Do Nurses Have to Take an Oath?

Do all nurses have to take an oath? What does the oath entail, and what is its significance in nursing? While nurses are not legally required to take an oath, many nursing schools incorporate oath-taking ceremonies into their graduation traditions. 

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The most well-known nursing oath is the Nightingale Pledge, which emphasizes nurses’ commitment to practicing their profession faithfully, maintaining high standards, and prioritizing patient welfare. In recognition of the profession’s evolving nature, some nursing organizations have created modern versions of the oath, reflecting contemporary values and concerns and ensuring its continued relevance in today’s healthcare landscape.

The Nightingale Pledge

The Nightingale Pledge: A Beacon of Nursing Ethics and Traditions The most well-known nursing oath is the Nightingale Pledge, a testament to Florence Nightingale’s enduring legacy. This pledge, created in 1893 by Lystra Gretter, a nursing instructor at the Harper Hospital in Detroit, Michigan, was designed to instill a sense of professionalism and dedication among nursing graduates. This tradition continues to this day.

The original Nightingale Pledge reads as follows:

“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.”

The pledge emphasizes the nurse’s commitment to faithfully practicing their profession, maintaining high standards, and prioritizing patient welfare. It also touches on the importance of confidentiality and loyalty to the physician.

The Evolution of Nursing Oaths

Over time, the Nightingale Pledge has undergone various modifications and adaptations. Some nursing schools and organizations have created versions of the oath, updating the language and content to reflect contemporary values and concerns.

Other variations of the nursing oath may focus on specific aspects of nursing practice, such as cultural competence, patient safety, or environmental sustainability. These adaptations demonstrate the evolving nature of nursing and the need for oaths to reflect the current challenges and priorities of the profession.

Legal Requirements for Nursing Oaths

The legal requirements for taking a nursing oath vary by state and country. No federal law mandates that nurses take an oath in the United States. However, some states may have their requirements or traditions regarding nursing oaths.

For example, in Texas, nursing graduates must take the Nightingale Pledge or a similar oath approved by their nursing school. In other states, such as California, nurses are not legally required to take an oath, but many nursing schools still incorporate the tradition into their graduation ceremonies.

It’s important to note that while taking a nursing oath may not be legally required, it is often considered a symbolic gesture of commitment to the profession and its ethical standards.

Ethical and Professional Implications of Nursing Oaths

Nursing oaths serve several important functions in the profession. First and foremost, they act as a public declaration of the nurse’s commitment to upholding the highest ethical and professional standards. By taking an oath, nurses affirm their dedication to providing compassionate, competent, and patient-centered care.

Oaths also help to establish a sense of trust between nurses and the public. When patients know that nurses have taken an oath to prioritize their welfare and maintain confidentiality, they may feel more confident in entrusting their care to these professionals.

Moreover, nursing oaths remind nurses of the core values and principles that guide the profession. By regularly reflecting on the content of their oaths, nurses can stay grounded in their purpose and maintain a strong sense of ethical and professional identity.

Controversies Surrounding Nursing Oaths

Despite the important role that nursing oaths play in the profession, they are not without controversy. Some critics argue that traditional oaths, like the Nightingale Pledge, are outdated and fail to reflect the complex realities of modern nursing practice.

For example, the Nightingale Pledge’s emphasis on loyalty to physicians and abstaining from “deleterious and mischievous” activities may not align with contemporary notions of patient advocacy, interprofessional collaboration, and evidence-based practice.

Some nurses may object to certain oaths’ religious language and connotations. For instance, the Nightingale Pledge’s invocation of God may not resonate with nurses who hold different spiritual beliefs or prefer a more secular approach to their profession.

There have been calls to update and modernize nursing oaths to reflect the diversity, challenges, and opportunities of 21st-century nursing. This may involve creating more inclusive, culturally sensitive oaths focused on patient-centered care and social justice.

Alternative Oaths and Pledges in Nursing

Several other oaths and pledges are available to nurses. These alternative oaths often reflect more contemporary values and concerns within the nursing profession.

The Oath of the Healer emphasizes the nurse’s commitment to promoting health, preventing illness, and alleviating suffering. This oath also acknowledges the nurse’s role in advocating for social justice and addressing health disparities.

The International Council of Nurses (ICN) Pledge focuses on nurses’ responsibility to provide culturally competent care, respect patient autonomy, and collaborate with other healthcare professionals. It also highlights the nurse’s duty to maintain their own health and well-being to provide the best possible care to others.

The American Academy of Nursing has also developed its own Nurse’s Oath, which stresses the importance of evidence-based practice, lifelong learning, and professional leadership. This oath calls upon nurses to actively shape healthcare policies and advance the profession.

These alternative oaths and pledges demonstrate the evolving nature of nursing and the diverse perspectives within the profession. Nurses can find one that aligns with their values and professional goals by exploring these different oaths.

The Importance of Living the Oath

Taking a nursing oath is not merely a symbolic gesture; it is a commitment to embodying the principles of the oath in one’s daily practice. The oath serves as a guide for ethical decision-making and a reminder of the nurse’s primary responsibility to the health and well-being of their patients.

Living the oath means consistently demonstrating compassion, respect, and integrity in all interactions with patients, families, and colleagues. It involves advocating for patient rights and autonomy and speaking up when witnessing practices that may harm or disadvantage patients.

Moreover, upholding the oath is essential for maintaining public trust in nursing. When nurses consistently adhere to the high standards outlined in their oaths, they demonstrate their dedication to providing safe, competent, and ethical care. This, in turn, strengthens the public’s confidence in nurses and the healthcare system as a whole.


While not all nurses are legally required to take an oath, these pledges serve an important symbolic and ethical function. Nursing oaths, like the Nightingale Pledge, represent a public commitment to upholding the highest standards of patient care, confidentiality, and professionalism.

As the nursing profession evolves, so must the oaths that guide it. Nurses can ensure that these pledges remain a meaningful and inspiring part of their professional identity by engaging in ongoing dialogue and reflection about the content and relevance of nursing oaths.

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