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do nurses take an oath

Do Nurses Take an Oath To Do No Harm? [NURSE ANSWER]

An oath is a pledge or promise that is often legally binding and done in front of witnesses. It is one's faithful affirmation to fulfill a sworn statement. Many medical and healthcare professionals may have taken an oath during their graduation ceremonies. Though these pledges are not legally binding, they are done instead to guide them in their future behaviors as medical professionals. So, do nurses take an oath?

Do Nurses Take An Oath?

Until now, many nursing schools require graduating nurses to recite the Florence Nightingale Pledge at pinning ceremonies during graduation. Reciting the pledge does not legally bind them in any way to uphold the promise. The purpose of reciting the Florence Nightingale pledge is to guide them morally in the performance of their duties as a nurse. 

Nurses are at the center of critical patient care, and they play a vital part in the healthcare system. Do nurses take an oath as they play this crucial role in the healthcare system?

A nurse's role is also relevant in coordinating the multiple functions of the healthcare team. Dedication and commitment to their profession are required from them.

To answer the question, do nurses take an oath? Nurses are challenged and assigned to give the best care with or without an oath. Thus, a nurse must ensure a patients' health, well-being, and improved outcomes.

Nurses take responsibility for their patients' health while being guided by their own set of morals and principles. Still, it would seem necessary for them to take an oath and follow a set of ethical codes. These commitments or pledges are still relevant for nurses and other healthcare professionals as it binds them to protect their patients' health at all times.

Hippocratic Oath

The Hippocratic Oath, written by the famous physician Hippocrates, was formulated 2,500 years ago in Greece. It is considered one of the oldest binding documents in history. 

The Greek doctor wrote the Hippocratic Oath to set a creed of ethics and rules to be abided by future doctors. As early as 1750, the Hippocratic oath has already been translated to English and other languages. Graduating medical students have recited the pledge since then. 

Today, upon graduation from medical school, doctors still swear to the Hippocratic oath. But this tradition has quite become sporadic. While some doctors hold this pledge sacred as it is an expression of their moral and professional conduct as physicians, some don't mind reciting it.

The original 1893 oath mentions the Greek God Apollo and other statements that would seem outdated in today's modern world. Here are some of its contexts:

  • Hippocrates swore by Apollo to treat his medical mentor as the father
  • He also mentioned teaching students at no charge
  • It says not to perform surgery if you are not a surgeon
  • It also covers relationships with slaves and euthanasia, which do not apply to today's legal system

The Hippocratic Oath is said to have been written in the 6th century. Thus, changes are made necessarily to them to adhere to the practices of the 21st century.

The modification was deemed necessary as some doctors view the oath not only for upholding tradition. They believe that it should also adhere to present relevant medical realities. The core points of the pledge are the following:

  • To protect patients' privacy
  • Treat patients as humans rather than as an experiment
  • Avoid intentional harm
  • Respect colleagues and share knowledge among them and the next generation

The Hippocratic Oath is for graduating doctors only and is not being recited by graduating nurses. Instead, a nurse may take a similar oath under the Florence Nightingale Pledge, depending on the nursing school's policies.

Florence Nightingale Pledge

nurses pledge

Quite interestingly, Florence Nightingale was not the author of this pledge. It was written by a committee for the Farrand Training School for Nurses in Detroit, Michigan, led by Lystra Gretter in 1893. 

It was written by the committee in honor of Florence Nightingale, the founder of modern nursing, who established the first scientifically-based nursing school. Florence Nightingale served as a nurse during the Crimean War in London in 1860. The Florence Nightingale Pledge was inspired by Nightingale's belief that a nurse should be empowered while being committed to their profession.

Lystra Gretter was the principal of the school during that time. She made relevant nursing school changes, like adding a few years to the nursing program to obtain more resources and experience. In 1935, the pledge's last sentence was changed to reflect the current public health model.

Is It An Oath?

The Florence Nightingale Pledge was based on the Hippocratic Oath and is considered a modernized version of it. It is acknowledged and recited by nurses to guide their morals as they emerge as full-pledged nurses. The Florence Nightingale Pledge is a set of ethical statements covering adherence to nursing ethics and faithfully serving doctors. Guiding principles include:

  • Not to administer any harmful drugs
  • Pass life in purity
  • Protect the privacy of patients
  • Elevate the standards of the nursing profession
  • Devote service for human wellness
  • Not be influenced by personal matters
  • Aid physicians in their work

The Florence Nightingale is a pledge of nurses to do "no harm" to patients in the performance of their nursing duties. The commitment also covers confidentiality to be one of the most significant pillars of the nursing profession. Nurses must also assist the doctors in their work at all times.

