In the vast landscape of professional symbols—from the judge’s gavel to the police officer’s badge—few carry the emotional weight and historical depth of the nursing pin. It is a small object, typically no larger than a coin, often crafted from gold or silver and filled with enamel. Yet, to the nurse who wears it, this pin weighs heavy with significance. It represents sleepless nights of study, the physical exhaustion of clinical rotations, and the solemn vow to protect human life.
Nursing is frequently described not merely as a job, but as a “calling.” It requires a unique blend of scientific knowledge, technical skill, and profound empathy. While a university diploma certifies the scientific knowledge, the nursing pin symbolizes the “calling.” It is the badge of the “brotherhood and sisterhood” of nurses, a tangible link in a chain that stretches back nearly a thousand years to the battlefields of the Crusades.
For many nursing students, the anticipation of receiving this pin surpasses the excitement of graduation itself. The “Pinning Ceremony” is an emotional rite of passage, distinct from the academic commencement, where the mantle of the profession is placed upon their shoulders—literally and figuratively. But where did this tradition come from? Why do we use lamps and snakes as symbols? And why do some nurses cherish this pin more than any other possession?
In this comprehensive guide, we will explore every facet of the nursing pin. We will delve into its 12th-century origins, decode the complex iconography etched into the metal, walk through the intimate details of the pinning ceremony, and share the real, tear-jerking stories of nurses who have worn these pins as badges of honor.
Sisällysluettelo
What Is a Nursing Pin? More Than Just Jewelry
A nursing pin is a decorative badge worn by nurses to identify the nursing school from which they graduated and to signal their entry into the professional world. However, to define it simply as “identification” is to miss its spirit. It is a medal of excellence, a token of achievement, and a public declaration of competence.
Unlike a college diploma, which certifies that a student has passed their academic requirements, the nursing pin symbolizes the transition from theory to practice. It is a public declaration that the wearer has the clinical skills and the ethical fortitude to care for patients. It represents a rite of passage, transforming a “nursing student” into a “nurse.”
Historically, the pin served a very practical purpose. In centuries past, when uniforms were less standardized and literacy was not universal, the nursing pin (or badge) distinguished a trained, educated nurse from a layperson or an untrained volunteer. It was a visual signal that said, “I am trained to help you.” Today, while hospital ID badges perform the legal function of identification, the nursing pin remains the emotional and historical identifier of the nurse. It connects the modern nurse to a lineage of caregivers stretching back centuries.
Each pin is unique to the school that issues it. While many share common symbols (which we will explore later), the specific design—including the shape, the school crest, the colors, and the motto—serves as a lifelong connection to the nurse’s alma mater. It is not uncommon for nurses to look at a colleague’s lapel and instantly recognize where they trained, sparking a conversation and an immediate bond of shared experience.
The Comprehensive History: From Crusaders to Modern Wards
The history of the nursing pin is a fascinating journey that intertwines with military history, religious orders, and the fight for women’s professional recognition. It is a tradition that predates modern medicine itself, rooting the profession in a legacy of chivalry and service.
The 12th Century: The Knights Hospitaller
The origins of the nursing pin can be traced back to the 12th Century during the Crusades. As armies clashed, the number of sick and wounded soldiers and pilgrims skyrocketed. A religious military order known as the Knights of the Order of the Hospital of St. John the Baptist (commonly known as the Knights Hospitaller) was founded to care for these individuals.
These early “nurses” were monks who took vows of poverty, chastity, and obedience, along with a vow to serve “our lords the sick.” When a new monk was initiated into the order, he was not given a diploma; he was given a Maltese Cross. This badge was worn on his habit (tunic) as a public symbol of his vow. This Maltese Cross is widely considered the first “nursing pin.” It represented the eight beatitudes and the selfless service required of those who tend to the dying.
The Crimean War and the “Lady with the Lamp”
The tradition lay somewhat dormant until the mid-19th century, when Florence Nightingale arrived in the Crimea. The conditions she found were horrific—filth, disease, and neglect. Nightingale and her team of nurses reorganized the military hospitals, introducing sanitation and organized care. Her efforts saved countless lives and elevated nursing from a menial task to a respected profession.
