Florence Nightingale: to Pledge or Not to Pledge


Lystra Gretter composed the nightingale pledge in 1893. It was named after the founder of modern nursing, Florence Nightingale (Brown 2003). It is a modified version of the Hippocratic Oath. The pledge comprises several statements that include ethics and standards of nursing. Two of the main principal pledges contained in the pledge include a vow to avoid any mischievous behavior, and a vow to care for those in need in all places. The oath was revised in 1935 to include a vow that makes nurses missioners of health wherever they are. Their main role is advancement of human welfare by offering both bedside care and public health care. Nurses are required to recite the pledge during graduations and other ceremonies. The pledge is still relevant and used today. However, many nursing schools have revised it by removing the vow of loyalty to physicians and included vows that make nursing an independent profession (Brown 2003). The pledge has both opponents and proponents. Many people consider it as a necessary aspect of maintaining ethics in the nursing profession (Herman, 2013). However, others consider it as a way of restricting nurses and limiting their scope of work.

The pledge

The nightingale pledge contains several vows that aim to maintain ethics and professional standards in the nursing profession. It contains several solemn vows. They include vows to pledge to god, live in purity, maintain professionalism in nursing profession, avoid administration of harmful drugs, and take all necessary measures to improve the nursing profession (Herman, 2013). In addition, nurses pledge to devote themselves to improving human welfare, aid physicians in their work, and avoid any evil activity or practice. Modern versions of the pledge include a pledge to adhere to nursing standards and ethics, and a pledge to keep information obtained on line of duty confidential (Brown 2003).

Historical role

The pledge was named after Florence Nightingale as a show of respect and admiration for his contribution to the nursing profession (Brown 2003). Nightingale was the founder of the modern nursing profession. She was phenomenal in providing health care services to victims during the Crimean War (Herman, 2013). Her role was to care for wounded soldiers. She was referred to as the lady with the lamp because she made rounds during the night to take care of injured soldiers.

Function and purpose

The Nightingale pledge plays an important role in the nursing profession. It is aimed at helping nurses adhere to ethics of the nursing profession (Brown 2003). By reciting the vows, nurses promise to maintain professionalism in their practice. In addition, it is a sign of willingness to maintain integrity in the nursing profession. The fundamental goal of the pledge is to form a foundation for professionalism (Herman, 2013). The pledge s recited by graduating nurses as a sign of their readiness ad willingness to fulfill the requirements of the nursing profession in advancement of human welfare.

Ethical benefits

The pledge has several benefits that explain why many nursing schools adopt it. First, it shows an individual’s willingness and readiness to maintain integrity and professionalism in the nursing profession (Brown 2003). The nursing profession is one of the professions that have many ethical problems that require attention. For example, patient self-determination, confidentiality of patient information, and administration of correct drugs are issues that have far-reaching ethical implications. The pledge enables nurses make the right decisions in their practice. Second, the pledge is a sign of a nurse’s commitment to professionalism, and a promise to adhere to nursing ethics during practice (Brown 2003). It is therefore necessary for nurses to take the pledge in order to ensure the public that they are willing and ready to advance the welfare of the people. The nursing profession has its foundation on the personal values of nurse. Therefore, the pledge is necessary to act as a guide for nurses’ values. Third, it creates a sense of responsibility in nurses (Brown 2003). Pledges are binding promises that people make to fulfill certain requirements and expectations. It is an effective way of keeping nurses on track in their practice. In addition, it is an effective method that enables nurses make ethical.

Limitations of the pledge

Many nursing schools have modified the original version of the nightingale pledge because it contained several limitations. First, when the pledge was established in 1893, the situation of the nursing profession was different from the situation in the 21st century. Therefore, there is need for extensive revision and modification of the pledge to include aspects that reflect the situation of nursing today (Vickie, 2009). For example, the ethical challenges that nurses faced during the period of its establishment are different from the ethical challenges that nurses face today. Therefore, it limits nurses in their scope of practice.

Second, the vows contained in the pledge do not reflect the scientific nature of nursing in today’s world. For example, nurses undergo a lot of training and learning that imparts a lot of knowledge. However, the pledge does not recognize the role nurses play in using that knowledge in advancement of nursing profession as well as provision of quality health care services. That is why many nursing schools have introduced several modifications to the pledge to suit their requirements of the nursing profession.

