this, except for the calling part. This is my job, my career, my passion. I am not "called," I am doing this by choice of my own volition. Nobody, celestial or otherwise, controls my life trajectory.

"With loyalty will I endeavor to aid the physician in his work, and devote myself to the welfare of those committed to my care."

I will not have loyalty to any person who has not earned it. I do not "aid" anybody in "their" work. I am a member of a team. I will devote myself to the welfare of those I care for.

So my pledge looks like this:

"I solemnly pledge myself before this assembly, to practice my profession to the best of my ability and to continually seek to improve my practice.

"I will not knowingly administer any harmful drug, perform or participate in any harmful procedure, and will refuse to engage in acts deleterious to the health and well-being of the patients in my care"

"I will do all in my power to maintain and elevate the standard of my profession, and will hold in confidence all personal matters committed to my keeping and all family affairs coming to my knowledge in the practice of my profession. With compassion, dedication, empathy, intelligence and perseverance I will endeavor to aid the advancement of the art and science of medicine, and devote myself to the welfare of those committed to my care."

I would also change our symbol from the Caduceus to the Staff of Asclepius

gypsyd8

Specializes in TELE, CVU, ICU. Has 10+ years experience.

Cjcsoon2brn, that is an awesome assignment.

Personally, I like it because it unites all nurses and connects us to those who practiced the profession before us. It's a great tradition that is old fashioned but is up there with "who gives this woman away in matrimony?" Old fashioned, outdated, but a great tradition.

GHGoonette, BSN, RN

Specializes in PACU, OR.

Here's the South African version: it's been around for quite a while, as it's the same one I recited at my graduation ceremony:

Nurses' Pledge of Service

I solemnly pledge myself to the service of humanity and will endeavour to practise my profession with conscience and with dignity.

I will maintain, by all the means in my power, the honour and noble tradition of my profession.

The total health of my patients will be my first consideration.

I will hold in confidence all personal matters coming to my knowledge.

I will not permit consideration of religion, nationality, race or social standing to intervene between my duty and my patient.

I will maintain the utmost respect for human life.

I make these promises solemnly, freely and upon my honour.

Short,sweet and to the point. I like the one elkpark posted, though. Very nice.

pmabraham, BSN, RN

Specializes in Hospice, Palliative Care. Has 3 years experience.

For me, there is only one deity, God, and it is through His only son Jesus that I have life. I've no problem with the current wording due to my faith in God, and being Ok to give God my pledge.

jitomim

Specializes in Cardiology, CICU, CTICU. Has 10 years experience.

For me, there is only one deity, God, and it is through His only son Jesus that I have life. I've no problem with the current wording due to my faith in God, and being Ok to give God my pledge.

Yes, but you are probably aware that not everyone holds the same faith..

I was brought up in a poorly practicing orthodox Jewish home, but have never really adhered to any form of religion. Now that I am adult, I consider myself an agnostic. I wouldn't be phased by pronouncing a pledge with some evocation of any deity, but I sure wouldn't really believe it..

What's wrong with purity. I think it separates modern nurses from pre-Nightingale hookers. That's who and what " nurses" were before dear Flo came along to set some standards.

Julius Seizure

Specializes in Pediatric Critical Care.

What's wrong with purity. I think it separates modern nurses from pre-Nightingale hookers. That's who and what " nurses" were before dear Flo came along to set some standards.

It's not that something is wrong with purity. It's that ones pureness or lack thereof should not be a part of the discussion. Sure, I promise to care for my patients to the best of my ability, but I would like my personal life and purity level kept separate from that arena.

One of my greatest memories happened last week. I flew my family across country to attend one of my daughters graduation and pinning ceremonies. I was honored to be invited to stand up----only 15 feet from my daughter---we looked into each other's eyes as we recited the nursing pledge for all in attendance to witness. Yes, it could be updated but it is tradition--meant to be handed down through the generations. In this country where we tear everything down to replace with new, it felt wonderful.

I don't have an issue with the content because I believe it's more about the ceremony and tradition than anything else. Definitely not a handmaiden to doctors. ..I work overnights snd haven't seen or spoken to one the entire time I've worked there.