Children and young people’s (CYP) nursing leaders have experienced considerable challenges in the context of a complex health and social care system with rapidly changing organisational structures, including the establishment of integrated care systems in England on 1 July 2022. The CYP nursing lead at NHS England commissioned a review of CYP organisational structures in emerging integrated care systems across England. The review encompassed a vision for CYP services, leadership, governance structures and opportunities for progression. A proforma was used to collate data from CYP trusts, CYP standalone hospitals and children’s wards in district general hospitals. Qualitative interviews were also undertaken with senior children’s nurses. At the same time, the first author of this article interviewed senior children’s nurses as part of a Florence Nightingale Foundation leadership scholarship. The aim was to explore how they navigated their leadership journey and understand what advice they may give to future leaders in CYP nursing. The findings in this article identify ‘what good looks like’ in terms of CYP nursing leadership. Six recommendations for future development and enhancement of CYP nursing leadership are outlined.