Introduction
In many societies, in the world, the role of women was that of caregiver or nursing care. The nurturing of children by mothers gave people the supposition that the women can provide the same care to the ailing and wounded in the society. Nursing history, as a piece of women’s history, has faced the paradox of being women’s work: invisible, devalued, and underpaid and yet a critical necessity to society (Judd et al., 2010). In the early years, there were no learning that existed for the caregivers, it was a trade passed from one generation to another or through try-out and mistakes. The nurses were in structured settings and dealt with charities and service to others as commanded in the early Christian church. During the period of reformers, the catholic convents and monasteries shut and land was taken. The ill in the society who got care from the church were left in the hands of old women who could not perform other duties.
The Nightingale Pledge
Florence Nightingale was born in Italy to wealthy parents in early 19th century. The calling Nightingale had was that of care giving. Nightingale encountered obstacles from the parents in her ambition to become a nurse. This is because it was considered as profession for low class women who did most of the duties in the society. The expectations of the wealthy status Nightingale’s parents were for her to start and care for her family after marriage.
The parents eventually supported Nightingale and she started offering nursing training Kaiserwerth in Germany, that took a period of three months and she became the administrator for a hospital in London. Florence Nightingale assisted the wounded soldiers from the Crimean war by ensuring the barracks are sanitized to maintain high hygiene levels. The death of soldiers reduced drastically after the implementation of good hygiene standards. Nightingale started a training school for nurses at St. Thomas’ Hospital in London in the late 19th century. The trained nurses posted all over Britain on the basis of Nightingale theory Nightingale pledge is a modified form of Hippocratic Oath that was composed in the year 1893 by Lystra Gretter and the Farrrand Training School Nursing Committee. It was named as Nightingale pledge as the honor to contribution of Nightingale, the founder of the nursing profession. The pledge reads: 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. 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 endeavor to aid the physician in his work, and devote myself to the welfare of those committed to my care (American Nursing Association 2014).
Historical role, function and purpose
Lystra Gretter composed the pledge that nurses make on graduation. The nurses graduating from Farrand training school for nurses in Detroit, Michigan took the first nightingale oath. The pledge is an adaptation of the Hippocratic Oath taken by doctors. The Nightingale pledge is a promise and an obligation of the nurse towards good and moral standards and values. In reciting this, a nurse commits to “faithfully practice” her profession and to practice proper ethical values (Domrose, 2001). The oath, apart from graduation, is declaimed in nurses’ week and the birthday of Florence Nightingale. Some nursing schools are still using the pledge or while others have abandoned the use of the oath. The initial oath has the following promise.
A nurse is required to have certain virtues, and this is developed during learning. The most vital qualities are compassion, empathy and value for each patient irrespective of the age, sex, race or social class in effective concern for the ailing. The nursing code of conduct allows the nurse to be stern if there is the need. The consistency and promptness is apt for the caregiver to perform their tasks. A nurse requires being meticulous in their duty to get things done no matter the straining situation in work environment. Diplomacy and understanding are necessary for the nurse to communicate with the patients. The maintenance of hygiene is paramount to avoid cross infection. The nurses supervise the cleaning staff to ensure that cleaning is proper in the patients’ room or ward.
Ethical benefits and limitations
The line in the oath ‘to pass my life in purity and practice my profession faithfully’ the intention of the meaning of the word “purity” may have a different implication today than when this vow written. Nurses these days may not be viewing purity in the terms of chastity, but rather in provisions of one of its other meaning such as consistency or virtue.
‘I will abstain from whatever is deleterious and mischievous,’ Nurses are to be part of the curative process not obliterating or dangerous to their patients. To be impish is to cause harm carelessly; we must always apply great concern and interest to our tasks because they involve human lives. ‘Will not take or knowingly administer any harmful drug’ we need to be honest. The nurse wit cannot harm by use of medicine and the main goal of the nursing profession is to heal not to hurt.
‘I will do all in my power to maintain and elevate the standard of my profession’ the maintenance of standard to the nursing profession by providing care and the range of nursing practices. Nurses raise the standard by educating and finding better ways in increasing the nursing knowledge.
