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This reflection examines the past 50 years of Indigenous nursing, highlighting both progress and persistent inequities. Fifty years ago, Indigenous nurses were largely invisible within the profession, their voices marginalised and their cultural backgrounds undervalued. Although numbers have grown, Indigenous nurses, particularly Māori in Aotearoa New Zealand, remain significantly underrepresented in the workforce relative to population need. Enduring structural and systemic barriers continue to impede recruitment, retention and the integration of Indigenous worldviews into nursing curricula and practice. This commentary refers to historical and contemporary contexts that shaped this landscape, including colonisation, racism and the suppression of Indigenous knowledge. It acknowledges significant milestones such as Dr. Irihapeti Ramsden's leadership in establishing Kawa Whakaruruhau and Cultural Safety, while also noting the political backlash that diluted its original focus on Māori health inequities. Indigenous nurses, past and present, bring culturally grounded, relational and holistic approaches to care, bridging the clinical and cultural worlds and building trust with Indigenous communities. Their growing scholarly contributions and international collaborations—such as the Indigenous Global Research Alliance in Nursing—are advancing Indigenous methodologies and evidence. While gains have been made, the future requires culturally responsive pipelines and collective commitment to addressing inequity, racism and structural injustice in nursing.
Skin-to-Skin Contact or Kangaroo Mother Care is an evidence-based intervention proven to enhance breastfeeding rates, improve cardiorespiratory stability and promote neurodevelopment in neonates. While established as a standard of care for stable term infants and increasingly recognised for preterm infants, the implementation of sustained skin-to-skin contact faces significant systemic and clinical challenges, particularly within the intensive care environment. This editorial argues that the focus must shift from when skin-to-skin contact is permitted to how sustained skin-to-skin contact can be universally integrated as a non-negotiable core practice, even for extremely preterm infants. Addressing practical barriers, such as staff training, equipment design, parental support and perceived clinical instability, is essential to realise the full potential of sustained skin-to-skin contact to optimise neurodevelopmental and physiological outcomes for all neonates, closing the gap between compelling evidence and inconsistent global practice.
As healthcare accelerates into an era defined by artificial intelligence, precision medicine, and advanced technologies, nursing leadership faces a critical inflection point. This article argues that the most essential leadership capability for nursing now and in the decade ahead is heart-centred leadership: the intentional integration of compassion, ethical integrity, relational awareness and strategic competence. Far from being sentimental, heart-centred leadership is positioned as a practical and evidence-based response to escalating burnout, moral distress, and the erosion of nursing's professional identity—challenges intensified by the COVID-19 pandemic and ongoing workforce shortages. Drawing on nursing theory and contemporary leadership research, the article demonstrates how leadership grounded in psychological safety, moral resilience and authentic human connection strengthens patient outcomes, supports workforce sustainability and enables learning in complex healthcare systems. It highlights how heart-centred leaders approach error, technology adoption and performance measurement in ways that protect the nurse–patient relationship while maintaining organisational accountability. Attention is also given to the role of women leaders, equity and social justice and the necessity of leader wellbeing as a foundation for compassionate cultures. The article concludes that as healthcare becomes increasingly technologically sophisticated, nursing leadership must become more intentionally human-centred. Leading with heart ensures that innovation serves healing rather than eclipsing it, safeguarding nursing's core purpose of alleviating suffering and promoting human flourishing.
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