In recognition of her service, Queen Victoria awarded Nightingale the Red Cross of St. George. Nightingale valued this recognition deeply. When she later established the Nightingale School of Nursing at St. Thomas’s Hospital in London, she wanted to instill that same sense of honor in her students. She began awarding “medals of excellence” to the trainees who demonstrated the highest levels of skill and dedication. These early medals often incorporated the Maltese Cross, linking her modern nurses to the Knights of old.
The American Evolution: The Civil War to 1916
In the United States, the nursing profession gained traction during the Civil War, where women volunteers proved essential to the war effort. Following the war, formal nursing schools began to open, modeled after Nightingale’s system.
Bellevue Hospital (1880): The Bellevue Hospital School of Nursing in New York City was a pioneer in this tradition. In 1880, they designed a pin to be awarded to their graduates. However, they broke with the “cross” tradition and chose a crane, a symbol of vigilance, surrounded by a wreath of poppy (for pain relief) and ivy. Crucially, Bellevue awarded this pin to every graduate, not just the top few. This democratized the pin, making it a symbol of the profession itself rather than just an award for the elite.
Standardization (1916): By 1916, the practice of pinning graduates had become standard procedure in both the United States and the United Kingdom. It became the accepted method of welcoming new nurses into the field.
Global Terminology: Pins vs. Badges
While the US settled on the term “pin,” other parts of the world, like Australia and the UK, often use the term “badge.” In these systems, nurses could also earn “bars”—small enameled rectangles attached to the badge by chains—signifying extra qualifications. A “Triple Certificated Sister” in Australia, wearing a badge with three bars (General, Midwifery, Infant Welfare), was a figure of immense authority, commanding respect just by walking down the hall.
Decoding the Symbols: A Visual Language
A nursing pin is rarely a simple circle of metal. It is a canvas of symbolism. Every image embossed on the surface tells a part of the nursing story. Let’s decode the most common symbols found on these pins.
The Florence Nightingale Lamp
The most iconic and enduring symbol is the oil lamp (often resembling a genie’s lamp). This is a direct reference to Florence Nightingale. During the Crimean War, she became known as “The Lady with the Lamp” because she would walk the miles of hospital corridors at night, alone, checking on the soldiers while the rest of the world slept.
On a pin, the lamp represents:
- The Light of Knowledge: Education illuminating the darkness of ignorance and disease.
- Vigilance: The nurse is always watching, always caring, 24 hours a day.
- Hope: To the wounded soldier, the lamp meant safety and care were nearby.
The Tale of Two Staffs: Caduceus vs. Asclepius
You will often see snakes on nursing pins, but there is a major historical controversy regarding which symbol is correct.
The Staff of Asclepius: This symbol features a single snake coiled around a rough staff. Asclepius was the Greek god of healing and medicine. The shedding of the snake’s skin represented renewal and recovery. This is widely accepted by historians as the “true” symbol of medicine.
The Caduceus: This symbol features two snakes intertwined around a winged staff. In mythology, this was the staff of Hermes, the messenger god. Hermes was the patron of commerce, merchants, travelers, and—ironically—thieves. It had nothing to do with medicine. However, in the early 1900s, the U.S. Army Medical Corps adopted the Caduceus as their insignia, likely due to a misunderstanding of the iconography. Because of this military adoption, the Caduceus became deeply ingrained in American medical culture and is now a standard symbol of “medical knowledge” on many nursing pins, despite its commercial origins.
Other Key Symbols
| Symbol | Historical & Modern Meaning |
|---|---|
| The Cross | Often a Maltese or Red Cross. It symbolizes service, self-sacrifice, and the profession’s roots in religious orders. It represents the “burden” of care carried by the nurse. |
| The Open Book | Commonly found on pins from collegiate programs. It signifies that nursing is a science as well as an art. It represents “The Book of Knowledge” and evidence-based practice. |
| The Hands | A symbol of the tactile nature of nursing. Unlike other medical professions that might rely on distance or technology, nursing is defined by the human touch—holding a hand, checking a pulse, providing comfort. |
| The Globe | Used to symbolize the universality of healthcare. Disease knows no borders, and neither does the compassion of a nurse. It represents a commitment to worldwide service. |
| The Dove / Olive Branch | Universal symbols of peace. In the context of nursing, they represent the comfort and relief of suffering that the nurse brings to the patient. |
Unusual and Unique Symbols
Not all pins stick to the standard script. Historical accounts reveal some fascinating design choices. For instance, one hospital school of nursing featured a beaver on their pin. The logic? Beavers are industrious, hardworking, and modify their environment to solve problems—perfect metaphors for a busy nurse. Another pin featured a moose head. While it might seem odd, the reasoning was sound: a moose takes three years to reach maturity, matching the three-year length of that specific diploma program. It also symbolized the “broad shoulders” and strength required to survive the physical demands of the job.
