Fifty Years of Nursing Knowledge: A Conversation Between Generations

It is an extraordinary honour to write this editorial marking the 50th anniversary of the Journal of Advanced Nursing (JAN). This milestone is not only a moment of celebration for the journal, but also for the nursing profession itself, for all that nurses have achieved, all that has changed, and all that we continue to strive toward. In planning this special 50th anniversary issue, the JAN team set out to honour the diversity and vitality of the global nursing community. We invited nurses from across the world, representing different regions, settings and stages of career, to share their perspectives on two key questions: what have been the most significant developments in your area of nursing practice over the past fifty years? and what do you see as the major challenges and opportunities in your field for the next fifty years? We sought to create an authentic space for nurses to speak, to capture their insights, reflections and visions for the future in their own words. To preserve the integrity and authority of their voices, we took a deliberate editorial stance. We resisted the impulse to over-edit or impose uniformity, recognising that difference and diversity are sources of strength. We wanted each contribution to retain its distinctive rhythm and tone, to reflect the individuality of its author and the social and cultural context from which it emerged. So, we have taken a light touch editorial approach with this collection. The result is a collection that feels alive, textured and deeply human. It is both reflective and forward-looking, grounded in professional wisdom but suffused with hope, courage and a sense of shared purpose. JAN has always been a space of intellectual connection, a platform for nurses across the globe to share ideas that have both shaped and challenged the international community of nurses. Over the fifty years of its life, it has become more than a publication; it is a living archive of nursing's intellectual evolution and its moral, social and political commitments. This special 50th anniversary collection is not merely a retrospective but a conversation between generations, a bridge linking past, present and future. It invites us to listen to the voices of those who came before, to those working now in challenging contexts, and to those who will carry nursing's ethical and scholarly traditions forward. Among these contributions is a tribute to one of JAN's earliest authors, Professor Dame June Clark, whose paper was published in the first issue of JAN, and whose legacy reminds us how deeply our present is rooted in the labour, courage and imagination of those who shaped the journal's earliest pages. Over the life of this journal, nursing itself has been transformed. The world of practice, theory and research that shaped the first issue of JAN bears little resemblance to the profession today. In those early years, nursing was still consolidating its identity as a scholarly discipline. The move toward degree-based education was underway but far from complete. Nursing research was emerging, often in the face of scepticism about whether it was even necessary or possible. These formative struggles were not only about academic legitimacy but about redefining what counted as knowledge, whose voices shaped it and how nursing could claim authority in the broader health and social landscape. Today, nurses are leaders in research, policy and education, and the influence of nursing extends across every dimension of global health systems. The theoretical foundations of nursing have evolved from early conceptual models into rich, dynamic frameworks that engage with social determinants of health, power, intersectionality and planetary wellbeing. In claiming space within academic and policy arenas, nursing has redefined what counts as knowledge and who holds the authority to produce it. Nursing science now spans the molecular to the societal, encompassing everything from genomics and digital health to social justice and global health equity. JAN has borne witness to these transformations. Across its pages, the journal has chronicled the profession's deepening intellectual and moral engagement with the world. We have seen the profession extend its reach from local practice to global solidarity, from narrowly defined notions of patient care to expansive understandings of human health and experience. Yet at its heart, nursing remains a relational practice; nurses walk alongside individuals, families and communities in moments of vulnerability and change. Each decade of JAN's history has mirrored nursing's widening scope of influence, and its growing confidence in articulating a unique body of knowledge grounded in compassion, criticality, and advocacy. Equally, the role of nurses has evolved. Nurses are now clinical leaders, policy advocates and change agents who influence, design and evaluate the health, social and political systems within which health care is delivered. Nurses lead research that shapes national guidelines, informs global health policy and improves the health and the lives of millions. JAN has been privileged to publish many of these landmark studies and debates. Together, they stand as testament not only to the profession's intellectual maturity but also to its moral courage, the willingness to confront inequity, challenge injustice and engage critically with the politics of care. Over the past five decades, nurses have been at the forefront of social and health transformation. During this transformation, JAN has been a forum for theory-building and critique, for new methodologies and reflections on practice. The journal has also served as a mirror, reflecting back to the profession its achievements, its debates and sometimes its uncomfortable truths. In doing so, JAN has not only documented nursing's evolution but has also helped to shape it, through amplifying diverse voices, unsettling complacency