A pinning ceremony is a symbolic welcoming of newly graduated or soon-to-be graduated nurses into the nursing profession. The history of the ceremony dates back to the Crusades in the 12th century, and later, when Queen Victoria awarded Florence Nightingale the Royal Red Cross for her service as a military nurse during the Crimean War. By 1916, pinning ceremonies had become an established tradition in both the United Kingdom and the United States, although, by the 2010s, many nursing schools in the United States had abolished them. At pinning ceremonies, nurses are presented with nursing pins by either the faculty of their nursing school or by a person significant to them. These ceremonies also often include a candle-lighting or lamp-lighting ceremony, which commemorates Nightingale's nighttime aid to wounded soldiers by candlelight, and the reciting of the Nightingale Pledge, the International Council of Nurses Pledge, or another similar pledge. A pinning ceremony is not a graduation, as it does not signify the completion of all criteria necessary to earn a nursing degree, although it sometimes recognizes the completion of educational requirements that enable nurses to take their state licensing examinations. Historically, a nursing pin symbolizes an educated nurse who is prepared to serve society as a healthcare professional. History The history of nursing pins dates back to the Crusades in the 12th century. Monks initiated into the Knights Hospitaller that cared for injured and ill Crusaders were given a Maltese cross, which is considered to be the first form of a badge given for nursing. After the Crimean War, Queen Victoria awarded Florence Nightingale the Royal Red Cross for her service as a military nurse during the conflict. Nightingale later presented a somewhat similar "medal of excellence" to her outstanding nursing students. Initially, only nurses who attained exceptional grades or made remarkable contributions to practice received nursing pins, although in time pinning ceremonies came to include all nurses. The Nightingale School of Nursing at London's St Thomas' Hospital created a badge featuring a Maltese cross that it awarded to nurses who completed their studies. The first pinning ceremony in the United States occurred at New York City's Bellevue Hospital in 1880. By 1916, pinning ceremonies at which all nursing graduates were awarded pins had become an established tradition in both the United Kingdom and the United States. By the 2010s, many nursing schools in the United States had abolished their pinning