The Pinning Ceremony: An Intimate Rite of Passage
Ask any nurse about their college graduation, and they might have vague memories of sitting in a hot stadium. Ask them about their Pinning Ceremony, and they will likely tear up. This separate ceremony is the heart of the nursing school experience.
While graduation celebrates academic success (getting the degree), the Pinning Ceremony celebrates professional initiation (becoming a nurse). It is an event steeped in tradition, intimacy, and emotion.
The Anatomy of the Ceremony
Most pinning ceremonies follow a similar, revered structure:
- The Guesting: Unlike graduation where tickets might be limited, students often invite their entire support system—parents, children, spouses, and mentors. The atmosphere is less formal than commencement but more sacred.
- Opening Remarks & Speeches: The ceremony usually begins with the arrival of the faculty. Speeches are given not just by Deans, but often by student representatives who recount the shared struggles of the cohort—the difficult exams, the first clinical rotations, and the bonds formed.
- Awards and Recognition: Before the pinning, awards are often given for academic excellence, clinical leadership, or the “Florence Nightingale Award” for the student who best exemplifies compassion.
- The Pinning: This is the climax. Students are called by name. They walk across the stage, often carrying a dedication card. A faculty member or a loved one places the pin on their ribbon or lapel. This is the moment the student officially joins the profession.
- The Dedication: A unique feature of many modern ceremonies is the reading of dedications. As the student is pinned, a narrator reads a short thank-you note written by the student. These notes often thank parents for financial sacrifice, or children for patience (“Thank you for understanding why Mommy couldn’t play because she had to study”).
- The Lighting of the Lamp: Once all students are pinned, the lights in the auditorium are dimmed. Faculty members light candles (or turn on battery-operated lamps) held by the students. The flame is passed from person to person, creating a sea of light. This symbolizes the transfer of knowledge from teacher to student, and the light of Nightingale.
- The Pledge: Standing in the glow of the lamps, the new nurses recite the Florence Nightingale Pledge (or a similar oath). They vow to “pass my life in purity,” “practice my profession faithfully,” ja “devote myself to the welfare of those committed to my care.”
Who Pins You? From Authority to Family
One of the most beautiful evolutions of the pinning ceremony is the shift in who performs the pinning.
The Traditional Way: Historically, the pinning was a rigid, authoritative act. It was performed by the Director of Nursing or the Hospital Administrator. It was a “knighting” by a superior. It signified that the institution approved of you.
The Modern Way: Today, many schools allow the graduate to choose their pinner. This opens the door for profound emotional moments.
- The Mentor: Many students choose a clinical instructor or professor who made a difference in their education—someone who encouraged them when they wanted to quit.
- The Family Legacy: It is incredibly moving when a graduate is pinned by a parent or grandparent who is also a nurse. This symbolizes the “passing of the torch” within a family. Stories abound of mothers pinning daughters, creating a visual lineage of care.
- The Support System: Some students choose a spouse or child. They may not be nurses, but they are the ones who sacrificed time and energy to support the student’s dream. Seeing a 6-year-old child awkwardly try to pin their parent’s lapel is a moment of pure joy that captures the human side of the profession.
School-Specific Traditions: A Badge of Identity
While the symbolism is universal, the design of the pin is intensely local. It binds the nurse to their specific alma mater. Here are examples of how different institutions approach their pin design:
East Carolina University (ECU): The Shield of Trust
The ECU College of Nursing pin is rich in symbolism. It is based on a modified “shield of trust.” It features three points representing Love, Mercy, and Understanding. The pin also depicts a globe (worldwide service), a book and quill (knowledge), and uniquely, a ruby set in the flame of the lamp, symbolizing a “vibrant life.” The university motto “Servire” (To Serve) is emblazoned across the center.
