Background <p>There is a paucity of current research on the mechanisms that mediate the relationship between nurses’ levels of spiritual health and spiritual caregiving competence.</p> Aim <p>The aim of this study was to explore the mediating role of empathy and moral sensitivity between spiritual health and spiritual caregiving competence.</p> Methods <p>A cross-sectional survey was conducted from January to December 2023 in six tertiary hospitals in Liaoning Province, China.Using convenience sampling, 587 clinical nurses were selected. Using the Spiritual care compentence scale, The spiritual health scale, The Jefferson Scale of Empathy and the Moral Sensitivity Questionaire-revised into Chinese Data were collected from nurses. Mediating effects were analyzed using a structural equation model based on maximum likelihood estimation.</p> Results <p>The nurses’ spiritual caregiving competency score was (55.25 ± 12.25), which was moderate level. The model shows that the total effect of spiritual health on spiritual care competence (β = 0.475) is divided into a direct effect (β = 0.314) and an indirect effect. The indirect effects of empathy and moral sensitivity are 0.114 and 0.027, respectively. Additionally, empathy and moral sensitivity contribute an indirect effect of 0.019 between spiritual health and spiritual care competence.</p> Conclusion <p>The results show that nurses ‘spiritual care capabilities can be indirectly improved by improving nurses’ empathy and moral sensitivity.</p>