The award is made to a fully trained nurse of an officially recognized nursing service, military or civilian, who has shown exceptional devotion and competence in the performance of nursing duties, over a continuous and long period, or who has performed an exceptional act of bravery and devotion at her or his post of duty. It is conferred on members of the nursing services regardless of rank. Holders of the second class who receive a further award are promoted to the first class, although an initial award can also be made in the first class.

The decoration was conferred exclusively on women until 1976, when men became eligible, with posthumous awards permitted from 1979.