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Implementation Guide for Nursing Ceremonies

White Coat Ceremony with Nursing Students This online guide was developed to assist schools of nursing in planning events, including a white coat ceremony, oath ceremony, or other programs designed to inspire a strong commitment to providing compassionate care in all settings where nursing is practiced.

Nursing Ceremonies

Being a student in a pre-licensure school of nursing is a tremendous undertaking. Individuals are learning a new language, many new skills, and different ways of thinking in pursuit of a career in which they will become involved in the lives of individuals, families, and communities at some of their most vulnerable times. Schools of nursing are responsible for teaching students how to be quality nurses who are willing to provide courageous and innovative care to all patients. To underscore the importance of the nursing role and the student’s responsibility as a future healthcare professional, many schools of nursing host ceremonies at landmark moments during the educational process. Each ceremony has its own meaning in the process of becoming a nurse.

Nursing’s White Coat/Oath Ceremony

The white coat ceremony is a ritual used by schools of medicine and other health-related fields to mark a student's introduction to the clinical health sciences. During these events, students are asked to be explicit in their commitment to providing humanistic, patient-centered care as they begin caring for those in clinical settings.

Though white coat ceremonies are not new in the health professions, they are relatively new to nursing. In 2014, the American Association of Colleges of Nursing (AACN) formed a new partnership with The Arnold P. Gold Foundation to introduce this rite of passage to nursing schools in recognition of the need for all members of the healthcare team to commit to providing compassionate care. The partnering organizations recognized the value of an early career commitment to compassionate care and its potential to transform the entire healthcare experience given the benefits to patients, the care team, and individual providers.

The white coat ceremony – which is often referred to as an oath ceremony in nursing to distinguish this event from those offered at medical schools – typically consists of the recitation of an oath, distribution of a commitment pin, an address by an eminent role model, and a reception for students and invited guests. These ceremonies are typically offered as new students enter their nursing programs, though some schools offer these events at different points during a student’s program of study. With hundreds of nursing schools now offering these events, program administrators are seeking new ways to amplify the meaning behind these ceremonies and engage students more deeply in their personal discovery of what is means to be a professional nurse.

Pinning Ceremony

The Pinning Ceremony occurs at the end of a student’s program in a school of nursing and signifies the completion of this level of education and official initiation into the profession. In most instances, this is separate from the school graduation ceremony. The Pinning Ceremony is modeled from the ceremony in the 1860’s when Florence Nightingale was awarded the Red Cross of St. George in recognition for her service during the Crimean War. During the pinning ceremony faculty officially ‘pin’ students by placing a ribbon or pin on their lapel and offer words of congratulations. Most pinning ceremonies include the Nightingale Pledge, along with any other oath students may be encouraged to pledge. There is not one standard oath students take at Pinning Ceremonies. Schools adjust oaths for their needs, focus, or to align with their mission statement.

A Clear Commitment

In both white coat/oath and pinning ceremonies, students pledge to commit to providing care with compassion and embedding humanism in their work as a professional nurse. Since humanistic care is a primary theme threaded throughout 5B, schools are encouraged to consider adding this sentence to the oaths students are asked to take:

As a nurse I will practice with moral courage and agency to provide innovative person-centered care to all populations.

Incorporating 5B into Your Ceremony

Schools of nursing should consider using 5B as a featured element of a their ceremonies (or other student development activities) to help energize these events and engage students in critical conversations about their future practice.  Schools could host a viewing party (potentially right before your ceremony) in preparation for a robust dialogue. Alternately, students could be instructed to watch the documentary in advance of your school’s ceremony and come ready to share personal reactions and lessons learned. For schools that engage family members in their white coat/oath ceremonies, they too should be encouraged to view the documentary and take part in a larger community discussion.

To help spark the discussion at your event, schools may want to divide students into pairs or small groups, have them discuss the issues, and then report out to the larger group.  Regardless of mechanics, the program moderator may want to guide the discussion with pointed questions that will focus on topic areas of great concern.  These questions can be tailored to your institution’s mission, priorities, and approach to meeting community needs.  Potential questions to consider, include:

  • What is moral courage and when are nurses called to demonstrate this?
  • Why are nurses essential in the work to achieve health equity?
  • How can nurses confront personal bias and put patient needs first?
  • How do nurses treat the whole person versus just treating the disease?
  • Considering other groups that nurses may care for (homeless, substance use, justice-involved) who may be marginalized – how does this impact the care they receive?
  • What connections can you make to nurses addressing the early AIDS crisis and confronting COVID-19?
  • In the context of masking, isolation, and physical distancing, what can nurses do to help maintain connection with patients?
  • Does this depiction of nursing practice impact how you view the role of the nurse?
  • Why is innovation important to nursing practice?
  • Why is nursing leadership important?
  • Why is self-care and resilience important to professional success?