Values are at the heart of nursing leadership. They are what drive us to address the challenges in the healthcare systems of the 10 Canadian provinces and three territories, including equitable access to quality healthcare for all. As nurses, we know that the people in this country depend on us to be there for them and their families when they need our care, often at some of the most difficult and frightening times in their lives. To ensure that we can continue to fulfill this commitment, nursing leadership must remain vigilant in steering a path forward that enables bold new ideas that breathe life and vision into our changing workplaces in an increasingly complex world.

Amid all the changes and uncertainty, some things remain steadfast. As nurses, we are committed to a holistic view of people and their strengths and needs as individuals in the context of their families and communities. We value research and its application in evidence-based practice and the importance of data to enable nursing practice to reach all populations, especially those who are underserved and vulnerable. We know that structures are important to enabling that to occur.

The articles in this issue of the Canadian Journal of Nursing Leadership use research and quality-improvement methods to describe and evaluate various change initiatives at the organizational and system levels. Some of the initiatives featured have already been implemented, while others are under development. Each provides a clear portrait not only of the initiative but also of the leadership required to achieve the results.

The issue begins with our regular column from the Canadian Nurses Association. Chief Executive Officer, Valerie Grdisa addresses a pressing issue facing the nursing profession – specialization (Grdisa 2025). Knowledge about health, what keeps people healthy and the technologies and treatments needed to restore health continue to expand at a light-speed pace. Nurses and nurse practitioners (NPs) are, and will continue to be, the professionals who provide the care for patients at the receiving end of these developments, many of which are life-saving or life-improving. Grdisa (2025) makes a compelling case for certification as a means to achieve this, and the urgency for finding a way to move forward sooner rather than later.

Next, Strudwick et al. (2025) provide an evidence-informed commentary that outlines the vital role of nurse leaders in addressing the problematic separation of physical and mental healthcare in our systems. Their commentary outlines the barriers to the integration of mental and physical healthcare, highlights initial integration strategies that have been successful and recommends how nurse leaders can advance this system change. They point out how the structural separation of mental and physical healthcare in the healthcare system, for example, separate care facilities and sharply demarcated nursing care skill sets, has reinforced this division. Catalyzed by nursing leadership, a partnership was developed between two Toronto-based organizations to identify strategies to integrate mental and physical healthcare.

Then, Helfenbaum et al. (2025) report on the use of a developmental evaluation to guide the design and enhancement of a relational leadership coaching intervention that involved 29 leaders from 10 long-term care (LTC) homes in Ontario. The intervention offered an evidence-based path forward in supporting LTC leadership and teams to take a relational, collaborative and appreciative approach to supporting and evaluating desired team practice improvement changes while meeting both relational and organizational goals and responsibilities.

The fourth article, authored by Bigalky et al. (2025), explores substance use in Canada during the time from conception through the first year following birth, also known as the perinatal period. Their focus is on illegal substances and non-prescription opioids, both of which are being used with increasing frequency by people who become pregnant. However, there are no data systems that track the use of these substances, which in turn limits understanding and hinders intervention development. To rectify this, the authors emphasize the critical need for current, comprehensive and disaggregated data during the perinatal time period. The authors stress the importance of data-informed education and research that contributes to improving outcomes for affected people.

Next, Romano et al. (2025) describe the approach, methods and results of the development and evaluation of a pilot program to enhance the alignment of a large healthcare organization's mission and values with the meaning that healthcare staff, physicians and volunteers attributed to their work. The program they developed was called a mission champion community of practice. One of the findings from the evaluation of this program was that participation was transformative to their daily work and experience within the organization.

Finally, Devries-Rizzo et al. (2025) write about the implementation of the NP-Lead role in acute care. Although NPs have been practising in Canada for more than 25 years, their implementation in hospital settings is inconsistent. The reasons for this are unclear and complex and may be due to the complexity of their organizational structures, reporting systems and/or patient populations. The authors describe the NP-Lead's role, identifying that the role was introduced to promote role implementation and optimal utilization through advocacy, both internal and external to the organization. The authors conclude that NP-Leads will improve the understanding of the NP's role among the interprofessional team and executive leadership. Improved understanding of the role enables NPs to work to their full scope of practice and achieve maximum benefits for patient care and the mission of the organization.

I hope you enjoy this issue and find it as inspirational as I did. Amid all the challenges we are facing in healthcare, nursing leadership is driving change at all levels with values guiding the path forward.

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