Introduction

Similar to other professions, the nursing vocation has an ethical rubric used as a guideline in the profession. This template of character is codified in the Nightingale pledge in honour of one of the most outstanding personalities who have had a positive impact in the nursing profession, Florence Nightingale (Andrist and Wolf, 2006).

Other than being a guide to the nursing profession, the pledge plays a very significant role in boosting the psychological commitment of the nurses in making a commitment to the course of their profession despite the challenges that they experience. This paper shall focus on the historical role of this pledge and dig deeper into the significant of the pledge. In addition, this discourse lays emphasis on the benefits and limitations of this pledge.

Historical values and roles of Nightingale’s pledge

Professionals in the medical circles require very high ethical standards, the reason being that they deal with human life very directly. The need to make a pledge of professionalism and observance of high and uncompromised ethical standards is an assurance to the patients that indeed, they, the patients, are under intensive care of the professionals.

The pledge is an affirmation to the patients that they are in “safe hands.” The psychological impact that Nightingale’s pledge has on the nurses is very positive in terms of its contributions towards their professional and ethical rubric. It confines them to a given set of moral canons that are very significant in keeping the professionals in the nursing field in constant check (Veatch, 2009).

Motivation of the nursing fraternity

Other than being a template for both moral and professional actions, Nightingale’s pledge has been affirmed to be very significant in motivating the nursing fraternity. The pledge has been credited with the psychological accentuation of nurses; it emboldens their working spirit. The working morale of the nurses is inherently heightened by the pledge. Psychological studies have deduced that the undertaking of this pledge creates an attachment to one’s career.

The assurance to stick by these professional guidelines is not only a sign of fidelity to the ethical issues in the profession, but also a pledge of allegiance to the provisions of the profession. The significance of this is the enhancement of the bondage between an individual and the career. It has been acknowledged that the pledge has a lot of psychological “mojo” that helps in the resuscitation of the nurses’ spirits even as they face challenges in their profession (Butts and Rich, 2009).

Decision-making

The pledge outlines the role of nurses in the medical field. It describes their role in the decision-making process. While there have been several controversial issues in the content of the pledge, many pundits unequivocally agree that the pledge has a very prominent role in highlighting some of the responsibilities of nurses in the field.

Other than the demarcation of the responsibilities of the nurses, the pledge also outlines the duties of the nurses in relation to the medical officers. In terms of career and human resource issues, this clear demarcation of duties makes a clear-cut boundary of the roles of the nurses from those of the medical officers. It is factual to note that the roles of these two professionals do not have their existence from the pledge at all (Malka, 2007). The pledge directly helps an individual to act within the codes or boundaries of responsibilities thereby defining their specific roles.

Ethical benefits

Nightingale’s pledge has been a very firm pillar in the service delivery of the practicing nurses. In swearing this oath, pundits argue out that the greatest beneficiaries are the common persons who need the services of the nurses. Those who are loyal to the pledge have made a solemn vow to be always on call to assist any individual in danger of losing his life. In this regard, it can be deduced that the pledge is very instrumental in the enhancement of the service delivery in the health sector. It has had a positive impact on the employees regarding their conduct towards patients (Shelp, 2008)

Health quality is a salient issue in most countries in the contemporary society. The issue of quality, as enshrined in the healthcare charters of most nations, is anchored on the solid question of the characters of the medical personnel in their capacity as the caregivers to the sick. It is worth mentioning that the Nightingale’s pledge has given the patients a very substantial confidence in these professionals.

Since the pledge is taken with the assurance that the patient’s life matters most to the nurse, the confidence level of these patients have been boosted that the care and the treatment that they receive from the health workers is of high quality. Morally, it can thus be said that the Nightingale’s pledge has been very instrumental in instilling a relatively high confidence level on the patients regarding the treatment that these patients obtain from the nurses. The moral fabrics regarding the professional practice and the ethical conduct of the patients have been strengthened by the oath (Butts and Rich, 2009).

Limitations

The pledge has had a fair share of its controversies. Its recitations have become increasingly under sharp criticisms regarding its role in the profession and the choice of words used. Whether these critics of the oath are valid in the rejection of the oath is not a concern of this work. However, this paper shall try to analyze exclusively, the reasons behind the rebuff of the Nightingale’s pledge (Andrist and Wolf, 2006).

