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.