and advancing the collective moral and intellectual project of the profession. Over the life of the journal, the landscape of academic publishing has changed enormously. Systems of ranking and impact measurement have come to occupy a position of primacy, shaping what is valued, published and rewarded. While these metrics have brought greater visibility and accountability, they have also privileged certain kinds of discourse, particularly empirical and quantitative work, while simultaneously minimising others. At JAN, we continue to recognise the importance of discursive scholarship: the real value of papers that raise ideas, challenge assumptions and open new lines of inquiry. Some of the most meaningful and influential contributions to nursing knowledge are not traditional research reports but reflective, theoretical and conceptual papers that help us think differently. The discipline needs spaces where such ideas can be shared, debated and developed; spaces that keep nursing intellectually alive and socially responsive. In many ways, nursing's story over the past fifty years is one of expansion of intellectual ambition, professional reach and ethical responsibility. Yet with expansion comes complexity, and with complexity, tension. Growth inevitably raises questions about whose knowledge is amplified, whose voices are heard, and whose priorities shape the profession's future. The pressures of global health inequity, workforce shortages, ageing populations and digital transformation all pose profound challenges about what kind of profession nursing will become in the next fifty years. The need for research that is not only methodologically rigorous but also ethically grounded and socially responsive and attuned to power and context has never been greater. As we celebrate this milestone, it is important to acknowledge that many challenges remain. Health inequities persist across the world, and nurses continue to work in environments where their expertise is undervalued, their safety compromised and their voices underrepresented in decision-making spaces. The profession continues to wrestle with enduring issues of gender, power and recognition; forces that shape not only how nurses work, but how they are seen, heard and valued. These dynamics remind us that progress is uneven, and that advancing the profession requires confronting the social, political and institutional conditions that reproduce inequity. In many contexts, nurses remain constrained by outdated hierarchies that limit and constrain autonomy and obscure the intellectual and emotional labour that underpins nursing practice. For some nurses, these dynamics are compounded by experiences of workplace inequity and bullying, including, increasingly, cyberbullying, which continue to cause profound professional and personal harm. The accelerating pace of technological change presents both promise and peril. Artificial intelligence and digital health offer powerful new tools to enhance care and expand reach, but they also risk entrenching existing inequities and deepening divides between those with access and those without. Climate change, entrenched social inequities and persistent racialised health disparities will continue to contour the landscapes of care, underscoring that health is inseparable from the social, political and environmental conditions in which people live. In this complex terrain, nurses must think and act globally while holding fast to the human connection and ethical purpose that remain at the heart of nursing. The future will call upon us to show the same courage, creativity and solidarity that have defined the best of nursing's past, and to renew these qualities for a more complex and uncertain world. Meeting these challenges will require nurses everywhere to work collaboratively, to listen across difference, to share knowledge generously, and to amplify one another's voices while building systems that are equitable, inclusive and just. The global nursing community must remain united not only by profession but by purpose: a shared commitment to human dignity, social justice and the pursuit of health, equity and wellbeing for all people and the planet. Nursing does not exist outside the turbulence of the world, and the coming decades will continue to test the profession in profound ways. Around the globe, nurses are working in the shadow of war, political instability, and protracted conflict, in epidemics and pandemics and humanitarian crises, contexts in which health systems fracture, human rights are threatened and the simple act of providing care becomes an act of courage. The growing numbers of displaced people, including those seeking asylum and those with refugee status, demand forms of responsiveness that are not only clinical but also ethical and political, as nurses navigate cultures, borders and systems that often fail those most in need. These realities call for a profession that remains steadfast in its commitment to humanitarian principles, advocates for the protection of health workers and civilians and develops the knowledge and leadership required to provide compassionate, culturally safe care in the most challenging of circumstances. Alongside these global forces, the chronic and acute shortage of nurses remains one of the most urgent challenges confronting health systems worldwide. Rather than addressing the structural causes of these shortages, such as poor working conditions, inadequate remuneration, limited career progression and weak retention strategies, many high-income countries have sought to fill gaps by recruiting nurses from low- and middle-income nations. While international mobility can offer opportunity, it must be underpinned by fair and ethical recruitment practices, and by the equitable treatment of internationally recruited nurses once they arrive. Reliance on global recruitment may ease local pressures temporarily but risks deepening existing inequities, draining expertise from the very