Abstract
A complex global landscape and the imperative of well-being
Nursing is currently situated within an increasingly complex and demanding global health and social care landscape. Unprecedented pressures arising from ongoing conflict, forced migration, climate-related disasters and widening health inequities are reshaping the contexts in which care is delivered. Across healthcare systems, nurses are responding to escalating patient need while navigating resource constraints, ethical tensions and organisational instability. Within this context, we are seeing a strong and necessary emergent emphasis on nurse well-being, not as an adjunct concern, but as central to the sustainability of the profession and the safety of care delivery. Globally, the scale of workforce strain is significant. The World Health Organization (WHO) estimates a shortage of approximately 5.8 million nurses worldwide, with inequities in distribution leaving large populations without access to essential care (WHO, 2025). At the same time, workforce attrition remains a critical concern, with up to 40% of nurses having considered leaving the profession, reflecting mounting pressures on retention (Kiptulon et al., 2025).
Yet, despite these pressures, the continued excellent and creative submissions to the Journal of Research in Nursing attest to a clear and enduring commitment within nursing to excellence in practice, scholarship and knowledge development. The papers in this issue reflect three interrelated priorities: supporting workforce well-being in a demanding global context; advancing the scientific and theoretical foundations of nursing and deepening understanding of the lived, relational and experiential dimensions of care.
Several papers speak directly to concerns related to workforce well-being. Poppert Cordts et al. (2025) highlighted the importance of systems-level approaches, demonstrating that burnout cannot be addressed solely through individual resilience strategies. Their findings emphasise the need to address organisational culture, structural barriers and resource constraints if meaningful and sustained improvements are to be achieved. This aligns with a broader shift in thinking across healthcare systems, where well-being is increasingly understood as relational and contextual rather than purely individual. The impact of challenging work environments is further illustrated by Ananzeh and Miller (2025), whose integrative review of moral distress among critical care nurses underscores the consequences of being unable to act in accordance with professional and ethical values. Their findings link moral distress to reduced well-being, burnout, turnover intentions and compromised patient care. In this sense, well-being is inseparable from the ethical conditions of practice. The emotional and professional burden of nursing work is also evident in Mustonen et al.’s (2025) study of nurses conducting initial health assessments with asylum seekers. The metaphor offered by participants ‘carrying the weight of the world on your shoulders’ captures the intensity of working at the intersection of global migration, trauma and health need. Despite these challenges, nurses described practices centred on trust, compassion and continuity, reinforcing the relational foundations of care in complex environments.
Taken together, these studies make clear that supporting nurse well-being requires more than individual coping strategies. It demands attention to ethical practice environments, organisational structures and the broader socio-political contexts in which nursing takes place. This position is reinforced by global policy frameworks led by the WHO, including the Global Strategic Directions for Nursing and Midwifery (2021–2025) (WHO, 2021), complemented by the State of the World’s Nursing 2025 report, which extends policy priorities for workforce investment, protection and sustainability. Similarly, the International Council of Nurses (ICN) continues to call for urgent global action to safeguard nurse well-being and retention, emphasising the ethical responsibility of governments and organisations to invest in and protect the workforce (ICN, 2025).
Commitment to excellence in practice
Alongside this focus on well-being, there remains a strong and enduring commitment to excellence in nursing practice. This commitment is clearly reflected in de Oliveira Lopes et al.’s (2025) development of a framework for establishing evidence levels within the Nursing Interventions Classification (NIC) (Bulechek et al., 2013). Their work addresses a critical issue in nursing: how to determine the strength and reliability of evidence across diverse research designs and contexts. By proposing a structured classification system, they contribute to the ongoing refinement of evidence-based practice, supporting nurses to make informed decisions and reinforcing the scientific foundations of nursing care. In this sense, the framework is akin to established reporting guidelines, offering a systematic and transparent approach to evaluating evidence and is a seminal contribution focused on assessing the research underpinning key nursing taxonomies. Similarly Nashwan et al. (2026) builds research rigor through the development of a comprehensive reporting guideline for concept analysis in nursing research, guided by the EQUATOR Network toolkit.
Excellence in practice is also evident in work focused on patient outcomes and care quality. Cruz Neto and de Oliveira Lopes (2025) identified a wide range of aetiological factors influencing ineffective health self-management in individuals with cardiovascular disease, highlighting the need for nuanced, theory-informed approaches to care planning. Their findings extend beyond clinical determinants to include social, behavioural and contextual influences on health, reflecting the distinctive contribution of nursing in applying a holistic, biopsychosocial lens. In doing so, this work reinforces nursing’s role in integrating these dimensions to support person-centred, comprehensive and effective care.
Similarly, Mustonen et al. (2025) demonstrated how high-quality care for asylum seekers depends on trust-building, effective communication and continuity of care. These are highlighted not as additional components but fundamental to the person-centred and relational core of nursing practice, particularly in complex and culturally diverse settings. Susanto et al. (2025) extends understanding through their evaluation of a self-control and self-reflection intervention for older adults. Their findings demonstrate improvements not only in physical health outcomes but also in mental and spiritual well-being, again reinforcing the value of holistic, nurse-led approaches. Collectively, this work highlights that excellence extends beyond clinical effectiveness to encompass holistic, relational, person-centred practices that underpin patients’ broader quality of life.
Research as the driving force
If well-being provides the foundation and excellence the aspiration, research is the driving force that enables nursing to move forward in both domains. The papers in this issue demonstrate the critical role of research in shaping practice and advancing knowledge. Specifically, Birks et al. (2025) revisited the concept of memoing in qualitative research, reaffirming its importance as a tool for reflexivity, analytical rigour and methodological transparency. In a research environment increasingly influenced by technological developments, including artificial intelligence, their work underscores the continued need for human interpretation, critical thinking and reflexive engagement. Memoing is presented not simply as a procedural task, but as a way of thinking and making sense of complex data. This emphasis on meaning-making is further developed in Byrne and Mulvogue’s (2026) paper on the use of metaphor in research. Their eight-step framework offers a structured yet creative approach to applying metaphor, enabling researchers to connect concepts, construct coherent narratives and communicate complex ideas. Importantly, metaphor is positioned as a way of engaging with lived experience, bridging abstract theory and real-world practice. The value of this approach is exemplified in Saatçi and Akın’s (2025) study of missed nursing care, where metaphorical analysis reveals emotional and systemic dimensions that may otherwise remain hidden. By identifying themes such as neglect, dysfunction and risk, the study provides a richer understanding of how nurses perceive and experience missed care, highlighting its implications for patient safety and professional identity.
Finally, Susanto et al. (2025) also reinforces the role of reflection in both research and practice through their focus on self-reflection as a mechanism for improving health outcomes. This aligns with broader principles of reflective practice in nursing, where ongoing reflection supports learning, adaptation and professional development.
Concluding thoughts
In bringing these strands together, this issue highlights a profession that is simultaneously responding to significant global challenges and continuing to evolve. The emphasis on workforce well-being acknowledges the realities of contemporary practice, whereas the commitment to excellence reflects the enduring values of the profession. Research provides the bridge between these domains, enabling nursing to respond thoughtfully, critically and creatively to the complexities it faces. As nursing continues to navigate a demanding landscape, the integration of well-being, excellence and research will remain essential. Supporting the workforce, delivering high-quality care and advancing knowledge are not separate goals but interconnected priorities.
