#Article: FLAWS AND CRITICS OF NURSES' PLEDGE by Omolola Adams
Lystra Gretter, formerly Miss Lystra Eggert,
born in Ontario changed the face of nursing profession in the early 19th
century. She changed nursing training from one year to two years and later
three years while working at Ferrand Training School for Nurses Detroit,
Michigan between 1889 – 1907. A major contribution of Lystra Gretter was
working with a committee for the Ferrand Training School for Nurses in
composing and editing the original version of the pledge in 1893. Later the
pledge was named as Florence Nightingale Pledge since she’s been credited
founder of modern nursing. The pledge was formulated after Hippocrates oath.
Below is the original version of Florence
Nightingale Pledge.
Original "Florence Nightingale Pledge
I solemnly pledge myself before God and in the
presence of this assembly to pass my life in purity and to practise my
profession faithfully.
I shall abstain from whatever is deleterious and
mischievous, and shall not take or knowingly administer any harmful drug.
I shall 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.
I shall be loyal to my work and devoted towards the
welfare of those committed to my care 1.
This pledge has
been tested over times and thus reviewed in 1935. All the ‘shall’ changed to ‘will’
hence give it a true state of pledge. I don’t want to bore you with the grammar
of shall and will, in legal terms ‘shall’
is used as requirements and obligations while ‘will’ is used as willingness, predictions, natural behaviour and
habitual occurrence2. Few lines were added to the pledge. Below is
the 1935 Revised Version
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| Florence Nightingale image; biography.com |
1935 revised version
I solemnly pledge
myself before God and in the presence of this assembly to pass my life in
purity and to practise my profession faithfully.
I will abstain
from whatever is deleterious and mischievous, and will not
take or knowingly administer any harmful drug.
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.
With
loyalty will I aid the physician in his work, and as a missioner of health, I
will dedicate myself to devoted service for human welfare1.
Few lines in the
above revised pledge had attracted several criticism. A lot of twentieth
century researchers had frowned at the pledge which is believed to have not
reveal the true professionalism of nursing profession. A lot of credits were
given to those that wrote nursing pledge with view of attaining one of the
criteria of professionalism, yet its flaws cannot be overlooked. After several
deliberations and rigorous revisit of this version, considering some missing
important elements and to test the time of reality, it was reviewed and
established ‘Practical Nurse Pledge’
a modern version of Nightingale Pledge. Below is the modern version of
Nightingale Pledge.
Modern Version of the Nightingale Pledge
Before God and those
assembled here, I solemnly pledge;
To adhere to the code
of ethics of the nursing profession;
To co-operate
faithfully with the other members of the nursing team and to
carryout faithfully and to the best of my ability the instructions of the
physician or the nurse who may be assigned to supervise my work;
I will not do anything
evil or malicious and I will not knowingly give any harmful drug or assist in
malpractice.
I will not reveal any
confidential information that may come to my knowledge in the course of my
work.
And I pledge myself to
do all in my power to raise the standards and prestige of the practical
nursing;
May my life be devoted
to service and to the high ideals of the nursing profession1.
There have been several objections on Nightingale pledge with different
critics on the subject. Schools, Colleges, Faculties and Organisations had
adopted a pledge suiting its purpose. Even countries had a modified version of
its Nightingale pledge thereby making it difficult to adopt a universal nursing
pledge.
Critics ranging from religious view not depicting today’s nursing
objectives including professionalism has not reflected with the latest version
of Nightingale pledge. If we all agreed that nursing is a profession,
establishing its metamorphosis from primitive to a full-fledged profession,
then it’s imperative to adopt a universal and accepted nursing pledge.
I stumbled across different versions of nursing pledge in my quest for ‘most
acceptable version’ with no one found. Guess what I discovered? There were
series of different nurse’s pledge: The International Pledge for Nurses3,
Nurses’ Pledge for Trained Nurses’ Association of India incorporated into
Commonwealth Nurses’ Federation4. Nurses’ Pledge of Service adopted
by Democratic Nursing Organisation of South Africa (DENOSA)5 and KZN
Department of Health South Africa6. The Nurses’ Pledge adopted in
Ghana7, Christian Nurses’ Oath8, Nursing Pledge Gifts on
Zazzle and many more, just to mention but a few.