Columbia University: The Evolution of Name
The Columbia University School of Nursing pin has evolved to reflect the identity of its students. Originally bearing the text “Columbia University,” it was recently updated to read “Columbia Nursing.” This small change was significant to alumni, who felt it better represented their specific community. Alumni describe the pin as a reminder that “nursing is truly the finest art,” wearing it with pride to signify their devotion to the school.
Yale University: Unity in Adversity
For Yale University, the pin became a beacon of stability during the COVID-19 pandemic. While traditional celebrations involving confetti poppers were toned down, the distribution of the nursing pin remained a sacred constant. Faculty and students describe the pin as a “symbol of unity,” representing the commitment to provide holistic care to all humans, regardless of race or gender, even in the midst of a global crisis.
Lakeview College of Nursing: A Century of History
Founded in 1894, Lakeview College of Nursing maintains a rich archive of pins. They proudly display pins from 1929—when the school was still affiliated with Lakeview Hospital—and from 1944, marking the 50th anniversary. Current faculty members, like the one who wrote to the ANA, keep their own pins on bookshelves attached to their nursing caps, viewing the ceremony as a welcome to new colleagues rather than just a graduation event.
The Registry of Dedication: Stories from the Nursing Community
The true value of a nursing pin isn’t found in its metal content, but in the stories it carries. The Illinois Nurses Foundation and various nursing blogs have collected touching narratives that reveal just how much this object means to those who hold it. Here are the real stories of the nurses who wear the pin.
1. The “Life-Giving” Pin: Gary L.C. Reschak
For Gary L.C. Reschak, his nursing pin is the most important object in his life. He has worn it for 46 years since graduating in 1979. To Gary, the pin represents his livelihood—it allowed him to provide for his family while simultaneously providing “life” for thousands of patients. He recently retired on Valentine’s Day, 2025, after turning 70. While he has other pins representing his Master’s degree, his original nursing pin is the one he cherishes, as it was the key that opened the door to a lifetime of service.
2. The Lost and Found Pin: Laurie Behrendt
Laurie Behrendt returned to college at age 33 with three children in tow. Nursing school was a blur of homework, clinicals, and part-time jobs. When she graduated in 1999, her pinning ceremony meant more to her than the college graduation. She proudly wore her pin to her new job in the ER—until, devastatingly, she lost it. She felt she had lost the physical proof of her accomplishment. Years later, her three children surprised her. They had secretly contacted her college, verified her graduation, and ordered a replacement pin. When they gifted it to her, Laurie noted that this new pin meant even more than the first, because it carried the love and thoughtfulness of her children.
3. The Formative Years: Jeannine Haberman
Jeannine Haberman shared a photo of her mother’s pin from St. Joseph’s School of Nursing in Joliet, IL, class of 1960. In those days, nuns ran the program, curfews were strict, and skirts were measured before shifts. Jeannine’s own pin comes from MacMurray College, a school that no longer exists. She recalls the era of starched white uniforms, white hose, and caps with a Scottish tartan stripe. Her pin reminds her of getting her cap caught in IV tubing and the camaraderie of a class that relied on electric typewriters and library visits. It symbolizes the foundation of an adventurous life.
4. The Teacher Returns: Joanne Whiteside
Joanne graduated from Loyola University Chicago in 1994. Her pin represents the place that formed her professional identity. The connection was so strong that, 30 years later, she returned to the same university as a faculty member in the Simulation Lab. Now, she wears the pin not just as a graduate, but as a mentor, helping the next generation earn theirs.
5. The Legacy of 86 Years: Melanie Reynolds
Melanie Reynolds shared a powerful photo from May 2024. It featured her daughter, Grace, being pinned at St. John’s College of Nursing. But Grace wasn’t pinned by a stranger; she was pinned by her grandmother, Virginia Long (Class of 1968), and her mother Melanie (Class of 1997). Collectively, the three women represent 86 years of nursing service. The pin, in this family, is a hereditary title of honor.
