At its core, sustainable nursing practice involves striking a balance between progress and preservation. The profession’s responsibility is to innovate continuously while ensuring that innovation does not exhaust the very people who sustain it. Shaban et al. (2024) describe sustainability as an ethical standard that is woven into the nursing identity. When stewardship of human and environmental resources becomes part of the nursing role, it boosts engagement, moral satisfaction and alignment with organizational values. Sustainability is where ethics, efficiency and endurance meet, making it an ethical framework as much as an operational one.

Operational sustainability requires system-level design. Molero et al. (2021) argue that true sustainability happens when precision, resource optimization and innovation work in harmony. Although their analysis focuses on laboratory medicine, the principles also apply to nursing. It shows that efficiency and sustainability are not opposites but rather reinforce each other when guided by evidence-based system design. Clinical excellence depends on innovative structures that eliminate redundancy, integrate technology thoughtfully and prioritize human capability over sheer volume.

Education is the engine that powers sustainable practice. Nursing curricula must go beyond technical skills to develop professionals who think systemically, interpret evidence, design solutions and influence policy. Empowering nurses to lead change through evidence-based practice is not just an academic goal — it’s a strategic necessity. Ten Ham-Baloyi (2022) notes that giving nurses the knowledge and confidence to apply evidence strengthens their role as transformational leaders, ensuring innovation lasts. This empowerment creates a ripple effect across care systems, building a culture where progress is driven by evidence, guided by inquiry and rooted in excellence. Academic–practice partnerships are key to turning these principles into measurable improvements, producing nurses who are not only skilled clinicians but also system stewards.

Leadership is the anchor for sustainability. Chiou (2025) identifies equity, adaptability and mentorship as essential traits of sustainable leaders that are linked to workforce stability, trust and engagement. Leaders who promote psychological safety, inclusivity and purpose make sustainability a cultural norm, not just a compliance task. They understand that maintaining high-quality care means supporting caregivers, integrating well-being and professional growth into the organization’s foundation.

Sustainability also encompasses the environments where care is provided. Corvalán et al. (2020) emphasize that health systems must be resilient to ecological disruptions and social pressures. Climate-resilient, environmentally responsible facilities are no longer optional — they are essential for health equity and long-term viability. Their research confirms that environmental stewardship, workforce well-being and operational efficiency are interconnected pillars of sustainable health care.