This article emerged at the “Gathering of Wisdom: American Indian Nursing Summit III,” which took place in October 1997 on the Flathead Indian Reservations in Polson, Montana. This gathering described and clarified the distinctiveness of Native American nursing. Nursing literature has explored the essence of nursing from a variety of perspectives. This article describes a process of discovery in which seven themes emerged on the essence of Native American nursing. These themes, in ascending order of significance, are caring, traditions, respect, connection, holism, trust, and spirituality. These themes are connected and interwoven throughout the center of Native American culture and can provide a creative outlook for transcultural nursing and nursing in general. Furthermore, these themes provide a vehicle for care delivery innovation.