2015 is the 100th anniversary of Florence Nightingale’s Death.   And May 12th is typically thought of as Florence’s Birthday.  So pause for a moment and reflect on our profession and the legacy we offer to our communities.  We are clearly a profession worth celebrating.

For entertainment, here are some of Florence’s pledges.  The original and a more contemporary version:

Original “Florence Nightingale Pledge”

  • 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 shall abstain from whatever is deleterious and mischievous, and shall not take or knowingly administer any harmful drug.
  • I shall 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.
  • I shall be loyal to my work and devoted towards the welfare of those committed to my care.

Interestingly, the pledge was not written by Florence Nightingale. The pledge was actually written by a committee at the Farrand Training School for Nurses in Detroit, Michigan, in 1893. The committee was chaired by Lystra Gretter

“Practical Nurse Pledge”, a modern version based on the “Nightingale Pledge”

Before God and those assembled here, I solemnly pledge:

  • To adhere to the code of ethics of the nursing profession
  • To co-operate faithfully with the other members of the nursing team and to carryout [sic] faithfully and to the best of my ability the instructions of the physician or the nurse who may be assigned to supervise my work
  • I will not do anything evil or malicious and I will not knowingly give any harmful drug or assist in malpractice
  • I will not reveal any confidential information that may come to my knowledge in the course of my work
  • And I pledge myself to do all in my power to raise the standards and prestige of the practical nursing
  • May my life be devoted to service and to the high ideals of the nursing profession

However a favorite comes from “the truth about nursing” and is quite inspirational:

As I care for you, it is my job to protect you from all harm. That means any harm from your illness or its symptoms, from outside forces including the care environment, and from other people if necessary, even those involved with your health care or health financing. As an autonomous health professional who reports only to senior nurses, it is my job to defend you from poor or misguided health care from any source. I am your advocate. I vow to do my best to protect you as if you are a member of my family.

So go forth and celebrate choosing profession that makes the world better. – Jim Kane



It was another Saturday night in the intermediate step-down unit where I had been working as a registered nurse for a little over a year.  I suctioned Harry and decided to bathe him because it was already 4 AM, and I thought I’d have him “fluffed and buffed” by the change of shift.

Harry and I spent many Saturday nights together.  We had CNN on and the lights dimmed while I chattered to this 69-year-old man who was far away from home.  He and his wife Claire had been driving through Pittsburgh in their Winnebago, fulfilling a dream to travel throughout the United States.

On a cool March morning, Harry and Claire stopped to “gas up” the Winnebago and have breakfast before moving on to Washington, D. C. to see the cherry blossoms in bloom.  As the two began to drive out of the gas station, Harry clutched his chest and, putting the Winnebago in park, lost consciousness.

Alone in a strange city without family or friends, Claire called 911, described their situation, and waited for help.  The paramedics arrived, stabilized Harry, and sent them to Allegheny General Hospital.  After an unsuccessful angioplasty of his coronary blood vessels, Harry was sent to the OR for emergent coronary bypass surgery.  Harry never regained consciousness.  He was put on a ventilator and his electrolytes were unstable.  The calendar changed.  Harry’s mediastinal wounds had healed, and Claire continued to sit faithfully by his side day after day, but Harry was still asleep after sixty-one days.

I bathed Harry as I continued my one-sided conversation with him about my diabetic dog.  I washed his arm and carefully in between each and every finger, because nurses often forget those parts, and then I respectfully asked Harry to hold his arm up so that I could wash under it, though I knew he couldn’t hear me.  This evening was different for Harry and me though.  This time when I asked him to hold up his arm, I could feel his arm straighten and stiffen.  I let go of his wrist and his arm stayed in the air!

With tears in my eyes, I asked Harry if he could hear me, but his eyes remained shut and his facial expression was unchanged.  I then asked him to squeeze my hand and he did.  By the end of the week Harry was awake and following commands. Eleven weeks after surgery, Harry’s tracheostomy tube had been capped and he began to whisper.

Harry asked where he was, and where was Claire, his wife and best friend for 37 years.  We had been chatting for an hour when he looked at me with the deepest blue eyes I have ever seen in a man his age, and asked me how my dog was.  Stories about my diabetic dog, Marti’s little girl, Dr. Rich’s fishing trip, and details about a surprise spring snow began pouring from his lips.  I’ve had patients tell me stories that they had remembered hearing while asleep, but never did a patient remember so many different stories in so much detail.  After 77 days, Harry and Claire walked out of the hospital together to go home to Oregon to recuperate.

Nine years have passed since I met Harry, and I continue to talk to my patients about the weather, world issues, their family, and what has been happening on my favorite television shows, even though my patients may be unconscious or unable to clearly understand the words that I babble.

I know that my patients can hear me speak hopeful words.  They can feel me touch them with caring hands, and they know, for that moment, that I am caring only about them while I wait for them to wake from a sleep that cannot always end with a stretch and a yawn.

Karen A. Tarolli, RN, BSN

Allegheny General Hospital, Pittsburgh, PA

Mrs. Dundee was a 50-year-old woman with end-stage lung cancer, which had metastasized to her brain and bones.  She was from out-of-state, but she and her husband had done their homework and selected our university teaching hospital and our doctors.  I’d spoken to Mr. Dundee twice while Mrs. D was semiconscious, and had established some rapport.

Family and friends from all over were gathering to say goodbye to the patient, including her daughter who was eight months pregnant.  The room was often filled with laughter and tears, and many loving stories of good times in the past.

I visited one day, and was surprised to see the patient out of bed.   I greeted Mrs. Dundee, she began talking softly, her voice barely audible.  Her friends began interpreting her statements to me, explaining that Mrs. D was meaning this or that, and that she was confused. I continued to focus on the patient, and encouraged Mrs. Dundee to speak.  I also encouraged the family to listen to her.

Mrs. Dundee then told us an amazing story of sitting alone in her motor home soon after being diagnosed with cancer.  She described crying her heart out, overcome with fear about what the future might bring.  After a while she began talking to God, and soon felt a warm breeze move over her, followed by being completely filled with peace, a feeling which remained with her ever since.  She said, “Everything will be okay, I’m in God’s hands.  I’m so lucky to have my husband, I’m so lucky to have my family, I’m so lucky to have my friends,” and she went on and on, listing people she cared about.

She relaxed as she spoke, and her voice became stronger and clearer as we listened.  A sense of awe descended in the room.  When she became silent, I acknowledged the beautiful gift she’d given us.  One of her friends offered to write the story down and share it with family and friends who had not been present

I believe it took a nurse to recognize the potential in this situation.  This was a sacred moment in Mrs. D’s life.  She was displaying more energy and alertness than she had in several days.  She had something to say.  I modeled patience, presence and active listening for the friends and family gathered, and this empowered her to bring forth her story.  Once her story was received, its value became clear to all of us. Her daughter would write down her mother’s words for those not present, including the unborn grandchild.  Mrs. Dundee’s’ story would live on.

Ramita Bonadonna, RN, MSN 

Charleston, South Carolina