Over the years, the pledge has been amended to fit the contemporary society’s understanding of the medical field. The vagaries in the profession have been encompassed in the modern versions of the pledge. The earlier versions of the pledge have been incessantly accused of relegating the nursing profession below the physician’s level. Many professionals in the field have taken issue with the assertion in the pledge.

“To cooperate 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…” (Mcburney and Filoromo, 2011).The impression of this assertion is that the nursing profession is subservient in comparison to the physician’s duties.

Opposition to the pledge

The desire to outline the significance of the nursing profession without equating it to the physician’s duties has been the centre of controversy in the discounting of the pledge. The “relegation” of the nursing profession to a step lower than the doctors is a concern for the nurses. The weightiness of this matter is incessantly escalated at every moment the nurses take an oath as entailed in Nightingale’s pledge.

The personnel in the sector argue that the nurses and the doctors’ duties cannot be weighed on a linear scale as the oath suggests, but must be laid side by side. The functional roles of these two professions are complementary and not supplementary as may be perceived from the oath, this is why some groups are outraged against the contents of the pledge that makes the nursing professions subservient to the physician’s.

Nurses, therefore, feel the pledge should be revised to remove the tag that they work under the guidance of the physicians and not their own discretion. Currently, most colleges are using the revised version that has strategically eliminated the term “under the guidance of the physician,” to assert the authority of the nursing profession in the medical field.

Feminism movement

Affirmative action and gender issues have fuelled the fire over the contents of the pledge. Factually speaking, the nursing profession has been, for a long time, the reserve of the female gender. There is a misnomer that the males are predominantly the physicians and their “aids” are the female nurses. Basing their argument on the same assertion that the nurses shall work to “aid the physicians,” the reasoning is that this line has been used by the male dominated world to “resign” the female fraternity into medical “helping hands” (Mcburney and Filoromo, 2011).

While the fundamental values and the professional responsibilities of the profession have all been preserved in the pledge, there is a consensus that the fault line of controversy and disagreements in the pledge is based on the choice of words used. The clamour for the “editing” of these words describes the several versions of the oath in the profession. The need to amend it in the future is still inevitable considering the endless agitations from various factions in the profession (Shelp, 2008).

Religious subscription

In an era of religious liberty, the pledge is continually becoming a subject of discussion amongst professionals whose belief in a supreme deity is non-existence. The atheists have rejected the mention of God in the pledge terming it as “discriminatory.” The need to amend it and make it religiously neutral has been an issue. Notice the first line of the pledge, “Before God, and those assembled here…” (Mcburney and Filoromo, 2011).

The proposed amendment is to omit the name “God,” to “accommodate” the non-believers. This topic on religion has been met with much resistance from the Christian arm of the nurses who claim that Nightingale was a Christian, and it would be seriously “defiling” if the term “God” were omitted. Whether these two camps are right, depends entirely on an individual’s philosophical subscription (Malka, 2007).

Several institutions are currently adapting the contents of the pledge to accommodate these emerging socio-political vagaries, this is aimed at making everyone feel “accommodated” in the profession. The term “purity” has also been at the centre of controversy regarding the pledge. The impression created by the opponents of the term is that it refers to spiritual “purity” which appears rather obscure (Veatch, 2009).

Conclusion

Despite the salient issues raised by the representatives of several factions in the nursing profession, it is agreeable that the pledge plays a crucial role in the enhancement of the ethical and professional practice in the profession of nursing. As long as the fundamental values are entailed in the pledge, the choice of words does not matter, no wonder several adaptations of the pledge are currently in use.

References

Andrist, L., Nicholas, P., & Wolf, K. (2006). A History of Nursing Ideas. New York, NY: Jones & Bartlett Learning.

Butts, J. B., & Rich, K. (2009). Across the Curriculum and Into Practice. New York, NY: Jones & Bartlett Learning.

Malka, S. G. (2007). Daring to Care: American Nursing and Second-wave Feminism. New Brunswick: University of Illinois Press.

Mcburney, B. H., & Filoromo, T. (2011). The Nightingale Pledge. Nursing Management (Springhouse), 25(1), 7275.

Shelp, E. (2008). Virtue and Medicine: Explorations in the Character of Medicine. Boston: Springer.

Veatch, R. M. (2009). Cross cultural perspectives in medical ethics: readings. Boston: Jones and Bartlett.

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