Explanation:
Most nurses are familiar with the Nightingale Pledge, named to honor nurse pioneer Florence Nightingale, and until the 1970s, recited by graduating nurses at their “pinning” ceremonies. But did you know who is responsible for helping create it?
That person is Lystra Eggert Gretter (1858-1951), the woman who lobbied for shorter shifts for working nurses and encouraged the school for which she taught to extend the length of a typical nurse education from one to two years (and later, three years). The Nightingale Pledge was just one of the many things for which she was known. This professional reformer and public health advocate is one of the women who is to thank for elevating the reputation of nursing as a respectable profession.
Widowed Before Starting Her Career
Gretter married at the young age of 19 but became widowed at 26 with a three-year-old daughter. Two years later, she followed her late physician father’s footsteps into a career in healthcare by enrolling in the Buffalo General Hospital Training School for Nurses. She graduated in 1888.
Her first job was as the principal of the Farrand Training School for Nurses at Harper Hospital in Detroit. She held the role as nursing school superintendent until 1907. Because of her urging, the Farrand School was the first to institute eight-hour (vs. 12-15-hour) shifts among nursing students and instead extended the length of their training. This became a model for nursing education everywhere. Gretter even wrote the first standardized textbook for nursing students. Michigan became one of the first states that required practicing nurses to become certified.
A Leader in Nursing, Including the National League for Nursing
Gretter established the Detroit Visiting Nurses Association and became its director in 1908. In this role, she lobbied for in-home nursing care, established tuberculosis hospitals and became a vocal public health advocate for the poor. She established the first statewide health inspections of school children and a free maternity/infant clinic in Detroit as well.
Another milestone in Gretter’s long advocacy for nursing was her effort to forge a strong relationship between the Michigan Nursing Association, for which she was appointed president in 1904, and suffragettes who were fighting for women’s right to vote. She was a founding member of the American Society of Superintendents of Nursing Training Schools, which later became the National League for Nursing.
A Missioner of Health
For many years, every nurse recited an oath at their nursing school graduation (or “pinning”) ceremonies: the Florence Nightingale Pledge. This pledge of ethics and principles of the nursing profession is largely credited to Gretter, who chaired the committee that created it. She altered the oath in 1935 to state that a nurse would become a “missioner of health” dedicated to the advancement of human welfare. For the time, this was a big step forward to encourage nurses to consider themselves public health professionals and not simply bedside aides.
Elaine Foster, dean of nursing and healthcare programs at American Sentinel University, says that Lystra Gretter is to thank for elevating the nursing profession to one of ultimate importance. “Ms. Gretter is best known for taking the educational reforms she championed at her own school of nursing and forming organizations that would carry those efforts to other schools as well,” says Dr. Foster. “She drove Michigan to begin requiring state licensure. She also fought tirelessly for public health contributions that laid the groundwork for modern public health. Here at American Sentinel, we know that the standard to which we hold our nursing school programs is high because of the work of nursing pioneers like her.”
A Lasting Legacy
Gretter never stopped working to better nursing. She recruited nurses to the American Red Cross Nursing Service during both World Wars while continuing to serve as a leader for the Detroit Visiting Nurses Association. Gretter died in 1951. In 2004, she was inducted into the Michigan Women’s Hall of Fame for her efforts to promote nursing as a profession.
Build Your Bright Future Through Further Education

Leaders like Lystra Gretter have had a significant impact on the field of nursing. If you too are inspired to make a difference, contact American Sentinel University to learn more about our online,