AIM/OBJECTIVE: This review aims to provide a comprehensive analysis of the integration of machine learning (ML) (1) in nursing by exploring its implications on patient care, nursing practices, and healthcare delivery. It highlights current applications, challenges, ethical considerations, and the potential future developments of ML in nursing. BACKGROUND: With the advent of ML in healthcare, the nursing profession stands on the cusp of a transformative era. Despite the technological advancements, discussions on the utilization of ML in nursing, which are crucial for advancing the profession, are lacking. This review seeks to fill this gap by examining the balance between technological innovation and the human-centric nature of nursing. DESIGN: This narrative review employs a detailed search strategy across several databases, including PubMed, Embase, MEDLINE, Scopus, and Web of Science. It focuses on articles that were published from January 2019 to December 2023. Moreover, this review aims to illustrate the current use, challenges, and future potential of ML applications in nursing. METHODS: Inclusion criteria targeted articles that focus on ML application in nursing, challenges, ethical considerations, and future directions. Exclusion criteria omitted opinion pieces and nonrelevant studies. Articles were categorized into themes, such as patient care, nursing education, operational efficiency, ethical considerations, and future potential, thus facilitating a structured analysis. RESULTS: Findings demonstrate that ML has significantly enhanced patient monitoring, predictive analytics, and preventive care. For example, the COMPOSER deep learning model for early sepsis prediction was associated with a 1.9% absolute reduction (17% relative decrease) in in-hospital sepsis mortality and a 5.0% absolute increase (10% relative increase) in sepsis bundle compliance. In nursing education, ML has improved simulation-based training by facilitating adaptive learning experiences that support continual skill development. Furthermore, ML contributes to operational efficiency through automated staffing optimization and administrative task automation, thus reducing nurse workload and enhancing patient care outcomes. However, key challenges include ethical considerations, such as data privacy, algorithmic bias, and patient autonomy, which necessitate ongoing research and regulatory oversight. CONCLUSIONS: ML in nursing offers transformative potential across patient care, education, and operational efficiency, which is balanced by significant challenges and ethical considerations. Future directions include expanding clinical and community applications, integrating emerging technologies, and enhancing nursing education. Continuous research, ethical oversight, and interdisciplinary collaboration are essential for harnessing ML's full potential in nursing to ensure that its advancements improve patient outcomes and support nursing professionals without compromising core nursing values.