The third item of the pledge needs to be revisited. At different fora
I’ve made it clear that nurses aren’t subservient to physicians, we are two
parallel professionals that has its ethics and professional boundaries. Nurse’s
pledge has not nothing to do with physicians, we work as a team and not obliged
to perform all physician’s orders. Without a nurse (depending on the
speciality) a physician cannot perform efficiently and maximally, hence nurses’
indigenous and homogenous practice isn’t under any physician liability. Gone
are the days when nurses were considered ‘physician aide’ or ‘physician
servant’ the story is no more in this twenty-first century.
A vey fascinating and widely commended Nightingale Pledge has been
circulating on social media. The pledge has received a lot of attentions and
accolades. In fact various organisations, schools and faculties had adopted the
pledge as it’s found to meet current nursing professionalism and practical
diversity. Lorita Renfro, a registered nurse, an instructor at Kaplan College San
Diego, modified the modern version of Nightingale Pledge. Based on the comments
on www.ajnoffthechats.com/one-instructors-updated-nightingale-pledge9
. The modified pledge had been consumed by many institutions and been preferred
to other Nightingale pledge. Sasha Nelson reported May 2, 2018 that 23 new
nurses from Colorado Northwestern Community College were honoured and adopted
the modern version of Nightingale pledge modified by Lorita Renfro10.
Below is the full version of Lorita Renfro Modified Version of Nightingale
Pledge:
A Modern Nightingale Pledge
By Registered Nurse Lorita Renfro
By Registered Nurse Lorita Renfro
I pledge myself here, before my God and
in the presence of this assembly, to practice my profession with integrity.
I will endeavor to maintain and elevate
the standard of nursing, both as a science and as an art.
I wholeheartedly recognize the
importance of high standards of care and of personal accountability.
I devote myself to the healing,
protection, and welfare of those committed to my care.
I accept a duty to work for the
improvement of health in the communities in which I live and work.
I will hold in confidence all personal
matters committed to my keeping, and will respect the privacy of medical
information.
I will act with compassion in ethical
matters.
I will not knowingly administer or
consume any harmful substance.
I commit to interdisciplinary
collaboration and lifelong learning.
I fully acknowledge the seriousness of
the responsibility that I accept in my calling, and the significance of this
pledge that I take today10.
This pledge has thoroughly and immensely suited nursing profession, its
merit are greatly acceptable making it a favourable pledge. Lorita has been
able to capture minds of progressive nurses thus assuming to be credited as
‘Modern Nightingale Pledge’. I am calling on International Nursing Organisation
to fine tune this pledge making it world acceptable Nightingale Pledge. I found
a demerit on this pledge, the last verse of the pledge need to be fine tune ………..that I accept in my calling, and ………… if
we all accept that nursing is an art and science, then nursing is not a
calling. I don’t support the statement nursing is a calling, it’s a common word
among nurses believing that it’s like a prophetic call. Historically, during
the primitive stage of nursing, most missionaries’ are found to be nurse hereby
incorporating nursing care with the missionary work. Below is a definition of
nursing
Nursing is defined as science and art of life which is
evidenced-based practice profession that is built upon a desired goal in
attaining maximal health status of a client well or sick (Omolola 2014)11
Nursing is evidenced based and not a ‘calling’. There are educational
attainment and clinical hours to be achieved before been a licensed or
registered as a professional nurse, thus can’t be equate with a so-called
‘calling’. Some of us that attended a Christian faith-based training
institutions, can attest that were strongly cultivated to believe nursing is a ‘calling’.
I don’t want to bore you with this. I will detail this in my next write up; is
nursing a calling or profession?
REFERENCE
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| OMOLOLA ADAMS Public Health Expert & Strategist |
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