6. The 1920 Heirloom: Margaret Miller
Margaret Miller possesses a pin that is over 100 years old. It belonged to her grandmother, Lulu Crawshaw, who graduated in 1920 from the “Training School For Nurses State of Illinois” at Anna State Hospital. The school closed in 1929, making the pin a rare historical artifact. Engraved with the state seal, it connects Margaret to a grandmother who nursed in an era of “menial tasks” and strict discipline. Margaret plans to donate this precious item to a museum to preserve the history it holds.
7. Access and Opportunity: Linda Ruholl
For Linda Ruholl, a 1964 graduate, the pin was a symbol of overcoming poverty. Raised on a poor farm, her father expected her to work in a glove factory. Instead, she worked as a secretary for $127 a month, saving every penny to afford the $1,200 tuition for nursing school. Her pin represents “access and opportunity”—proof that a farm girl could become a professional through grit and determination. She later earned a PhD, but the original nursing pin remains the root of her professional life.
8. The Star of David: Denise Pang Hong
Denise Pang Hong shared her pin from the Michael Reese Hospital School of Nursing (1890-1981). The pin is shaped like the Star of David. This school was founded by the Jewish community to serve Jewish patients and was one of the few programs that did not discriminate based on race in the 1940s. Denise chose this program because she could not afford university tuition and grants were scarce for minorities. The pin represents resilience and the fight for equality in healthcare education.
9. The Comforting Presence: Kandie Halleran
Kandie Halleran became a nurse because of a pin. At age 25, facing a terrifying hysterectomy, she was crying uncontrollably in her hospital room. A nurse named Ella entered, sat by her side, held her hand, and calmed her fears. Ella’s compassion inspired Kandie to go to nursing school. Years later, when Ella passed away, her family gifted Ella’s nursing pin and cap to Kandie. Kandie now treasures that pin as the ultimate symbol of the “nurse’s heart” she strives to emulate.
10. The Badge of Authority: “Old Fool RN”
A retired nurse blogger known as “Old Fool RN” described the pin as a psychological anchor. In the early days of her career, when she felt unsure or overwhelmed, she would look down at her pin. It reminded her that a Chief of Surgery had pinned it on her, essentially saying she was “good enough.” In moments of doubt, the pin was the external validation she needed to keep going. She writes, “My pin has got me through hell in the past and I think it will probably be a prudent idea to bury me with it.”
Types of Pins and Customization
While the design is tied to the school, the pin is personal property, and graduates often have choices regarding its composition and details.
Pins by Role and Degree
- RN Pins (Registered Nurse): These are the most common. They often feature the school’s crest or the lamp symbol.
- LPN/LVN Pins (Licensed Practical/Vocational Nurse): These pins honor the completion of practical nursing programs and are distinct to the LPN role.
- BSN Pins (Bachelor of Science): Graduates with a four-year degree often receive pins that denote this higher academic achievement.
- NP Pins (Nurse Practitioner): For those with advanced degrees, these pins—often in gold—signify elevated expertise and specialization.
Material Choices
- 14K Gold: The gold standard. These are heirlooms, designed to last a lifetime and be passed down. They do not tarnish and hold significant monetary and sentimental value.
- Gold-Filled or Plated: A more affordable option that provides the look of gold.
- Sterling Silver: A classic, medical look. Silver is durable and beautiful, often preferred by those who wear silver jewelry.
- Enamel: Most pins use hard enamel to display school colors (e.g., blue rims, red crosses).
Customization Options
Making the pin unique is a cherished tradition.
- Engraving: Most nurses have their initials and year of graduation engraved on the back. Some add their student ID number.
- Gemstones: It is common to add a birthstone or a school-color stone to the pin. As seen in the ECU example, these stones can carry symbolic meaning (like a ruby for vitality).
- Guards: A “guard” is a small charm that attaches to the main pin via a small chain. These serve a practical purpose (keeping the pin safe if the clasp fails) and a descriptive one. Guards often spell out “BSN,” “RN,” “MSN,” or display a gavel (for student government) or a cross.
Etiquette: Wearing and Keeping the Pin
Where to Wear It
The nursing pin is always worn on the left lapel, positioned near the heart. This placement is not accidental; it emphasizes that nursing is a profession of the heart as well as the mind. It is appropriate to wear the pin for professional headshots, graduation ceremonies, nursing conferences, and special hospital events.
