Every year on May 12 the Nursing community around the world commemorate the birth anniversary of Florence Nightingale and celebrate International Nurses’ Day to mark nurses’ contribution to people’s health.
The Nightingale pledge is known as a pledge taken by all new nurses upon entering the Nursing profession after completion of the relevant examinations. As its name implies, it was named after the famous pioneer Florence Nightingale, who was a championed English nurse as well as a woman who laid down the foundations of modern nursing with her Nursing School at St Thomas’ Hospital in London. The Nightingale pledge was created by a committee chaired by a woman called Lystra Gretter, a nursing instructor at Detroit Harper Hospital. The Nightingale pledge was used for the first time in the spring of 1893, by the Detroit Harper Hospital’s graduating class. It is the nurses’ way of expressing their intentions of fulfilling their responsibilities. This pledge has been the symbol of a nurse’s values, where a nurse commits to ‘faithfully practise’ her profession and to practise proper ethical values.
Some consider the oath taking as a symbol of one’s professionalism and promise to abide by ethical values. It is crucial for all licensed workers to make a pledge to assure the public that they are dedicated and committed to serve and help the suffering.
The Nightingale Pledge reads as follows
“I solemnly pledge before God and presence of this assembly, to pass my life in purity and to practise my profession faithfully. I will abstain 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 family affairs coming to my knowledge in the practise of my calling, with loyalty will I endeavour to aid the physician in his work, and devote myself to the welfare of those committed to my care”.
The Nightingale pledge is a statement of ethics and principles of nursing care. Ethics is a discipline studied in almost all professional fields, including medicine, nursing, business and philosophy. It deals with the actions of being what is good and what is bad.
Nursing is a profession that requires high levels of dedication, kindness, attention to detail and compassion for humans in all walks of life. Practising nurses are skilled, trained and educated. Because of the profession and the caring role that nurses fulfil they are expected to follow a Code of Ethics as a guideline for conduct while performing their duties. The Code of Ethics for nurses identifies goals, ethical principles, and grievance procedures. It is universal, recognised and valued in many countries.
Professional recognition for nurses grew to newer heights in 1953 when the International Council of Nurses (ICN) established the International Code of Ethics for the nursing field. This international Code identifies four fundamental responsibilities that nurses would be accountable for. They include, the promotion of health, illness prevention through healthy lifestyle choices, alleviating suffering and health restoration. Nurses need to follow these guidelines and also respect various cultural rights while treating patients with the dignity they deserve while vulnerable and ill.
Each day, nurses are faced with making life and death decisions, sometimes within no more than a few seconds. Although nurses have the authority and skills to make independent decisions about a particular patient or situation, they are still responsible to the profession in general.
The behaviour of a nurse demands a caring nature, and a nurse must abide by a professional code of conduct. The nurse’s code of professional conduct encourages them to provide fair, safe, and ethical treatment for all patients.
A nurse’s sole responsibility is to provide the best care for her patients. Primarily, a nurse should respect a patient’s wishes when compiling a medical care plan, even when it poses a personal conflict of interest. Just as a customer is the first priority in a retail store patients come first in a medical setting.
The nurse’s code of professional conduct stipulates that all nurses must treat a patient with dignity, respect and compassion regardless of the nature of the health condition, economic status, gender, race or personal attributes. The code strictly enforces that all patients are worth the dignity and rights of human beings and so should not be discriminated against for any reason while under a nurse’s care.
The fact that patients trust the nurses with their lives makes it all the more important for ethics to be followed carefully. Nursing is a people-oriented career, and it is a primary responsibility for nurses to make sure the patients’ needs are properly met. Nurses must also protect the patients’ right to privacy. Information must be confidential and not divulged to anybody unless they are permitted to do so by the patient.
It is important to be compassionate towards the patient. Health care relies on compassion as this is one of the most effective ways of treating a person who is ill.
Nursing ethics relies heavily on competence. A nurse is responsible for all the procedures to be performed or decisions to be taken.
Nurses have a hectic work schedule. Just like the doctors, they too have to work round the clock in different shifts. They must never allow their personal issues to come in the way of delivering quality health care to their patients.
It is important to understand what happens psychologically to patients when they are admitted to hospital. Except for childbirth and selective surgeries hospital admissions are often times not by choice but by circumstances beyond a patient’s control. Patients feel vulnerable and fearful, with many facing fatal or disastrous outcomes. When working in busy environments, it is easy for nurses to lose sight of what the Code of Ethics requires of them.
It is therefore important to remember the key principles of the Code of Ethics. It is the nurses’ responsibility to make sure their patients’ needs are properly met. Nurses must be kind and courteous to the patients, speak in a soft voice, with a smile, and check on their comforts at all times. This also applies to friends and family who might be visiting the patient. This is a very stressful time for patients and a little caring and concern on the part of their nurse goes a long way in their convalescence.
(The writer is former Principal, School of Nursing, Kandana).