Like the Hippocratic oath, the Florence Nightingale Pledge that nurses take oath under has also been shrouded with controversial issues. Some wanted to change wordings on the pledge to suit the nursing context of modern times. Here are some of it:

  • To pass my life in purity - this phrase somehow limits a nurse's freedom to live her personal life
  • Referencing to one God. This belief could be an ethical dilemma of some nurses
  • Helping physicians. May create a dilemma and division between doctors and nurses

While the Florence Nightingale is an old pledge, some schools continue to believe in its solemnity and relevance. Other nurses take an oath to it and still think it is relevant even in today's modern practice.

Some nursing schools continue to recite a revised pledge to make it fit today's current situations. The decision to adopt the original or the modified version is commonly left to be evaluated by nursing school leaders. 

As the Nightingale Pledge does not bind nurses legally, nurses are guided by their own set of morals. What legally binds them, for now, is the nurse practice act (NPA) of the current state they are in.

Guidelines For Practicing As A Nurse

Aside from the Florence Nightingale Pledge, nurses are required to follow professional standards set by the law. Nurses are encouraged to foster and adhere to clinical guidelines and standards of care in their professional practice. These standards act as a foundation as to how nurses should efficiently perform their duties. 

Importance of Nursing Standards

Nursing standards are essential in healthcare settings for many reasons. These are professionally developed protocols and guidelines on the acceptable variations from norms in the nursing practice. It could also be defined as an achievement benchmark based on the desired level of excellence in healthcare service.

These standards do not only measure actual performance and be used as one comparison tool against competency checklists. It also gives nurses information, resources, and proper protocol on how to provide quality care to patients. 

Below are some of the purposes of these standards:

  • Maintain clinical competency for nurses
  • Mastery and use of theoretical knowledge
  • Continued self-enhancement in their profession
  • Ensure clinical proficiency and patient safety
  • Provide consistency throughout the profession
  • Prevent unsafe work habits and reduce inappropriate variations in practice
  • Establish measures to evaluate the quality of care rendered
  • Improving health outcomes
  • Provision of penalties against incompetency or violation of ethical standards

A registered nurse is mandated by the law to carry out the care under nursing practice standards. These standards are developed at a national level. As different states may establish their own set of standards of care, some rules may vary.

The three components of the standards of nursing practice, as defined by the American Nurses Associations (ANA), are:

  1. Professional Standards. These define competencies in diagnostic, intervention, and evaluation skills. 
  2. Professional Performance Standards. It identifies roles and functions in consultation, care, and quality assurance.
  3. Specialty Practice Guidelines. These are care protocols for specific patient populations.

Legal Implications

More so, if it caused harm to the patient, a nurse found negligent to their duties will be dealt with legally. In the medical profession, these violations are called malpractice and may include:

  • Inappropriately administering medication or the proper drug
  • Failure to monitor equipment
  • Mishandling patient identification
  • Disclosing a patient's condition publicly
  • Failure to report patient assessment on time
  • Failure to communicate to the physician the changes in patients' health conditions
  • Neglect to warn patients about known harms or danger
  • Non-compliance to state rules on nursing standards

A nurse should realize the relevance of complying with these standards. When a nurse follows these standards by heart, legal liability or ethical violation will not be a future problem.

Like oaths or pledges, these standards are essential in the nursing profession. These are the rules that will protect the interest of both the patient and the nurse. It calls for improving patient care and outcomes and encourages accountability as well. These sets of protocols and guidelines are what legally bind them to their profession. 

Final Words

The 21st century has brought about much technological modernization and changes in organizational structures and laws. Because these changes are unpredictable, no particular set of ethical codes and pledges will remain permanent. For some, the pledges may be solemn covenants, and for others, it could be a mere ritual that serves no influence on their practice. 

Both pledges were modified to address the many complex realities of modern medicine. Through the years, some words may have been changed, but the sentiment remains.

For so long as their moral principles, ethical codes from medical associations, and state laws on the nursing practice act guide them. The answer to the question, "do nurses take an oath" is yes. Nurses, with the commitment to save lives, indeed, do take an oath to do no harm to their patients.