‘Will hold in confidence all personal matters committed to my keeping and all family affairs coming to my knowledge’ The nurses have an exciting responsibility of becoming involved with human life that they are privy to personal information of their physical purpose as well as their social role and associations. The patients’ belief that nurses will uphold and promote their human rights and confidentiality.
‘In the practice of my calling’ this is the core of the pledge. Nursing is a calling not a duty. The love of the profession is more than just a career or a profession there is no amounts of wealth in the world that can describe the passion and love the nurses have for the caring for their patients and seeing them get well. Nurses always confess that they have always wanted to be caregivers.
‘With loyalty will I endeavor to aid the physician in his work’ this means that there is need to work as team. A part of a team cannot work without one another; no one member is significant than the other team member in the health facility. The doctors have their areas of knowledge while nurses have their own. The exercising of mutual respect is the key to being a successful team member.
‘And devote myself to the welfare of those committed to my care.’ The nurse ought to give of oneself totally to the caring for sick people, and this is both physically and emotionally exhausting. The rewards the nurses receive is not quantifiable and obvious, but have enabled to care for the ailing for many years.
Arguments in favor and against nightingale pledge
The American Nurses Association alongside other healthcare firms accepts the nightingale pledge as the foundation for modern proficient nursing moral values. The code of ethics main purpose is to provide a concise statement of the ethical responsibility and obligation on duties of individuals entering the nursing career, the profession has standards that are not negotiable and an expression of the nursing commitment to the humanity.
The code of ethics is an element critical in the nursing organization. The ethics are in the implementation of the operation, idea, beliefs of care. The nine provisions from the code of ethics are in the strategy and procedures to administer the nursing institution. The ethical structure in nursing assists them to have a relationship with the patient. The ethics allow the nurse to resolve lawful and principled issues concerning the patient. There are four fundamentals to the ethics code interwoven throughout in relationship between nurses and people, nurses and practice, nurses and the profession, and nurses and co-workers. These elements provide a structure for the nine provisions. Because codes are unable to provide exact directives for moral reasoning and action in all situations, some people have stated that virtue ethics provides a better approach to ethics because the emphasis is on a person’s character rather than on rules, principles and laws (Beauchamp & Childress, 2001). The nurse is realistic to reflect on the requirements and appraise how they relate to one’s practice.
There has been an argument by the nursing fraternity on the issue of the oath and its significance. The arising issues concerning the pledge requires tenacity because it affects the promise made by the nurse including their honor. The issues need immediate addressing to avoid a negative impact to the nursing occupation. The nursing career is transforming, and the nurses require acclimatizing to remain relevant. Some training schools have changed the oath to include all religions. The other amendment is the nurses relating with other members in the health sector acknowledging there has to be mutual understanding.
Conclusion
The nightingale oath has been marked in the nursing professional since Christianity era, and the use of solemn pledge by the name of God was acceptable by all. The nursing field has people from different religious background and refers to God in different names like Islam Allah. The pledge controversies have seen amendments to the oath by different nursing schools. Florence Nightingale is the motivation that restores the nurses’ dedication to remaining dedicated to this journey by being concerned to do well, not for selfish admiration but to respect and precede the cause, the work we have taken up. The nurses’ value training not as it makes us wiser to others, but it enables them to be more functional and accommodating to our fellow beings, the ill, which most want our help. Let it be the aim for nurses to be good, and never let us be embarrassed by the name of being a nurse.
References
American Nursing Association. (2014). Florence Nightingale Pledge. Retrieved on 13th March, 2014 from: http://nursingworld.org/FunctionalMenuCategories/AboutANA/WhereWeComeFrom/FlorenceNightingalePledge.aspx
Beauchamp, T.L., & Childress, J. F. (2001). Principles of biomedical ethics. New York: Oxford University Press
Domrose, C. (2001). A fresh tradition: Students, schools usher Nightingale pledge into a new era of nursing. Nurse Week, 123, 15-16.
Judd, D. M., Sitzman, K., & Davis, M. (2010). A history of American nursing: Trends and eras. Sudbury, Mass: Jones and Bartlett Publishers.
