Pinning and the Pledge

Yesterday was my pinning ceremony.

It was a nice ceremony, all in all, and 14 out of 20 of the people I distributed tickets to were able to make it. I don't think the speakers were as good as last year's, the keynote speaker merely dished out some career advice that we had been getting drilled into our heads in our Trends in Nursing class anyway, and the school's president ended her short speech with an assertion that she hopes she never has to encounter us in our newfound professional capacity. Since she lives in our community, and it's inevitable that she'll require nursing care at some stage in her life, it requires some charity on my part not to take that as an insult. The class president also gave a speech, and I couldn't help but think that this and the keynote address were given "to us" (the graduates) and not to the assembly at large (which included our friends and family).

The only part that seriously bothered me, however, was the recitation of the nightingale pledge. We all had one version of the pledge in our programs, and then they displayed a -different- version on the overhead projector on the stage. When the class adviser started reading one and we all started reading two different ones, we faltered and went silent. When we all started reading the one printed in the program, I remained silent and stared at the class adviser with an arched eyebrow.

The pledge that the rest of the class read:

"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."

Underneath the print it said "Author Unknown", even though it was written by Lystra Gretter, an instructor of nursing at the old Harper Hospital in Detroit, Michigan. One last lapse in scholarly rigor before we part company, I guess.

Now, I take issue with a lot of things in that pledge, which is why I didn't recite it. Some of the reasons are expounded here.

Up on the projector there was a modernized version of the pledge, which I don't have a copy of, but a quick google search rendered something that seems similar:

"I solemnly pledge myself before God and in the presence of this assembly to faithfully practice my profession of nursing. I will do all in my power to make and maintain the highest standards and practices of my profession.
I will hold in confidence all personal matters committed to my keeping in the practice of my calling. I will assist the physician in his work and will devote myself to the welfare of my patients, my family, and my community.
I will endeavor to fulfill my rights and privileges as a good citizen and take my share of responsibility in promoting the health and welfare of the community.
I will constantly endeavor to increase my knowledge and skills in nursing and to use them wisely. I will zealously seek to nurse those who are ill wherever they may be and whenever they are in need.
I will be active in assisting others in safeguarding and promoting the health and happiness of mankind."

That version was somewhat less objectionable, omit the first half of the first sentence and it's almost completely palatable. Still, I'd argue that it's not our role to "assist" the physician anymore than we're here to "assist" the respiratory therapists or health unit coordinators, we're supposed to be a team, nowadays. Citizenship, also, I think is something very seperate from what we're talking about, and another thing that means different things to different people.

Honestly, though, if the second pledge was read I probably wouldn't have said anything, either. Even though neither version was penned by "flo", it's still called "the nightingale pledge", and I think that's one sorry little bit of history we should be letting go of, if for no other reason than the fact that she was staunchly opposed to including both genders in the profession.

Oh, sure, history is quaint and informative and interesting to reflect on, but the past belongs in the past. We need new models. New traditions. If the anchor of tradition becomes too heavy, then it must be cast off. Sure, nursing is "special", in a lot of ways, but in order to survive it's going to have to become more inclusive and multifaceted. Gone are the days when nurses lept over each other to give a doctor their seat, and long, long gone are the days when nursing implied some kind of special religious or moral piety.

Yes, we have a lot of responsibility as members of -the- most trusted profession, a profession which mediates life and death issues for the most vulnerable...but compare this to lawyering or policing for a moment. Ostensibly they're role is to either help people navigate the intricacies of the legal system (just as nurses help people navigate the medical system) or protect them from harm or loss of property, and yet the police and lawyers are almost universally distrusted to the extent that nurses are trusted. To say that it takes a "special kind of person" to do one of those other two types of jobs must be just as true as it is for nursing, no?

I wouldn't argue that there isn't some value to traditions and ceremonies and pledges of this nature, all through my previous educations I saw the grand traditions of the organizations I joined stripped away in the name of political correctness and legal liability. Even as the leaders of these organizations revised and revisited their traditions to make them safer, voluntary and more universally acceptable and applicable, these traditions were stripped away one after the other. The value in these experiences, I would argue, comes from the same system of responses that post-traumatic stress disorder stems from. Things stick with you when they're imprinted properly (and -really- stick with you when they're imprinted during acute stress).

The traditions need revising, though, as I've already said. If your profession is made up entirely of fourty-five year old protestant white women, you can afford to rock the monoculture. The time for that is done, though. It's time for a change.


vdubstress said...

I love your blog, I just found it tonight when searching out ways to deal with my own objections to the antiquated Nightingale Pledge. I'm gettin' pinned tomorrow morning. I couldn't agree more with your sentiments in this post, and in your other postings about Nursing School.

PM, RN said...

Glad you're enjoying it.

Congratulations on your pinning! I'll be thinking about ya as I brave the snow to get to work at 0:dark30 in the morning.