Safety Considerations
In the “old days,” nurses wore their pins on their white uniforms every single shift. Today, usage varies. Infection control protocols in many hospitals discourage jewelry that can harbor bacteria. Furthermore, metal pins can scratch patients during transfers or close contact. Nurses in high-activity areas like the ER or Pediatrics often retire their pins to a safe place, wearing them only on special occasions to prevent loss or injury.
Displaying the Pin
Because it is not always worn daily, many nurses create displays for their pins. Shadow boxes are popular, combining the pin with the nurse’s stethoscope, graduation tassel, and diploma. Others attach the pin to their old-fashioned nurse’s cap (if they have one) and display it on a bookshelf.
Celebrating the Milestone: Gifts and Parties
The completion of nursing school is a monumental achievement. Because the Pinning Ceremony is distinct from graduation, it often warrants a separate celebration known as a “Pinning Party.”
The Pinning Party
This is an intimate gathering of the friends and family who supported the student. It is less about the degree and more about the career. It is a great opportunity to give gifts that are specific to the profession.
Gift Ideas for the New Nurse
- The Pin Upgrade: If the school offers a base metal pin, offering to pay for the upgrade to 14K gold is a gift that will last a lifetime.
- Pin Guards: A chain guard is a thoughtful gift that shows you want to help them protect their hard-earned badge.
- Vintage Lamps: Small ceramic “Nightingale Lamps” are traditional gifts symbolizing the ceremony.
- Protection: A high-quality jewelry box or velvet pouch to keep the pin safe when not in use.
Conclusion: The Everlasting Light
From the dusty roads of the Crusades to the high-tech ICUs of today, the nursing pin has survived as a potent symbol of service. It is far more than a piece of metal; it is a tangible representation of the “light” nurses bring into the world.
The pin represents the sleepless nights spent studying anatomy, the trembling hands that learned to start IVs, and the courageous heart required to sit with a dying patient. It connects every modern nurse to Florence Nightingale and the Knights Hospitaller, creating an unbroken chain of care that spans a millennium.
To the graduates: Wear your pin with the immense pride it deserves. You have not just learned a trade; you have answered a calling. To the families: Know that this small badge is the highest honor a new nurse can receive. It is not just a symbol of what they have done; it is a promise of what they will do.
Usein kysytyt kysymykset (FAQ)
Is the pinning ceremony the same as graduation?
No, they are distinct events. Graduation (Commencement) is a university-wide academic ceremony where degrees are conferred. The Pinning Ceremony is a specialized, intimate professional induction specifically for nursing students. Nurses often consider the pinning ceremony more meaningful because it celebrates their entry into the profession rather than just the completion of classes.
Do I have to buy my own nursing pin?
It depends on the school. Some programs include the cost of a standard base-metal pin in the tuition or graduation fees. However, many schools allow students to purchase their own pins. This is often preferred by students who want to upgrade to precious metals like sterling silver or 14K gold, or who want to add personal engravings to the back.
What should I wear to a pinning ceremony?
Tradition dictates that graduates wear their nursing uniforms (scrubs) or a white lab coat to the ceremony. This symbolizes their readiness for the workforce. Some schools may allow business professional attire, but the uniform is the classic choice. Guests should dress in semi-formal or business casual attire.
Why is there a lamp on the nursing pin?
The lamp is a tribute to Florence Nightingale, the founder of modern nursing. She was famous for making rounds at night during the Crimean War with an oil lamp in hand. The lamp on the pin symbolizes the “light of knowledge,” vigilance, and the comfort nurses bring to patients in their darkest hours.
Can I customize my nursing pin?
Yes. While the front design is usually determined by the school (featuring the school crest), you can customize the metal quality (Gold vs. Silver) and add personal touches. Common customizations include engraving initials and graduation year on the back, adding a gemstone (like a birthstone), or attaching a “guard” charm (like “BSN” or “RN”) with a chain.
What is the difference between a nursing pin and a white coat ceremony?
The White Coat Ceremony usually happens at the beginning of a student’s education or clinical rotations, symbolizing their entry into the study of medicine/nursing. The Pinning Ceremony happens at the end of the program, symbolizing the completion of training and the entry into the professional workforce.
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