OBJECTIVE: To explore the moderating effect of working years on nurses' medical narrative ability and empathy ability. METHODS: A multi-center cross-sectional survey was conducted among 1920 clinical nurses from 12 general hospitals of different levels in 7 cities of Hunan Province. Data were collected using a general information questionnaire, Narrative Competence Scale (NCS), and the Jefferson Empathy Health Professional Scale (JSE-HP). The general situation, medical narrative ability and empathy ability were investigated by questionnaires. The correlations among nurses' working years, medical narrative ability and empathy ability were analyzed. The group regression method was used to analyze the moderating effect of different working years on nurses' medical narrative ability and empathy ability, and the differences of regression coefficients were further analyzed to understand the specific effects of different working years. RESULTS: A total of 1852 valid questionnaires were collected, and the effective recovery rate was 96.46%. Medical narrative ability was positively correlated with empathy ability (r = 0.198, P <
0.05), working years was positively correlated with medical narrative ability (r = 0.047, P <
0.05), and there was no correlation between medical narrative ability and empathy ability (P >
0.05). Working years had a moderating effect on the relationship between medical narrative ability and empathy ability (β=-0.174, P <
0.001). Group regression analysis showed that with the increase of nurses' working years, the regression coefficient of medical narrative ability and empathy ability decreased gradually (0.077 >
0.036 >
0.019). The difference of regression coefficient was statistically significant (P <
0.05). CONCLUSIONS: Nurses with different working years have different effects on empathy. With the increase of working years, the positive effect of medical narrative ability on empathy is gradually weakened. It suggests that nursing managers should carry out hierarchical intervention for nurses with different working years.