Third, the pledge ignores the complexities of modern medicine (Vickie, 2009). When the [ledge was developed, the medicine of the time involved simple procedures and methods. Dangerous diseases were not as prevalent as they are today. In addition, the requirements and challenges of the nursing profession were simple and easy. However, the situation today is complex. Nurses encounter complex problems and difficult challenges every day. The behavior of nurses is largely determined by other factors such as law and policies of the nursing profession (Vickie, 2009). The nursing profession has undergone several changes that need to be reflected in the pledge. However, most parts of the pledge have remained the same and unchanged for past years. Doubts exist as to whether the pledge will survive this century as the nursing profession becomes more complex by the day.

Arguments that support the pledge

Proponents of the pledge argue that it is a representation of a nurse’s promise to the public, patients, and the profession to maintain professionalism and nursing’s standards and ethics (Vickie, 2009). It is important and necessary for patients to trust nurses. It is one of the ways that nurses use to ensure the public that they are competent to provide quality health care without violating their ethics. In addition, proponents argue that the pledge unites all nurses and eliminates chances of conflicts of interests in the profession (Herman, 2013). Eliminating the pledge would subject the nursing profession to different interpretations that would adversely affect practice.

Arguments against the pledge

The oath has been rejected by many professionals in the medical field because of several reasons. It is considered demeaning when it requires nurses to aid physicians in executing their roles (Vickie, 2009). The inclusion of that statement shows that nurses are inferior to physicians and their role is a supportive one. They are under the jurisdiction of physicians and should therefore follow their commands (Vickie, 2009). In many nursing schools, the statement has been replaced by more appropriate statements that do not subject nurses to the jurisdiction of physicians (Herman, 2013). Opponents have proposed new versions of the pledge that include statements that refer to social justice, eliminate reference to purity and God, and that do not include the requirement to aid physicians. Opponents reject the pledge because they claim that it is too shallow. They consider it dictatorial by requiring nurses to pledge to maintain purity and commit to God (Herman, 2013).

Opponents also claim that nightingale’s qualifications do not qualify her as a role model for nurses in the modern world (Vickie, 2009). She is not worth of the honor bestowed upon her through the pledge. For example, she barred a British nurse from working on her hospital during the Crimean war because she was of mixed race. This suggests that she was not accommodative of all people despite their race. One of the requirements of the modern nursing profession is ability to treat all people equally despite their race or gender. However, nightingale did not exhibit that quality thus creating doubts as to whether she deserves the recognition and honor that has been bestowed upon her.

Finally, the words of the pledge are very ambiguous and prone to different interpretations to suit different situations (Vickie, 2009). That is why the pledge has been revised to suit requirements of modern nursing profession. For example, the pledge does not expound on the meaning of purity. It has been interpreted in many ways that include professional purity, spiritual purity, and emotional purity.


The nightingale pledge is one of the principal aspects that define the nursing profession. I was established in1893 by Lystra Gretter in honor of Florence nightingale. Nightingale was the founder of the modern nursing profession. She is recognized for her role during the Crimean War. The pledge has many ethical benefits. It shows nurses’ willingness and readiness to maintain integrity and professionalism in the nursing profession. In addition, it is a sign of a nurse’s commitment to professionalism, and a promise to adhere to nursing ethics. However, it has been criticized for its many limitations and ambiguities. It does not reflect the complexities of the modern medical field, and does not reflect the scientific nature of nursing in today’s world. Some statements in the pledge are ambiguous and prone to different interpretations. For example, the requirement to maintain purity is ambiguous and has been interpreted differently. In addition, opponents propose a revision of the pledge to exclude certain statements. In addition, the statement requiring nurses to aid physicians is demeaning and does not recognize nurses as independent medical practitioners. Many medical training schools have modified the pledge to reflect their goals and objectives.


Brown, V. (2003). The Hippocratic Oath and the nightingale pledge. The American Journal of Nursing, 10, 34-41.

Herman, A. (2013).Florence nightingale pledge. Journal of Holistic Nursing, 3(1), 18.

Vickie, A. (2009). A closing word: national nurses’ week and the nightingale pledge. Dimensions of Critical Care Nursing, 28(3), 145-146.

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