systems that can least afford to lose it. A sustainable solution demands that all nations invest in their own nursing workforces, creating conditions where nurses can thrive, contribute and remain within their communities. Facing these challenges will demand from us the same courage, creativity and solidarity that will require nurses everywhere to work collaboratively, to share knowledge generously, to amplify one another's voices, and to build systems that are equitable, inclusive and just. Such solidarity is not only professional but moral and political, a recognition that our struggles and successes are interconnected across borders. The global nursing community must remain united not only by profession, but by purpose: a shared commitment to human dignity, social justice and the pursuit of health and wellbeing for all people and the planet. Reading through these contributions has been both humbling and energising. Together, they form a chorus, voices from across the globe, each with its own inflection, shaped by its own realities, yet united by a shared purpose: an unwavering belief in nursing as a moral and intellectual force for good. The issues these authors write of are as diverse as the profession itself: reflections on mental health nursing, gerontological care, paediatrics, rural health, chronic illness, cancer survivorship and the evolution of evidence-based practice; explorations of intersectionality, feminism, social justice, hybrid intelligence and the changing foundations of nursing education; and insights into leadership, person-centred fundamental care and the ethical future of nursing knowledge. What stands out is the clarity of vision these nurses bring. They do not shy away from the difficult questions about inequity, power and the politics of care. They articulate not only what nursing has achieved but also what it must yet become. Across their contributions runs a shared understanding that nursing must continue to confront the structural forces that shape health and health care, and to challenge the assumptions that have historically constrained our practice, knowledge and leadership. Their visions remind us that the future of nursing will not emerge by chance, but through deliberate, collective and courageous action. As we reflect on half a century of scholarship in JAN, it is impossible not to feel both gratitude and awe. The journal's founders could scarcely have imagined the world we now inhabit, nor the scale of nursing's contribution to global health. Yet their vision, to create a space for rigorous, critical and compassionate scholarship, remains as vital today as it was in the beginning. The intellectual foundations they laid continue to guide us, reminding us that the work of knowledge-making is always unfinished, always evolving and always tied to the social and moral commitments of the profession, as well as to the shifting contexts in which nurses live and work. We are deeply aware that JAN's achievements belong to many: the authors who entrust us with their work; the reviewers who give their time and expertise; the readers who engage with our content and translate ideas into practice; and the editorial teams, past and present, who have shaped its direction with care and vision. In our roles as the current custodians of the journal, we see ourselves as links in a much longer chain of stewardship, honouring the traditions that have guided JAN for fifty years while ensuring that its scholarship remains responsive, critical and attuned to the realities of the world in which nurses live and work. Looking ahead, our responsibility is to ensure that JAN continues to reflect and serve the profession in all its diversity. We must remain open to new voices and ideas, attentive to the varied contexts in which nursing occurs, and committed to publishing work that not only advances knowledge but also challenges assumptions and drives change. This includes sustaining the highest standards of excellence in publishing and continuing to bring the voices of leading and emerging researchers to the global nursing community. Equally, we must foster scholarship that speaks to the social, political and environmental realities shaping nursing today and create space for perspectives that have historically been overlooked or marginalised. As the Journal of Advanced Nursing turns fifty, we celebrate not just a journal but a community, a global movement of nurses who think deeply, act courageously and care profoundly. The challenges of the next fifty years will be formidable, but so too are the capacities of the profession that faces them. The future of nursing will be written, as it always has been, through the daily acts of care, courage and curiosity that define our work. It will be shaped by nurses who continue to question, to research, to advocate and to lead. And it will be illuminated by journals like JAN, which provide the space for nursing's intellectual life to flourish. This anniversary is therefore both celebration and call to action. Let us honour the past by building a future that remains true to nursing's deepest values, compassion, justice and respect for human dignity. Let us continue to speak truth to power, to generate knowledge that matters and to stand with those whose health and wellbeing depend on our commitment. To all who have contributed to JAN's remarkable journey, authors, reviewers, editors and readers, we offer a very sincere and heartfelt thank you. This journal is your legacy, and together, we will continue to write its next chapters. We hope you will enjoy this collection of voices; These contributors represent a tapestry of experience: clinicians, educators, researchers, policymakers and leaders who together illustrate the breadth and depth of nursing today, while sharing their hopes, insights and visions for the future of nursing and health care. The authors have nothing to report. The authors declare no conflicts of interest. The authors have nothing to report.